Capecitabine (Generic Name)

Other Names: Xeloda

About This Drug

Capecitabine is used to treat cancer. It is taken by mouth.

Possible Side Effects (More Common)

  • Diarrhea. If you have more than four stools in a day or diarrhea at night, you need to be carefully monitored for dehydration and electrolyte problems.
  • Hand-and-foot syndrome. The palms of your hands or soles of your feet may tingle, become numb, painful, swollen, or red.
  • Edema, which is swelling, usually in your ankles, feet, arms and hands.
  • Increased total bilirubin in your blood.  This may mean that you have changes in your liver function. Your blood work will be monitored by your doctor. 
  • Eye irritation.  You may have watery eyes.  Your eyes and lids may become red and painful.
  • Effects on the nerves called peripheral neuropathy. You may feel numbness or tingling in your hands and feet. It may be difficult for you to button your clothes, open jars, or walk normally. The effect on the nerves may get worse with additional doses of the drug. These effects get better in some people after the drug is stopped but it may not get better in some people.
  • Decreased appetite
  • Nausea and vomiting
  • Abdominal pain
  • Bone marrow depression. This is a decrease in the number of white blood cells, red blood cells, and platelets. It may increase your risk of infection, fatigue, and bleeding.
  • Soreness of the mouth and throat. You may have red areas, white patches, and/or painful sores.
  • Constipation
  • Back, joint, or muscle pain

Possible Side Effects (Less Common)

  • Headache
  • Excessive water loss from the body (dehydration)
  • Hair loss. You may notice hair thinning. Usually hair loss is temporary; your hair should grow back when treatment is completed.
  • Dizziness
  • Tiredness
  • Weakness
  • Blood clots.  A blood clot in your leg may cause your leg to swell, appear red and warm, and/or cause pain. A blood clot in your lungs may cause shortness of breath, pain when breathing, and/or chest pain.
  • Darkening of your skin
  • Changes in your nails
  • Taste changes
  • Cough
  • Irregular heart beat.  This drug may cause a rapid or irregular hearbeat.  You may feell your heart beating rapidly (palpitations).
  • Chest pain

Sexual Problems and Reproductive Concerns

  • In men and women both, this drug may temporarily or permanently affect your ability to have children. This cannot be determined before your therapy. In men, this drug may interfere with your ability to make sperm, but it should not change your ability to have sexual relations. In women, menstrual bleeding may become irregular or stop while you are taking this drug. Do not assume that you cannot become pregnant if you do not have a menstrual period. Women may experience signs of menopause like vaginal dryness or itching.
    • Pregnancy warning: This drug may have harmful effects on the unborn child, so effective methods of birth control should be used during your cancer treatment.
    • Speak with your doctor or nurse if you plan to have children.  Ask for information on sperm or egg banking.
    • Genetic counseling is available to you to discuss the effect of this drug therapy on future pregnancies. In addition, a genetic counselor can review the potential risks of problems in the fetus due to this medication if an exposure during pregnancy has occurred.  
    • Breast feeding warning:  It is not known if this drug passes into breast milk. For this reason, women are advised to discuss with their doctor the risks and benefits of breast feeding during treatment with this drug because this drug may enter the breast milk and seriously harm a breast feeding infant.
    • Vaginal lubricants can be used to lessen vaginal dryness, itching, and pain during sexual relations.

Treating Side Effects

  • Mouth care is very important. Your mouth care should consist of gently brushing your teeth with a very soft toothbrush and rinsing your mouth with a mixture of 1/2 teaspoon of salt in 8 ounces of water or 1/2 teaspoon of sodium bicarbonate (baking soda) in 8 ounces of water. This should be done at least after every meal and at bedtime.
  • Avoid mouthwash that contains alcohol. Avoid alcohol and smoking because they can irritate your mouth and throat.
  • Ask your doctor or nurse about medication to help you prevent or lessen nausea, vomiting, headache, constipation, and/or diarrhea.
  • Check with your doctor or nurse before you use enemas, laxatives, or suppositories.

Important Instructions

  • Take the capecitabine tablets with food or within 30 minutes after the end of a meal.
  • Swallow the tablets whole with water.

Food and Drug Interactions

Capecitabine may interact with other medications. Tell your doctor and pharmacist about all the medications that you are currently taking, including over-the-counter antacids and vitamins (especially the vitamin folic acid).

When to Call the Doctor

Stop taking capecitabine immediately and call your doctor if any of these symptoms occur:

  • Diarrhea – if you have an additional 4 bowel movements in a day beyond what is normal or any diarrhea at night
  • Vomiting – if you vomit more than once in a 24-hour period
  • Nausea – if you lose your appetite, and the amount of food you eat each day is much less than usual
  • Mouth sores – if you have pain, redness, swelling, or sores in your mouth
  • Hand-and-foot syndrome – if you have pain, swelling, or redness of hands and/or feet
  • Fever or infection – if you have a temperature of 100.5 F or greater, or other evidence of infection
  • If caught early, most of these side effects usually improve within two to three days after you stop taking capecitabine. If they don’t improve within two to three days, call your doctor again. After side effects have improved, your doctor will tell you whether to start taking capecitabine again or what dose to use.

Call your doctor or nurse immediately if you have any of the following symptoms:

  • Shortness of breath
  • Unusual bleeding or bruising
  • Chest pain
  • Rapid or irregular heartbeat or palpitations
  • Difficulty catching your breath
  • Dizziness

Notify your doctor or nurse as soon as possible if you have any of the following symptoms:

  • Headache that is not helped by prescribed medication
  • Swelling in your ankles, feet, arms or hands
  • Yellowing of the skin or eyes
  • Numbness, tingling, or decreased sensation in fingers and toes
  • Difficulty walking or changes in the way you walk
  • Clumsiness buttoning clothes, opening jars, or doing other routine activities
  • No bowel movement for three days, or bowel discomfort
  • Abdominal pain
  • Persistent loss of appetite or rapid weight loss (such as 5 pounds in one week)
  • Extreme fatigue that interferes with normal activities
  • Rash that is bothersome

Revised February 2011

©  UPMC | Affiliated with the University of Pittsburgh Schools of the Health Sciences
Supplemental content provided by A.D.A.M. Health Solutions. All rights reserved.

For help in finding a doctor or health service that suits your needs, call the UPMC Referral Service at 412-647-UPMC (8762) or 1-800-533-UPMC (8762). Select option 1.

UPMC is an equal opportunity employer. UPMC policy prohibits discrimination or harassment on the basis of race, color, religion, ancestry, national origin, age, sex, genetics, sexual orientation, marital status, familial status, disability, veteran status, or any other legally protected group status. Further, UPMC will continue to support and promote equal employment opportunity, human dignity, and racial, ethnic, and cultural diversity. This policy applies to admissions, employment, and access to and treatment in UPMC programs and activities. This commitment is made by UPMC in accordance with federal, state, and/or local laws and regulations.

Medical information made available on is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have. Further, is not a tool to be used in the case of an emergency. If an emergency arises, you should seek appropriate emergency medical services.

For UPMC Mercy Patients: As a Catholic hospital, UPMC Mercy abides by the Ethical and Religious Directives for Catholic Health Care Services, as determined by the United States Conference of Catholic Bishops. As such, UPMC Mercy neither endorses nor provides medical practices and/or procedures that contradict the moral teachings of the Roman Catholic Church.

Pittsburgh, PA, USA