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)

  • Loose bowel movements (diarrhea) that may last for several days
  • Abdominal pain
  • Decreased appetite (decreased hunger)
  • Nausea and throwing up (vomiting). These symptoms may happen within a few hours after your treatment. Medicines are available to stop or lessen these side effects.
  • Soreness of the mouth and throat. You may have red areas, white patches, and/or sores that hurt.
  • Constipation (not able to move bowels)
  • Hand-and-foot syndrome. The palms of your hands or soles of your feet may tingle, become numb, painful, swollen, or red.
  • Eye irritation. You may have watery eyes. Your eyes and eye lids may become red and painful.
  • Skin may become red or itchy (dermatitis)
  • Swelling in your ankles, feet, arms or hands.
  • Increased total bilirubin in your blood. This may mean that you have a change in your liver function. Your blood work will be checked by your doctor.
  • Effects on the nerves are called peripheral neuropathy. You may feel numbness, tingling, or pain in your hands and feet. It may be hard for you to button your clothes, open jars, or walk as usual. The effect on the nerves may get worse with more doses of the drug. These effects get better in some people after the drug is stopped but it does not get better in all people.
  • Bone marrow depression. This is a decrease in the number of white blood cells, red blood cells, and platelets. This may raise your risk of infection, make you tired and weak (fatigue), and raise your risk of bleeding.
  • Tiredness
  • Weakness that interferes with your daily activities
  • Fever

Possible Side Effects (Less Common)

  • Headache
  • Dizziness
  • Back, joint, or muscle pain
  • Easy bleeding or bruising
  • Wheezing and/or feeling short of breath
  • Too much water loss from the body (dehydration)
  • This drug may affect how your kidneys work. Your kidney function will be checked as needed.
  • Hair loss. You may notice your hair getting thin. Some patients lose their hair. Your hair often grows back when treatment is done.
  • Changes to the color of your skin or nails
  • Changes in the way food and drinks taste
  • Cough
  • Irregular heartbeat. This drug may cause a rapid or irregular heartbeat. You may feel your heart beating fast (palpitations).
  • Chest pain or symptoms of a heart attack. Most heart attacks involve pain in the center of the chest that lasts more than a few minutes. The pain may go away and come back. It can feel like pressure, squeezing, fullness or pain. Sometimes pain is felt in one or both arms, the back, neck, jaw or stomach. If any of these symptoms last 2 minutes, call 911.
  • Changes in the tissue of the heart. Some changes may happen that can cause your heart to have less ability to pump blood. Your heart function will be checked as needed.
  • Electrolyte changes. Your blood will be checked for electrolyte changes as needed.

Treating Side Effects

  • Drink 6-8 cups of fluids each day unless your doctor has told you to limit your fluid intake due to some other health problem. A cup is 8 ounces of fluid. If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack water in the body from losing too much fluid).
  • Mouth care is very important. Your mouth care should consist of routine, gentle cleaning of your teeth or dentures and rinsing your mouth with a mixture of ½ teaspoon of salt in 8 ounces of water or ½ teaspoon of baking soda in 8 ounces of water. This should be done at least after each meal and at bedtime.
  • If you have mouth sores, avoid mouthwash that has alcohol. Avoid alcohol and smoking because they can bother your mouth and throat.
  • If you have a nose bleed, sit with your head tipped slightly forward. Apply pressure by lightly pinching the bridge of your nose between your thumb and forefinger. Call your doctor if you feel dizzy or faint or if the bleeding doesn’t stop after 10 to 15 minutes.
  • Ask your doctor or nurse about medicines to help you stop or lessen nausea, throwing up, headache, constipation, and/or loose bowel movements (diarrhea).
  • If you have constipation, check with your doctor or nurse before you use enemas, laxatives, or suppositories.
  • If you are dizzy, get up slowly after sitting or lying down.
  • If you have numbness and tingling in your hands and feet, be careful when cooking, walking, and handling sharp objects and hot liquids.
  • If you get a rash do not put anything on it unless your doctor or nurse says you may. Keep the area around the rash clean and dry. Ask your doctor for medicine if your rash bothers you.

Special Instructions

  • Take the capecitabine tablets with food or within 30 minutes after the end of a meal.
  • Take this medicine with water. Swallow the tablets whole. Do not cut or crush tablets.
  • Missed dose: If you miss a dose of capecitabine, do not take the missed dose at all and do not double up on the next dose. Instead, go back to using your normal dosing schedule and contact your physician.
  • Notify your doctor if you are taking warfarin or warfarin-like medications. Increased monitoring will be needed due to interactions with this drug.

Food and Drug Interactions

  • This drug interacts with warfarin and warfarin-like drugs in a way that may increase the risk of bleeding. Increased monitoring is necessary.
  • Check with your doctor or pharmacist about all other prescription medicines and dietary supplements you are taking before starting this medicine as there are a lot of known drug interactions with capecitabine. Also, check with your doctor or pharmacist before starting any new prescription or over-the-counter medicines, or dietary supplement to make sure that there are no interactions.

When to Call the Doctor

Stop taking capecitabine right away and call your doctor if any of these symptoms happen:

  • Blistering or peeling of skin

Call your doctor or nurse right away if you have any of these symptoms:

  • Hand-and-foot syndrome – if you have pain, swelling, or redness of hands and/or feet
  • Mouth sores – if you have pain, redness, swelling, or sores in your mouth
  • Easy bleeding or bruising
  • Feeling that your heart is beating in a fast or not normal way (palpitations)
  • Swelling in your ankles, feet, arms or hands
  • Severe abdominal pain
  • Severe headache
  • Coughing, gagging or choking during eating or drinking
  • Fever of 100.5 F (38 C) or higher
  • Chills
  • Seizures
  • Rash, sores, reddened areas or itching that is not relieved by prescribed medicines
  • Confusion or agitation
  • Feeling dizzy or lightheaded
  • Wheezing or trouble breathing
  • Blurred vision or other changes in eyesight
  • Nausea that stops you from eating or drinking
  • Throwing up more than 3 times a day
  • Pain when passing urine; blood in urine
  • Pain in your lower back or side
  • Loose bowel movements (diarrhea) more than 4 times a day or diarrhea with weakness or lightheadedness
  • Chest pain or symptoms of a heart attack. Most heart attacks involve pain in the center of the chest that lasts more than a few minutes. The pain may go away and come back. It can feel like pressure, squeezing, fullness or pain. Sometimes pain is felt in one or both arms, the back, neck, jaw or stomach. If any of these symptoms last 2 minutes, call 911.
  • Symptoms of a stroke such as sudden numbness or weakness of your face, arm, or leg, mostly on one side of your body; sudden confusion, trouble speaking or understanding; sudden trouble seeing in one or both eyes; sudden trouble walking, feeling dizzy, loss of balance or coordination; or sudden, bad headache with no known cause. If you have any of these symptoms for 2 minutes, call 911.
  • Signs of liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired and weak, unusual itching, or yellowing of the eyes or skin

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

  • Swelling in your legs, ankles, feet, legs, arms or hands
  • Lasting loss of appetite or rapid weight loss of five pounds in a week
  • Fatigue that interferes with your daily activities
  • Rash that is not relieved by prescribed medicines
  • Change in hearing, ringing in the ears
  • Decreased urine
  • Pain in your mouth or throat that makes it hard to eat or drink
  • Pain, nausea, throwing up, or loose bowel movements that are not relieved by prescribed medicines
  • Heavy menstrual period that lasts longer than normal
  • Numbness, tingling, decreased feeling or weakness in fingers, toes, arms, or legs
  • Trouble walking or changes in the way you walk, feeling clumsy when buttoning clothes, opening jars, or other routine hand motions
  • Weight gain of 5 pounds in one week (fluid retention)
  • Lasting loss of appetite or rapid weight loss of five pounds in a week
  • Headache that does not go away
  • Painful, red, or swollen areas on your hands or feet
  • No bowel movement for 3 days or you feel uncomfortable
  • Extreme weakness that interferes with normal activities
  • Bad abdominal pain, especially in upper right area
  • Pain between shoulder blades, or in right shoulder
  • Abnormal blood sugar
  • Unusual thirst, passing urine often, headache, sweating, shakiness, irritability
  • Feeling that heart is beating too slow or too fast

Sexual Problems and Reproductive Concerns

  • 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.
  • Genetic counseling is available for you to talk about the effects of this drug therapy on future pregnancies. Also, a genetic counselor can look at the possible risk of problems in the unborn baby due to this medicine if an exposure happens during pregnancy.
  • Breast feeding warning: It is not known if this drug passes into breast milk. For this reason, women should talk to their doctor about the risks and benefits of breast feeding during treatment with this drug because this drug may enter the breast milk and badly harm a breast feeding baby.

Updated December 2016​​​

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