CAPE

CAPE is the code name of your cancer treatment regimen.

It may be used to treat colorectal, pancreas, breast or other cancers.

This regimen name is made up of one or more letters from the name of the medication in your treatment.

Here are the name of the medication in this regimen:

For most people, treatment is divided into cycles. Each cycle is 3 weeks long. Your health care team will tell you how many cycles you need.

Capecitabine may be given on a schedule that is different from what is shown on the calendar below. Speak with your health care team to see if the below schedule applies to you.

Here is a picture of the schedule for CAPE treatment:

Cycle 1

CAPE

( 3 weeks)

Repeat 

CAPE

(3 weeks)

Your health care 
team will tell you
how many cycles 
you will have.

During each 3-week cycle, you will take capecitabine tablets for 14 days at home (2 weeks of treatment, then 1  week with no treatment).

Each cycle looks like this:

Your health care team may ask you to have a blood test to check for DPD deficiency before starting treatment.

• DPD deficiency is when you have low or no activity of an enzyme called DPD (dihydropyrimidine dehydrogenase). A deficiency can cause you to have severe side effects from capecitabine.
   
• See the Testing for people taking capecitabine or 5-fluorouracil (5-FU) pamphlet for more information.

You will have a blood test to check for hepatitis B before starting treatment. See the Hepatitis B and Cancer Medications pamphlet for more information.

Capecitabine comes in the form of tablets (pills) that you swallow.

• Your health care team will tell you how many capecitabine tablets you need to take.

• Do not take your medicine more often or for longer than you have been told to.

• You may need a mix of  tablets of different strengths to get the right dose. Make sure you look at your tablets closely so that you take the right dose.

• Take capecitabine two times each day. Space each dose about 12 hours apart.

• Swallow the tablets whole with a full glass of water. Take with food (up to 30 minutes after eating a meal (for example, right after breakfast and dinner)).

• Do not crush or chew capecitabine tablets.

• If you vomit (throw up) after taking your medication, talk to your health care team about what to do. Do not take another dose until you have talked to them. If you are unable to talk to your healthcare team, take your next dose at the usual time.

• If you forget to take a dose, do not take an extra dose to make up for the missed dose. Follow the instructions given to you or talk to your health care team if you are unsure about what to do. If you are unable to talk to your health care team, take your next dose at the usual time.
   

You will have a blood test before each treatment cycle to make sure it is safe for you to get treatment.

To Prevent Nausea and Vomiting

You may be given medications to have at home in case you have nausea (feeling like throwing up) and vomiting (throwing up).

• These are called anti-nausea medications and include medications such as prochlorperazine (Stemetil^®), metoclopramide (Maxeran^®) or others.

To Treat Diarrhea

Capecitabine can cause diarrhea. Diarrhea is when you have loose bowel movements (watery poo) or you need to go poo (have bowel movements) more often than usual. Diarrhea may start a few days after your treatment begins.

You will be given a medication called loperamide (Imodium®) to help treat your diarrhea. Take this medication only if you need it.

Keep your loperamide with you all the time. When diarrhea starts, take the loperamide right away.

If you start to have diarrhea:

• Take 2 tablets (4mg) of loperamide right away.

• Take 1 tablet after each loose bowel movement (watery poo).

• Do not take more than 8 tablets in one day.

This treatment may cause Hand-Foot Syndrome

Hand-foot syndrome is a side-effect of capecitabine treatment that affects the skin on your hands and the bottoms of your feet. It usually starts with tingling or swelling of your skin. Your skin can become painful, red and numb. In worse cases, your skin may start to peel and you can get blisters or sores. This may start days or weeks after your treatment begins.

You can help to prevent symptoms of hand-foot syndrome by doing these things:

• Keep your skin moist, especially in the skin folds.

• Gently apply moisturizer cream or lotion to the inside of your hands and bottom of your feet as needed. Choose a fragrance-free cream that contains lanolin (like Bag Balm®, Udderly Smooth®) or urea 10% (like Uremol 10®).

• Do not let your hands and feet get too hot. Wash sweat from your skin. Bathe or shower in lukewarm water and gently pat yourself dry.

• Do not do activities that cause rubbing or pressure on your skin, like heavy-duty washing, gripping tools, typing, playing musical instruments, and driving.

• Wear gloves while cleaning to protect your skin from things like laundry detergent, bleach, cleaning products, and dish soap.

• Wear loose fitting clothes and loose fitting, comfortable shoes with cushioned soles. Do not walk in bare feet.

• Drink 6–8 glasses of liquids each day unless your health care team told you otherwise.

Yes, the medications in this regimen can interact with other medications, vitamins, foods and natural health products. Interactions can make the treatment not work as well or cause severe side effects.

Tell your health care team about all of your:

• prescription and over-the-counter (non-prescription) medications
• natural health products such as vitamins, herbal teas, homeopathic medicines, and other supplements

Check with your health care team before starting or stopping any of them.

If you take seizure medications (such as phenytoin), your health care team will monitor your blood levels closely and may change your dose.

If you are taking a blood thinner (such as warfarin), your health care team may need extra blood tests and may change your dose.

Talk to your health care team BEFORE taking or using these:

• Anti-inflammatory medications such as ibuprofen (Advil^® or Motrin^®), naproxen (Aleve^®) or Aspirin^®.
• Over-the-counter products such as dimenhydrinate (Gravol^®) 
• Natural health products such as St. John’s Wort
• Supplements such as vitamin C
• Grapefruit juice
• Alcoholic drinks 
• Tobacco 
• All other drugs, such as marijuana or cannabis (medical or recreational)

Talk to your health care team about:

• How this treatment may affect your sexual health.

• How this treatment may affect your ability to have a baby, if this applies to you.
   

This treatment may harm an unborn baby. Tell your health care team if you or your partner are pregnant, become pregnant during treatment, or are breastfeeding.

• If there is any chance of pregnancy happening, you and your partner together must use 2 effective forms of birth control at the same time while you are on treatment. Talk to your health care team about which birth control options are best for you, and how long you should use them after your last treatment dose.
   

• Do not use hormonal birth control (such as birth control pills), unless your health care team told you that they are safe. Talk to your health care team about the safest birth control for you.
   

• Do not breastfeed while on this treatment. Talk to your health care team about how long to wait before you start breastfeeding after your last treatment dose, if this applies to you.

• Keep capecitabine tablets in the original packaging at room temperature in a dry place, away from heat and light.

• Keep out of sight and reach of children and pets.

• Do not throw out any unused capecitabine tablets at home. Bring them to your pharmacy to be thrown away safely.