capecitabine
capecitabine
Pronunciation:
kape-SIGH-ta-been
Other Name(s):
Xeloda®
Appearance:
tablet in various strengths
This handout gives general information about this cancer medication.
You will learn:
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who to contact for help
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what the medication is
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how it is given
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what to expect while on medication
This handout was created by Ontario Health (Cancer Care Ontario) together with patients and their caregivers who have also gone through cancer treatment. It is meant to help support you through your cancer treatment and answer some of your questions.
This information does not replace the advice of your health care team. Always talk to your health care team about your treatment.
My cancer health care provider is: _____________________________________________
During the day I should contact: _______________________________________________
Evenings, weekends and holidays: _____________________________________________
This page gives general information about this cancer medication.
You will learn:
-
who to contact for help
-
what the medication is
-
how it is given
-
what to expect while on this medication
This information was created by Ontario Health (Cancer Care Ontario) together with patients and their caregivers who have also gone through cancer treatment. It is meant to help support you through your cancer treatment and answer some of your questions.
This information does not replace the advice of your health care team. Always talk to your health care team about your treatment.
For treating certain types of cancers such as coIon, rectum or breast. It can also be used for other cancers.
Tell your health care team if you have or had significant medical condition(s), especially if you have or had:
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liver, heart or kidney problems,
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personal or family history of severe side effects with other drugs (especially a drug called fluorouracil),
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or any allergies.
This drug contains a small amount of lactose. If you cannot tolerate lactose, talk to your health care team.
Remember To:
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Tell your health care team about all of the other medications you are taking.
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Keep taking other medications that have been prescribed for you, unless you have been told not to by your health care team.
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.
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.
Capecitabine comes in the form of tablets (pills) that you swallow.
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Your health care team will tell you how many capecitabine tablets you need to take.
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Do not take your medicine more often or for longer than you have been told to.
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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.
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Take capecitabine two times each day. Space each dose about 12 hours apart.
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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)).
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Do not crush or chew capecitabine tablets.
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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.
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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.
Warning: If you take too much capecitabine by accident, or if you think a child or a pet may have swallowed your capecitabine, you must call the Ontario Poison Control Center right away at: 1-800-268-9017.
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).
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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:
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Take 2 tablets (4mg) of loperamide right away.
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Take 1 tablet after each loose bowel movement (watery poo).
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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:
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Keep your skin moist, especially in the skin folds.
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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®).
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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.
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Do not do activities that cause rubbing or pressure on your skin, like heavy-duty washing, gripping tools, typing, playing musical instruments, and driving.
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Wear gloves while cleaning to protect your skin from things like laundry detergent, bleach, cleaning products, and dish soap.
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Wear loose fitting clothes and loose fitting, comfortable shoes with cushioned soles. Do not walk in bare feet.
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Drink 6–8 glasses of liquids each day unless your health care team told you otherwise.
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DO check with your health care team before getting any vaccinations, surgery, dental work or other medical procedures.
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DO talk to your health care team about your risk of getting heart problems with this treatment.
- DO NOT smoke or drink alcohol while on treatment without talking to your health care team first. Smoking and drinking can make side effects worse and make your treatment not work as well.
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DO check with your health care team before getting any vaccinations, surgery, dental work or other medical procedures.
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DO talk to your health care team about your risk of getting heart problems with this treatment.
- DO NOT smoke or drink alcohol while on treatment without talking to your health care team first. Smoking and drinking can make side effects worse and make your treatment not work as well.
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 may 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.
- 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)
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Always check your temperature to see if you have a fever before taking any medications for fever or pain (such as acetaminophen (Tylenol®) or ibuprofen (Advil®)).
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Fever can be a sign of infection that may need treatment right away.
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If you take these medications before you check for fever, they may lower your temperature and you may not know you have an infection.
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How to check for fever:
Keep a digital (electronic) thermometer at home and take your temperature if you feel hot or unwell (for example, chills, headache, mild pain).
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You have a fever if your temperature taken in your mouth (oral temperature) is:
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38.3°C (100.9°F) or higher at any time
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OR
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38.0°C (100.4°F) or higher for at least one hour.
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If you do have a fever:
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Try to contact your health care team. If you are not able to talk to them for advice, you MUST get emergency medical help right away.
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Ask your health care team for the Fever pamphlet for more information.
If you do not have a fever but have mild symptoms such as headache or mild pain:
- Ask your health care team about the right medication for you. Acetaminophen (Tylenol®) is a safe choice for most people.
Talk to your health care team before you start taking ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or ASA (Aspirin®), as they may increase your chance of bleeding or interact with your cancer treatment.
Talk to your health care team if you already take low dose aspirin for a medical condition (such as a heart problem). It may still be safe to take.
Talk to your health care team about:
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How this treatment may affect your sexual health.
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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 you may become pregnant, you and your partner together must use 2 effective forms of birth control at the same time until 6 months after your last dose. Talk to your health care team about which birth control options are best for you.
- If you are a patient that can get somebody pregnant, you and your partner together must use 2 effective forms of birth control at the same time until 3 months after your last dose. Talk to your health care team about which birth control options are best for you.
- Do not breastfeed while on this medication and until 2 weeks after your last dose.
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Keep this medication 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.
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Do not throw out any unused medications at home. Bring them to your pharmacy to be thrown away safely.
If you are a patient:
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Wash your hands before and after touching your oral anti-cancer medication.
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Swallow each pill whole. Do not crush or chew your pills.
If you are a caregiver:
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Wear nitrile or latex gloves when touching tablets, capsules or liquids.
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Wash your hands before putting on your gloves and after taking them off, even if your skin did not touch the oral anti-cancer medication.
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Throw out your gloves after each use. Do not re-use gloves.
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Do not touch oral anti-cancer medications if you are pregnant or breastfeeding.
If medication gets on your skin:
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Wash your skin with a lot of soap and water.
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If your skin gets red or irritated, talk to your health care team.
If medication gets in your eyes:
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Rinse your eyes with running water right away. Keep water flowing over your open eyes for at least 15 minutes.
The following table lists side effects that you may have when getting capecitabine. The table is set up to list the most common side effects first and the least common last. It is unlikely that you will have all of the side effects listed and you may have some that are not listed.
Read over the side effect table so that you know what to look for and when to get help. Keep this paper during your treatment so that you can refer to it if you need to.
| Very Common Side Effects (50 or more out of 100 people) | |
| Side effects and what to do | When to contact health care team |
|
Rash on your hands and feet (hand-foot syndrome) (May be severe) What to look for?
What to do? To help prevent Hand-foot syndrome:
Also your health care team for the Hand-foot syndrome pamphlet for more information. |
Talk to your health care team if it does not improve or if it is severe. |
| Common Side Effects (25 to 49 out of 100 people) | |
| Side effects and what to do | When to contact health care team |
|
Diarrhea (May be severe) What to look for?
What to do? If you have diarrhea:
Ask your health care team for the Diarrhea pamphlet for more information. |
Talk to your health care team if no improvement after 24 hours of taking diarrhea medication or if severe (more than 7 times in one day). |
|
Nausea and vomiting What to look for?
What to do? To help prevent nausea:
If you have nausea or vomiting:
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Talk to your health care team if nausea lasts more than 48 hours or vomiting lasts more than 24 hours or if severe. |
| Less Common Side Effects (10 to 24 out of 100 people) | |
| Side effects and what to do | When to contact health care team |
|
Mouth sores What to look for?
What to do? To help prevent mouth sores:
If you have mouth sores:
Ask your health care team for the Oral Care (Mouth Care) pamphlet for more information. |
Talk to your health care team as soon as you notice mouth or lip sores or if it hurts to eat, drink or swallow. |
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Liver problems (May be severe) Your health care team may check your liver function with a blood test. The liver changes do not usually cause any symptoms.
If you have any symptoms of liver problems, get emergency medical help right away. |
Get emergency medical help right away. |
|
Fatigue What to look for?
What to do?
Ask your health care team for the Fatigue pamphlet for more information. |
Talk to your health care team if it does not improve or if it is severe. |
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Pains or cramps in the belly What to look for?
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Talk to your health care team if it does not improve or if it is severe. |
Other rare, but serious side effects are possible.
If you experience ANY of the following, speak to your cancer health care provider or get emergency medical help right away:
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Irregular heartbeat, shortness of breath, chest pain, fainting spells or swelling in your legs, ankles and belly
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Pain, swelling and hardening of a vein in an arm or leg
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Feeling confused, having trouble with speaking, moving your arms or legs or problems with balancing yourself
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Any sudden changes to your vision
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Severe belly pain, bloating or feeling of fullness and severe constipation
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Lower back pain, swelling, pee less than usual, unexpected weight gain
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Signs of an allergy such as fever, itchiness, rash, swollen lips, face or tongue, chest and throat tightness, usually shortly after taking the drug
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New eye problems such as severe redness, irritation, pain, tearing, sensitivity to light or blurred vision
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Signs of bleeding such as bleeding from your gums, unusual or heavy nosebleeds, bruising easily or more than normal, black coloured stools (poo), blood in your stools (poo), red or pink coloured urine (pee), or coughing up red or brown coloured mucus
For more information on how to manage your symptoms ask your health care provider, or visit: https://www.cancercareontario.ca/symptoms.
July 2024 Updated/Revised information sheet
The information set out in the medication information sheets, regimen information sheets, and symptom management information (for patients) contained in the Drug Formulary (the "Formulary") is intended to be used by health professionals and patients for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or side effects of a certain drug, nor should it be used to indicate that use of a particular drug is safe, appropriate or effective for a given condition.
A patient should always consult a healthcare provider if he/she has any questions regarding the information set out in the Formulary. The information in the Formulary is not intended to act as or replace medical advice and should not be relied upon in any such regard. All uses of the Formulary are subject to clinical judgment and actual prescribing patterns may not follow the information provided in the Formulary.