Capecitabine
1 medicine
Capecitabine is an oral chemotherapy drug the body converts into fluorouracil; it commonly causes hand-foot syndrome and can cause severe, sometimes fatal, toxicity in people with a DPD enzyme deficiency, so any unexpected severe side effect needs urgent attention.
Key facts
- Capecitabine (sold as Xeloda) is a prodrug: it passes through the body inactive and is converted, mostly inside tumor cells, into fluorouracil (5-FU), the drug that actually attacks cancer cells.
- It's taken as tablets twice daily with food, usually in cycles of treatment days followed by rest days, exactly as your oncologist prescribes.
- Hand-foot syndrome (redness, peeling, or painful blistering of the palms and soles) is a common and sometimes treatment-limiting effect; tell your care team as soon as it starts.
- A small number of people lack an enzyme (DPD) needed to break capecitabine down and can develop severe, occasionally fatal, toxicity from a standard dose; report any unexpectedly severe side effect urgently.
What capecitabine treats
Capecitabine treats colorectal cancer, including cancer that has spread to other organs, and breast cancer, often when it has returned after earlier treatment. It's also used for some stomach (gastric) cancers. It's given alone or combined with other chemotherapy drugs, depending on the cancer type and stage.
How capecitabine works
Capecitabine itself is inactive when swallowed. A series of enzymes, the last one found in higher amounts inside tumors, convert it step by step into fluorouracil, which blocks cancer cells from building the DNA and RNA they need to divide. Because this final conversion happens more in tumor tissue than in normal tissue, capecitabine concentrates more of its effect on the cancer, though normal cells are still affected, which is the source of its side effects.
Before you take it
- Tell your doctor if you or a close relative has ever had a severe reaction to fluorouracil or capecitabine; this can indicate a DPD enzyme deficiency, which some centers test for before starting.
- Tell your doctor about heart disease, since fluorouracil-based drugs can rarely cause chest pain or heart rhythm problems.
- Avoid this medicine in pregnancy; reliable contraception is required during and after treatment.
- Tell your doctor about warfarin or other blood thinners, since capecitabine can increase their effect.
Side effects
Common effects include diarrhea, nausea, fatigue, and hand-foot syndrome.
Stop and seek urgent medical care for any of these:
- Severe diarrhea, vomiting, or signs of dehydration.
- Chest pain, palpitations, or shortness of breath.
- Fever or other signs of infection.
- Severe or rapidly worsening hand-foot symptoms, mouth sores, or unusual bleeding.
Safety essentials
- Capecitabine converts into fluorouracil in the body, and a minority of people who cannot break this down properly (DPD deficiency) can suffer severe, occasionally fatal, toxicity from a normal dose; any severe or unexpected reaction needs urgent medical review, not just a dose reduction at the next cycle.
- Hand-foot syndrome is common; keep skin moisturized, avoid friction and heat on hands and feet, and report symptoms early so your dose can be adjusted before it becomes severe.
- Attend all scheduled blood tests, since capecitabine can affect blood counts, kidney function, and liver function throughout treatment.
This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.