Generic Xeloda

Introduction

Xeloda (capecitabine) is an oral chemotherapy agent used primarily in the United Kingdom for the treatment of several solid tumours. The drug contains the active compound capecitabine, a fluoropyrimidine that is converted to 5‑fluorouracil (5‑FU) within cancer cells. It belongs to the anticancer medication group and is marketed by Roche. In addition to its main indications for colorectal and breast cancer, Xeloda is also employed in gastric, pancreatic and head‑and‑neck cancers when combined with other systemic therapies.

What is Xeloda?

Xeloda is a tablet formulation of capecitabine, a pro‑drug of 5‑fluorouracil. It was developed by Roche and received its first marketing authorisation in the European Union in 1998. The tablets are film‑coated, film‑type, and contain a range of strengths (150 mg, 500 mg) to allow flexible dosing. Xeloda is supplied under the prescription‑only medicine (POM) classification in the UK and is approved by the Medicines and Healthcare products Regulatory Agency (MHRA).

How Xeloda Works

Capecitabine is absorbed in the gastrointestinal tract and undergoes a three‑step enzymatic conversion. First, hepatic carboxylesterases convert capecitabine to 5′‑deoxy‑5‑fluorocytidine (5′‑DFCR). Second, cytidine deaminase transforms 5′‑DFCR to 5′‑deoxy‑5‑fluorouridine (5′‑DFUR). Finally, tumour‑expressed thymidine phosphorylase converts 5′‑DFUR to the active cytotoxic metabolite 5‑fluorouracil (5‑FU).

Because thymidine phosphorylase is present in higher concentrations in many tumour tissues than in normal cells, the final activation step occurs preferentially inside the tumour, achieving higher intra‑tumour concentrations of 5‑FU while limiting systemic exposure. 5‑FU inhibits thymidylate synthase, disrupting DNA synthesis and leading to cell death, especially in rapidly dividing cancer cells. The drug’s oral route provides a convenient alternative to intravenous 5‑FU infusions, though the pharmacokinetic profile remains comparable after metabolic conversion.

Conditions Treated with Xeloda

• Colorectal cancer (metastatic). Xeloda, often combined with oxaliplatin (CAPOX regimen), is a standard first‑line option for patients with unresectable metastatic disease. In the UK, NICE recommends it for patients unsuitable for infusional 5‑FU.
• Early‑stage breast cancer (adjuvant). When used after surgery, Xeloda in combination with docetaxel (TC regimen) has demonstrated disease‑free survival benefits versus standard chemotherapy.
• Gastric cancer (metastatic). Capecitabine plus cisplatin is an accepted first‑line regimen, offering similar efficacy to 5‑FU/ cisplatin with the convenience of oral dosing.
• Pancreatic cancer (metastatic). In the UK, capecitabine is sometimes added to gemcitabine in clinical practice, though evidence is modest.
• Head and neck squamous cell carcinoma (locally advanced). Xeloda combined with radiotherapy provides an organ‑preserving alternative to cisplatin‑based chemoradiation for patients who cannot tolerate cisplatin.

These indications reflect approvals from the European Medicines Agency (EMA) and subsequent endorsement by NICE and the British Society for Clinical Oncology (BSCO). The drug’s oral formulation and tumour‑selective activation make it a valuable component of multimodal cancer care.

Who is Xeloda For?

• Patients with metastatic colorectal cancer who have progressed on or are unsuitable for intravenous 5‑FU regimens.
• Women with early‑stage breast cancer for whom a taxane‑based adjuvant regimen is recommended and who prefer oral chemotherapy.
• Individuals with metastatic gastric or pancreatic cancer where combination chemotherapy is indicated and intravenous access is problematic.
• Patients with locally advanced head‑and‑neck cancer who cannot receive cisplatin due to renal insufficiency or severe ototoxicity.

Xeloda is contraindicated in patients with known hypersensitivity to capecitabine or 5‑FU, severe renal impairment (creatinine clearance < 30 mL/min), or in those with a history of dihydropyrimidine dehydrogenase (DPD) deficiency. Pregnant or breastfeeding women must avoid Xeloda because of documented teratogenicity in animal studies.

Risks, Side Effects, and Interactions

Common

• Hand‑foot syndrome (palmar‑plantar erythrodysesthesia) – redness, swelling, pain on the palms and soles.
• Diarrhoea – often mild to moderate, may require antidiarrhoeal medication.
• Nausea and vomiting – generally controllable with anti‑emetics.
• Fatigue – pervasive but usually improves with dose adjustments.
• Mild alopecia – hair thinning rather than complete loss.

Rare

• Severe mucositis or stomatitis – painful ulceration of the mouth and gastrointestinal tract.
• Cardiotoxicity – rare cases of angina‑like chest pain or myocardial ischaemia.
• Hyperbilirubinaemia – transient elevation of bilirubin without liver damage.
• Severe skin reactions – Stevens‑Johnson syndrome or toxic epidermal necrolysis (extremely uncommon).

Serious

• Myelosuppression – neutropenia, thrombocytopenia, and anaemia can increase infection risk and may require treatment interruption.
• Severe hand‑foot syndrome – may necessitate dose reduction or discontinuation.
• Life‑threatening diarrhoea – dehydration and electrolyte imbalance requiring hospitalisation.
• Anaphylactic reactions – rare but potentially fatal; immediate medical attention needed.

Drug–drug interactions

• Anticoagulants (warfarin, direct oral anticoagulants). Capecitabine can enhance anticoagulant effects, increasing bleeding risk.
• Cytarabine and other antimetabolites. Combined use may potentiate myelosuppression.
• Fluoropyrimidine‑targeted agents (e.g., eniluracil). May raise capecitabine plasma concentrations.
• Proton‑pump inhibitors (PPIs). Some evidence suggests PPIs may reduce capecitabine absorption; spacing administration by at least 2 hours is advisable.

Patients should provide a full medication list, including over‑the‑counter products and herbal supplements, to the prescribing clinician.

Practical Use: Dosing, Missed Dose, Overdose

• Standard dosing for metastatic colorectal cancer is 125 mg/m² twice daily for 14 days followed by a 7‑day rest period (21‑day cycle). For breast cancer, the dose is usually 100 mg/m² twice daily for 14 days followed by a 7‑day rest. Dose calculations are based on body surface area (BSA), which is determined by height and weight.
• Renal adjustment. Patients with creatinine clearance 30–50 mL/min should receive 75 % of the calculated dose; those below 30 mL/min are contraindicated.
• Missed dose. If a dose is forgotten and the next scheduled dose is more than 8 hours away, omit the missed dose. Do not double‑dose to compensate.
• Overdose. Symptoms may include severe diarrhoea, profound neutropenia, and hand‑foot syndrome. Immediate medical evaluation is required; activated charcoal is not effective because capecitabine is rapidly absorbed. Supportive care and dose interruption are the mainstays of management.
• Food and alcohol. Tablets may be taken with or without food, but a light meal is recommended to reduce stomach upset. Alcohol can exacerbate liver toxicity; moderate consumption is advised, and heavy drinking should be avoided.
• Comorbidities. Patients with cardiac disease, hepatic impairment, or active infections should be monitored closely, as capecitabine may aggravate these conditions.

Buying Xeloda from Our Online Pharmacy

Xeloda can be purchased from our online pharmacy in the UK with a focus on safety, affordability and discretion.

• Affordable pricing. We source the medication near manufacturer cost, passing savings directly to patients while maintaining rigorous quality standards.
• Verified quality. All tablets are supplied by licensed overseas pharmacies that meet European Good Manufacturing Practice (GMP) criteria, and each batch is accompanied by a certificate of analysis.
• Guaranteed delivery. Discreet packaging is used for all orders; express delivery typically arrives within 7 days, while standard airmail may take up to 3 weeks, depending on customs processing.
• Pharmacy‑broker service. As a broker, we partner with reputable international wholesalers, enabling us to offer medicines that may not be stocked locally. This model respects patient privacy and circumvents supply shortages without compromising safety.

Our service is intended for adults who have a legitimate medical need for capecitabine and who may face limited access through conventional pharmacies or insurance schemes. All purchases are fulfilled in compliance with UK import regulations for personal use.

FAQ

• Is Xeloda available in both brand‑name and generic forms in the UK?
  Yes. Xeloda is the brand name produced by Roche, while multiple generic capecitabine tablets are marketed by other manufacturers. The generic versions contain the same active ingredient and are usually less expensive.

• What is the recommended storage condition for Xeloda tablets?
  Store at controlled room temperature (15‑30 °C), protected from moisture, light and excessive heat. Do not keep the medication in the bathroom or near kitchen appliances that generate steam.

• How long does a typical Xeloda treatment cycle last?
  A standard cycle consists of 14 days of twice‑daily dosing followed by a 7‑day rest period, making a 21‑day cycle. The total number of cycles depends on the cancer type, response to therapy and tolerability.

• Can Xeloda be taken with other oral anticancer agents?
  While co‑administration is common in combination regimens (e.g., with oxaliplatin or docetaxel), each combination must be prescribed and monitored by an oncologist because of the potential for additive toxicity, especially myelosuppression.

• Are there differences in capecitabine formulation between regions?
  Yes. European‑marketed tablets contain specific inactive ingredients (e.g., magnesium stearate, microcrystalline cellulose) that may differ from formulations sold in the United States or Asia. Such differences can affect tablet size, colour and dissolution rate, but the active dose of capecitabine remains equivalent.

• What should a patient do if they develop severe hand‑foot syndrome?
  They should immediately contact their oncology team. Management includes dose reduction, temporary interruption, and symptomatic care such as moisturisers, cooling packs and analgesics. Prompt intervention can prevent permanent damage.

• Is capecitabine testing required before starting Xeloda?
  Testing for dihydropyrimidine dehydrogenase (DPD) deficiency is recommended because severe toxicity can occur in patients with reduced DPD activity. If a deficiency is identified, alternative therapies are considered.

• Can Xeloda be taken while travelling abroad?
  Yes, provided the patient carries a copy of the prescription and the medication is kept in its original packaging. Travelers should be aware of import limits (typically up to a 3‑month supply) and declare the medication if required by customs.

• Does Xeloda appear on standard drug‑testing panels?
  Capecitabine is not typically screened for in occupational or sports drug‑testing programs, as it is a chemotherapy agent and not a performance‑enhancing or recreational drug.

• What are the inactive ingredients in Xeloda tablets, and can they cause allergies?
  Inactive components include lactose, magnesium stearate, and microcrystalline cellulose. Patients with known lactose intolerance or hypersensitivity to any excipient should discuss alternatives with their clinician, although true allergic reactions to these ingredients are rare.

Glossary

BSA (Body Surface Area)

A calculation based on a person’s height and weight used to scale chemotherapy doses, expressed in square metres (m²).

Hand‑foot syndrome (Palmar‑plantar erythrodysesthesia)

A dermatologic toxicity characterised by redness, swelling, and pain on the palms and soles, commonly caused by capecitabine and other fluoropyrimidines.

DPD deficiency

A genetic condition resulting in reduced activity of the enzyme dihydropyrimidine dehydrogenase, which metabolises 5‑fluorouracil. Deficiency predisposes patients to severe toxicity from capecitabine.

Thymidine phosphorylase

An enzyme that is over‑expressed in many tumour tissues and catalyses the final conversion of capecitabine to the active chemotherapeutic agent 5‑fluorouracil.

⚠️ Disclaimer

The information provided about Xeloda is for general knowledge only. It does not replace professional medical consultation. All treatment decisions should be made under the supervision of a qualified healthcare provider. We assume all readers are responsible adults capable of making informed decisions about their health. Our online pharmacy offers access to Xeloda for individuals who may have limited availability through traditional pharmacies, prescription‑based insurance schemes, or who are seeking affordable generic alternatives. Always consult your doctor before starting, changing, or discontinuing any medication.