How does this medication work? What will it do for me?

Capecitabine belongs to the group of cancer-fighting medications known as antineoplastics, and specifically to the group of antineoplastics known as antimetabolites. Capecitabine fights cancer by killing cancer cells and preventing their growth. Capecitabine may be used alone or in combination with other medications to treat certain types of breast cancer and colorectal cancer.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

150 mg 
Each light-peach-coloured, oblong, biconvex, film-coated tablet debossed with "150" on one side and plain on the other side, contains 150 mg of capecitabine. Nonmedicinal ingredients: croscarmellose sodium, lactose anhydrous, ferric oxide red, ferric oxide yellow, hypromellose, magnesium stearate, microcrystalline cellulose, talc, and titanium dioxide.

500 mg
Each peach-coloured, oblong, biconvex, film-coated tablet debossed with "500" on one side and plain on the other side, contains 500 mg of capecitabine. Nonmedicinal ingredients: croscarmellose sodium, lactose anhydrous, ferric oxide red, ferric oxide yellow, hypromellose, magnesium stearate, microcrystalline cellulose, talc, and titanium dioxide.

How should I use this medication?

The recommended dose of capecitabine varies according to body size. You may need to take a combination of 150 mg and 500 mg tablets. Capecitabine is normally given in 2 equal doses twice a day for 2 weeks followed by a rest period of one week. This cycle is repeated until treatment is complete, as assessed by your doctor.

Capecitabine tablets should be swallowed whole with water within 30 minutes after the end of a meal. Do not crush, chew, or cut the tablets.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important that you take this medication exactly as prescribed by your doctor. If you vomit shortly after taking capecitabine, contact your doctor for instruction on whether to take more medication or not. If you miss a dose of this medication, skip the missed dose and go back to your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature in its original container, protect it from excessive heat and direct light, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not take capecitabine if you:

  • are allergic to capecitabine, 5-fluorouracil, or any ingredients of the medication
  • are being treated or have been treated in the last 4 weeks with brivudine or sorivudine as part of herpes zoster (chickenpox or shingles) therapy
  • have dihydropyrimidine dehydrogenase (DPD) deficiency
  • have severely reduced kidney function

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • changed sense of taste
  • constipation
  • dizziness
  • eye irritation
  • hair loss
  • heartburn
  • indigestion
  • mild diarrhea
  • mild nausea or vomiting
  • muscle pain
  • nail changes or abnormalities
  • pins and needles sensation
  • tiredness or fatigue
  • trouble sleeping

Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • arm or leg pain
  • fever
  • headache
  • loss of appetite
  • mild blistering, peeling, redness, or swelling of palms of hands or bottoms of feet
  • mouth irritation, swelling, sores, or ulcer in mouth
  • numbness, pain, tingling, or other unusual sensations in palms of hands or bottoms of feet
  • signs of anemia (low red blood cells; e.g., dizziness, pale skin, unusual tiredness or weakness, shortness of breath)
  • signs of dehydration (e.g., decreased urine, dry skin, dry and sticky mouth, sleepiness, dizziness, headache, thirst, confusion)
  • signs of heart problems (e.g., chest pain, irregular heartbeat or rate, fainting, heart skipping a beat, shortness of breath, swelling ankles or legs, weakness)
  • signs of infection (e.g., fever, chills, sore throat, cough, painful urination)
  • signs of kidney problems (e.g., change in the amount or colour of urine, increased urination at night, blood in the urine, swelling in the feet or legs)
  • signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
  • symptoms of leukoencephalopathy (e.g., decreased coordination, confusion, seizures, vision loss, trouble thinking clearly, difficulty walking)
  • unusual bruising or bleeding (e.g., bleeding gums, blood in the urine, nosebleeds, cuts that take longer to stop bleeding)
  • unusual tiredness or weakness
  • vision changes

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • diarrhea – more than 4 episodes during the day or any episodes at night, or any diarrhea in combination with soreness of the mouth that affects your ability to drink enough fluids
  • seizures
  • severe skin reactions (e.g., redness, pain, swelling or blistering of lips, eyes or mouth, skin peeling, and flu-like symptoms)
  • signs of a severe allergic reaction (e.g., hives; difficulty breathing; swelling of the face, throat, or tongue)
  • vomiting (more than once in 24 hours), especially in combination with diarrhea

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication. 

Anemia: Capecitabine may cause low levels of red blood cells. If you experience symptoms of reduced red blood cell count (anemia) such as shortness of breath, feeling unusually tired or pale skin, contact your doctor as soon as possible.

Your doctor will do blood tests regularly to monitor the number of specific types of blood cells, including red blood cells, in your blood.

Birth control: People who could become pregnant must take steps to prevent pregnancy if either they or their partner is taking capecitabine. People taking capecitabine who could become pregnant should use effective birth control while taking the medication and for 6 months after the last dose. People taking capecitabine whose partners may become pregnant should use effective birth control for at least 3 months after taking the last dose.

Bleeding: Capecitabine may cause a reduced number of platelets in the blood, which can make it difficult to stop cuts from bleeding. If you notice any signs of bleeding, such as frequent nosebleeds, unexplained bruising, or black and tarry stools, notify your doctor as soon as possible. Your doctor will order routine blood tests to make sure potential problems are caught early.

Diarrhea or dehydration: This medication frequently causes diarrhea. If you develop diarrhea that occurs more than 4 times a day or at all during the night, contact your doctor. Your doctor will monitor you closely for dehydration. Severe dehydration can cause rapid loss of kidney function and is a medical emergency. If you experience any symptoms of severe dehydration (e.g., increased thirst, dry mouth), stop taking the medication and contact your doctor immediately.

Drowsiness/dizziness: Capecitabine may cause drowsiness or dizziness, affecting your ability to drive or operate machinery. Avoid driving, operating machinery, or performing other potentially hazardous tasks until you have determined how this medication affects you.

Hand and foot syndrome: This medication can cause hand and foot syndrome (numbness, redness, tingling, burning, or pain in the hands and feet; blistering or peeling of the hands and feet). If you experience any of these symptoms, contact your doctor. If the symptoms are severe and interfere with your ability to walk or do other daily activities, stop taking this medication and contact your doctor immediately.

Heart disease: People with a history of heart disease may be more likely to experience side effects that affect the heart when taking this medication. Stop using the medication and contact your doctor immediately if you experience symptoms such as abnormal heart rate, chest pain, and swelling of your extremities while taking this medication.

Infection: As well as killing cancer cells, capecitabine can reduce the number of cells that fight infection in the body (white blood cells). If possible, avoid contact with people with contagious infections. Tell your doctor immediately if you notice signs of an infection, such as fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness. Your doctor will do blood tests regularly to monitor the number of specific types of blood cells in your blood.

Kidney disease: If you have reduced kidney function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. People with moderately-to-severely reduced kidney function will need lower doses of this medication.

Liver function: If you have reduced liver function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Skin rash: In rare instances, people taking capecitabine experience a severe skin reaction that can be life-threatening. If you experience a rash that gets worse, or develops into blisters, sores on the lips or eyes, or covers a large area of the body, contact your doctor immediately.

Pregnancy: This medication may harm the baby if used during pregnancy. Both men and women should use effective birth control (e.g., condoms, birth control pill) during treatment. If you or your partner become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if capecitabine passes into breast milk. Because of the risks associated with this medication, people should not breast-feed while taking capecitabine and for 2 weeks after the final dose.

Children and adolescents: The safety and effectiveness of using this medication have not been established for children under 18 years of age.

Seniors: People over the age of 60 may be at an increased risk of side effects from this medication.

What other drugs could interact with this medication?

For a full list of interactions, use the Drug Interaction Checker available on the website.

If you are taking other medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

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