Capecitabine

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Capecitabine Brand Name– Xeloda

What is Capecitabine

Capecitabine is a unique antineoplastic agent. It is an orally administered prodrug of 5′-deoxy-5-fluorouridine (5′-DFUR) which generates fluorouracil selectively in tumor cells.

Chemically, capecitabine is classified as a fluoropyrimidine carbamate. It was the first oral antineoplastic agent approved for the treatment of metastatic breast carcinoma.

In patients with metastatic breast cancer who were resistant to both paclitaxel and an anthracycline-containing chemotherapy regimen, a tumor response rate of about 25% has been observed.

However, no results are available from controlled trials in patients with breast cancer that demonstrate improvement in disease-related symptoms, disease progression, or survival.

Unlike many other antineoplastic agents, use of capecitabine has not been associated with alopecia, and myelosuppression is uncommon.

Capecitabine is FDA approved as monotherapy for the adjuvant treatment of colorectal cancer and for the treatment of metastatic colorectal cancer and metastatic breast cancer; it is FDA approved in combination with docetaxel for the treatment of metastatic breast cancer.

Indications

  1. biliary tract cancer
  2. breast cancer
  3. colorectal cancer
  4. gastric cancer
  5. ovarian cancer
  6. pancreatic cancer

For the treatment of metastatic breast cancer

for the treatment of metastatic breast cancer that is resistant to both paclitaxel and an anthracycline-containing chemotherapy regimen, or resistant to paclitaxel and for whom further anthracycline therapy is not indicated (e.g., patients who have received cumulative doses of 400 mg/m2 of doxorubicin or doxorubicin equivalent), as monotherapy

NOTE: Resistance is defined as progressive disease while on treatment regardless of an initial response or relapse within 6 months of treatment completion with an anthracycline-containing adjuvant regimen.

Side Effects

  1. abdominal pain
  2. agranulocytosis
  3. alopecia
  4. anemia
  5. angina
  6. anorexia
  7. arrhythmia exacerbation
  8. arthralgia
  9. ascites
  10. asthenia
  11. ataxia
  12. atrial fibrillation
  13. back pain
  14. bleeding
  15. bone pain
  16. bradycardia
  17. candidiasis
  18. cardiac arrest
  19. cardiomyopathy
  20. cardiotoxicity
  21. chest pain (unspecified)
  22. cholestasis
  23. coagulopathy
  24. confusion
  25. conjunctivitis
  26. constipation
  27. cough
  28. dehydration
  29. depression
  30. diarrhea
  31. dizziness
  32. dysarthria
  33. dysgeusia
  34. dyspepsia
  35. dyspepsia
  36. dysphagia
  37. dyspnea
  38. edema
  39. elevated hepatic enzymes
  40. encephalopathy
  41. enterocolitis
  42. epistaxis
  43. erythema
  44. esophageal ulceration
  45. fatigue
  46. fever
  47. flushing
  48. GI bleeding
  49. headache
  50. heart failure
  51. hemoptysis
  52. hepatic failure
  53. hepatitis
  54. hepatotoxicity
  55. hoarseness
  56. hot flashes
  57. hyperbilirubinemia
  58. hypercalcemia
  59. hyperhidrosis
  60. hypertension
  61. hypertriglyceridemia
  62. hypoalbuminemia
  63. hypocalcemia
  64. hypoesthesia
  65. hypokalemia
  66. hypomagnesemia
  67. hyponatremia
  68. hypophosphatemia
  69. hypotension
  70. ileus
  71. infection
  72. influenza
  73. insomnia
  74. irritability
  75. jaundice
  76. keratitis
  77. keratoconjunctivitis
  78. lacrimation
  79. laryngitis
  80. lethargy
  81. leukoencephalopathy
  82. leukopenia
  83. loss of consciousness
  84. lupus-like symptoms
  85. lymphopenia
  86. migraine
  87. myalgia
  88. myocardial infarction
  89. myocarditis
  90. nail discoloration
  91. nausea
  92. neurotoxicity
  93. neutropenia
  94. ocular irritation
  95. onycholysis
  96. palmar-plantar erythrodysesthesia (hand and foot syndrome)
  97. pancytopenia
  98. paresthesias
  99. peptic ulcer
  100. pericardial effusion
  101. peripheral neuropathy
  102. phlebitis
  103. photosensitivity
  104. pleural effusion
  105. polydipsia
  106. pruritus
  107. pulmonary embolism
  108. purpura
  109. radiation recall reaction
  110. rash
  111. renal failure (unspecified)
  112. rhinorrhea
  113. sinus tachycardia
  114. skin discoloration
  115. skin ulcer
  116. Stevens-Johnson syndrome
  117. stomatitis
  118. stroke
  119. supraventricular tachycardia (SVT)
  120. syncope
  121. thrombocytopenia
  122. thrombosis
  123. toxic epidermal necrolysis
  124. tremor
  125. typhlitis
  126. vertigo
  127. visual impairment
  128. vomiting
  129. weakness
  130. weight gain
  131. weight loss
  132. xerostomia

  • hepatic disease
  • herpes infection
  • infection
  • infertility
  • nausea/vomiting
  • pregnancy
  • pregnancy testing
  • radiation therapy
  • renal failure
  • renal impairment
  • reproductive risk
  • skin disease
  • varicella
  • viral infection

Interactions

  • Acetaminophen; Diphenhydramine
  • Allopurinol
  • Aluminum Hydroxide
  • Aluminum Hydroxide; Magnesium Carbonate
  • Aluminum Hydroxide; Magnesium Hydroxide
  • Aluminum Hydroxide; Magnesium Hydroxide; Simethicone
  • Aluminum Hydroxide; Magnesium Trisilicate
  • Amoxicillin; Clarithromycin; Lansoprazole
  • Amoxicillin; Clarithromycin; Omeprazole
  • Aspirin, ASA; Omeprazole
  • Calcium Carbonate; Magnesium Hydroxide
  • Carbetapentane; Diphenhydramine; Phenylephrine
  • Dexlansoprazole
  • Dextromethorphan; Diphenhydramine; Phenylephrine
  • Diclofenac
  • Diclofenac; Misoprostol
  • Diphenhydramine
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Diphenhydramine; Ibuprofen
  • Diphenhydramine; Naproxen
  • Diphenhydramine; Phenylephrine
  • Drospirenone; Ethinyl Estradiol; Levomefolate
  • Esomeprazole
  • Esomeprazole; Naproxen
  • Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
  • Famotidine; Ibuprofen
  • Folic Acid, Vitamin B9
  • food
  • Fosphenytoin
  • Hydrocodone; Ibuprofen
  • Ibuprofen
  • Ibuprofen; Oxycodone
  • Ibuprofen; Pseudoephedrine
  • Lansoprazole
  • Lansoprazole; Naproxen
  • Lesinurad; Allopurinol
  • Leucovorin
  • Levoleucovorin
  • Levomefolate
  • Magnesium Hydroxide
  • Meloxicam
  • Methadone
  • Nateglinide
  • Omeprazole
  • Omeprazole; Amoxicillin; Rifabutin
  • Omeprazole; Sodium Bicarbonate
  • Palifermin
  • Pantoprazole
  • Penicillamine
  • Phenytoin
  • Proton pump inhibitors
  • Rabeprazole
  • Torsemide
  • Tuberculin Purified Protein Derivative, PPD
  • Warfarin

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