Capecitabine: Uses, Dosage, Side Effects and More

Introduction: What is Capecitabine?

Capecitabine is an oral chemotherapy medication primarily used to treat certain types of cancer, including breast and colorectal cancer. It is a prodrug, meaning it is converted into an active form in the body that helps to inhibit the growth of cancer cells. Capecitabine is often prescribed when other treatments have not been effective or when patients are unable to undergo intravenous chemotherapy.

Uses of Capecitabine

Capecitabine is approved for several medical uses, including:

1. Colorectal Cancer: It is commonly used in the treatment of metastatic colorectal cancer, either alone or in combination with other chemotherapy agents.
2. Breast Cancer: Capecitabine is also indicated for patients with metastatic breast cancer, particularly after other treatments have failed.
3. Gastric Cancer: In some cases, it may be used for advanced gastric cancer, often in combination with other medications.
4. Adjuvant Therapy: Capecitabine can be used as adjuvant therapy following surgery to reduce the risk of cancer recurrence.

How It Works

Capecitabine works by interfering with the cancer cell's ability to grow and divide. Once ingested, it is converted into 5-fluorouracil (5FU), a potent chemotherapy agent. 5FU disrupts the synthesis of DNA and RNA, which are essential for cell division. By targeting rapidly dividing cancer cells, Capecitabine helps to slow down or stop tumor growth.

Dosage and Administration

Capecitabine is typically administered in tablet form. The standard dosage for adults is usually based on body surface area and can range from 1,250 mg to 2,500 mg per day, divided into two doses taken with food. Treatment cycles often last for 14 days, followed by a rest period. Pediatric dosages are less common and should be determined by a healthcare provider based on individual needs.

Side Effects of Capecitabine

Like all medications, Capecitabine can cause side effects. Common side effects include:

• Nausea and vomiting
• Diarrhea
• Fatigue
• Hand-foot syndrome (redness, swelling, and pain on palms and soles)
• Loss of appetite

Serious side effects may include:

• Severe allergic reactions
• Liver problems (elevated liver enzymes)
• Heart problems (chest pain, irregular heartbeat)
• Infections due to low white blood cell counts

Patients should report any severe or unusual symptoms to their healthcare provider immediately.

Drug Interactions

Capecitabine can interact with several medications, which may affect its efficacy or increase the risk of side effects. Major drug interactions include:

• Warfarin: Increased risk of bleeding.
• Phenytoin: May affect seizure control.
• Leucovorin: Can enhance the effects of Capecitabine.
• Other chemotherapy agents: Caution is advised when used with other cytotoxic drugs.

Always inform your healthcare provider about all medications and supplements you are taking.

Benefits of Capecitabine

Capecitabine offers several clinical and practical advantages:

• Oral Administration: Unlike many chemotherapy drugs that require intravenous administration, Capecitabine is taken orally, making it more convenient for patients.
• Targeted Action: It specifically targets cancer cells while sparing normal cells to some extent, potentially leading to fewer side effects.
• Flexible Dosing: The dosing schedule can be adjusted based on individual patient needs and tolerability.

Contraindications of Capecitabine

Certain individuals should avoid Capecitabine, including:

• Pregnant or breastfeeding women: It can harm the fetus or nursing infant.
• Patients with severe liver disease: Capecitabine is metabolized in the liver, and impaired function can lead to increased toxicity.
• History of severe allergic reactions: Individuals with known hypersensitivity to Capecitabine or its components should not use it.

Precautions and Warnings

Before starting Capecitabine, patients should undergo certain lab tests to monitor liver function and blood cell counts. It is essential to inform healthcare providers about any existing health conditions, especially:

• Heart disease: Capecitabine can affect heart function.
• Kidney problems: Dosage adjustments may be necessary.
• Infections: Patients with active infections should be treated before starting chemotherapy.

FAQs

1. What should I do if I miss a dose of Capecitabine?
   If you miss a dose, take it as soon as you remember. If it's close to the next dose, skip the missed dose and continue with your regular schedule. Do not double up.
2. Can I take Capecitabine with food?
   Yes, Capecitabine should be taken with food to help reduce gastrointestinal side effects.
3. How long will I need to take Capecitabine?
   Treatment duration varies based on individual response and cancer type. Your doctor will determine the appropriate length of therapy.
4. Will Capecitabine affect my ability to work?
   Some patients experience fatigue and side effects that may impact their ability to work. Discuss your situation with your healthcare provider.
5. Is Capecitabine safe for older adults?
   Yes, but older adults may be more sensitive to side effects. Close monitoring is essential.
6. Can I drink alcohol while taking Capecitabine?
   It is advisable to limit alcohol consumption, as it can increase the risk of liver problems and other side effects.
7. What should I do if I experience severe side effects?
   Contact your healthcare provider immediately if you experience severe side effects, such as chest pain or signs of infection.
8. Can I get vaccinated while on Capecitabine?
   Consult your healthcare provider before receiving any vaccinations, as some may not be recommended during treatment.
9. Will Capecitabine affect my fertility?
   Capecitabine may affect fertility in both men and women. Discuss family planning with your doctor before starting treatment.
10. How can I manage side effects of Capecitabine?
    Your healthcare provider can recommend strategies to manage side effects, including medications for nausea or diarrhea.

Brand Names

Capecitabine is marketed under several brand names, including:

• Xeloda
• Capecitabine Teva
• Capecitabine Accord

Conclusion

Capecitabine is a vital medication in the fight against certain cancers, offering an effective oral treatment option for patients. Understanding its uses, side effects, and interactions is crucial for safe and effective treatment. Always consult with your healthcare provider for personalized advice and to ensure the best outcomes in your cancer treatment journey.