Capecitabine

Generic Name : Capecitabine

TradeName : Xeloda

Overview :
• Capecitabine is a drug that is used in the treatment of certain cancers
• Tecnically it is a prodrug, that is transformed into 5-fluorouracil, with the help of enzymes, within in the tumor
• It then slackens tumor growth by inhibiting DNA synthesis
• Available as 150 mg and 500 mg tablets of peach color

Why it is prescribed (Indications) :
• Given to patients with colorectal cancer that has spread (metastasis) to other parts of the body.
• Prescribed for patients who have undergone surgery for colon cancer.
• Also administered, along with Docetaxel, to patients with breast cancer, which has metastasized.

When it is not to be taken (Contraindications) :
• Not given to patients with hypersensitivity to Capecitabine or any of its compounds or 5-fluorouracil.
• Not ideal for patients with known Ddihydropyrimidine D dehydrogenase (DPD) deficiency.
• Not suitable administered for patients with renal impairment.

How it should be taken :
• The recommended dose of Capecitabine is 1250 mg/m2. This is administered orally twice a day,twelve hours apart for 2 weeks.This forms one cycle, after which the medication is stopped for a week (rest).This cycle of treatment may be repeated every three weeks.
• This treatment is usually in combination with Docetaxel
• The tablet is swallowed within 30 minutes after meal.
• Docetaxel is administered intravenously at a dose of 75 mg/m2 every 3 weeks.
• In patients with Colon Cancer, capecitabine is recommended for a total of 6 months, ie, 1250 mg/m2, twice a day orally, for 2 weeks followed by a one week rest period. This three week cycle is carried out for 24 weeks (8 cycles).

Special Instruction :
• Patients receiving capecitabine and oral coumarin-derivative anticoagulant such as warfarin and phenprocoumon should be monitored for their anticoagulant response. Altered coagulation parameters and/or bleeding have been observed in patients who receive concomitant capecitabine and anticoagulant therapy.
• Capecitabine has the ability to inhibit the functioning of the cytochrome enzyme CYP2C9 , therefore there is an elevation in the levels of the enzyme substrates, such as phenytoin
• The associated use of leucovorin may increase the efficacy as well as the toxicity of capecitabine

Side Effects :
Some of the side effects associated with Capecitabine are the following-

• Diarrhea, stomatis, nausea,
• Vomiting
• Abdominal pain,constipation
• Alopecia
• Rash, erythema
• Fatigue,dizziness
• Anorexia
• Conjuctivitis
• Neutropenia, anemia, thrombocytopenia
• Epistaxis
• Hyperbilirubinemia
• Hand-foot syndrome-(tingling sensation, numbness, sores in the soles of palm and feet)
• Myocardial infarction, Angina,(more common among those already suffering from heart diseases)

Other Precautions :
• Caution must be observed when administering Capecitabine to patients with a history of coronary heart disease such as as cardiotoxicity such as myocardial infarction/ischemia, angina, dysrhythmias, cardiac arrest, cardiac failure, sudden death, electrocardiographic changes, and cardiomyopathy have been observed.
• It is known to have a teratogenic effect, hence women planning to start a family should avoid becoming pregnant while being treated with Xeloda.
• It is recommended that lactating mothers discontinue nursing when receiving Capecitabine .

Storage Conditions :
• Store Capecitabine at room temperature (about 65° to 85°F).
• Protect from excess heat.
• Do not store in damp places.