capecitabine
Other Name: Xeloda®
In various strengths
For treating certain types of cancers such as coIon, rectum or breast. It can also be used for other cancers.
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Tell your health care team if you have or had significant medical condition(s), especially if you have or had:
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liver, heart or kidney problems,
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personal or family history of severe side effects with other drugs (especially a drug called fluorouracil),
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or any allergies.
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This drug contains a small amount of lactose. If you cannot tolerate lactose, talk to your health care team
Remember to:
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Tell your health care team about all of the other medications you are taking.
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Keep taking other medications that have been prescribed for you, unless you have been told not to by your health care team.
Your health care team may ask you to have a blood test to check for DPD deficiency before starting treatment. DPD deficiency is when you have low or no activity of an enzyme called DPD (dihydropyrimidine dehydrogenase). A deficiency can cause you to have severe side effects from capecitabine. See the Testing for people taking capecitabine or 5-fluorouracil (5-FU) pamphlet for more information.
Talk to your health care team about:
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How this treatment may affect your sexual health.
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How this treatment may affect your ability to have a baby, if this applies to you.
This treatment may harm an unborn baby. Tell your health care team if you or your partner are pregnant, become pregnant during treatment, or are breastfeeding.
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If there is any chance of pregnancy happening, you and your partner together must use 2 effective forms of birth control at the same time until at least 6 months after your last treatment dose. Talk to your health care team about which birth control options are best for you.
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Do not breastfeed while taking this drug and for 2 weeks after the last dose.
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Take this medication as directed by your doctor and pharmacist. Do not take it more often or for a longer time than your doctor ordered.
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You may need tablets of more than 1 strength to have the correct dose. Ensure you identify the tablets correctly to get the right dose.
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Capecitabine is usually taken by mouth twice a day, about 12 hours apart.
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Swallow tablets whole with a glass of water, within 30 minutes after a meal (breakfast and dinner). Do not crush or chew the tablets.
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If you miss a dose, skip this and take your next dose as usual. Do not take an extra dose to make up for a missed dose.
To help prevent Hand-foot syndrome:
Hand-foot syndrome is a side-effect of capecitabine. It affects the skin on your hands and the bottom of your feet and usually starts with tingling or swelling of your skin. It can become painful, red and numb. In worse cases, your skin may start to peel and you can get blisters or sores.
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Do not do activities that cause rubbing or pressure on your skin, like heavy-duty washing, gripping tools, typing, playing musical instruments, and driving.
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Moisturize your hands and feet often, especially in the skin folds.
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Wear loose, comfortable footwear and clothes.
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Rest and try to keep off your feet.
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Do not let your hands and feet get too hot.
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Will this medication interact with other medications or natural health products?
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This medication can interact with other medications, vitamins, foods and natural health products. Interactions can make the treatment not work as well or cause severe side effects.
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Tell your health care team about all of your:
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prescription and over-the-counter (non-prescription) medications and all other drugs, such as cannabis/marijuana (medical or recreational)
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natural health products such as vitamins, herbal teas, homeopathic medicines, and other supplements
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Check with your health care team before starting or stopping any of them.
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If you take seizure medications (such as phenytoin), your health care team may monitor your blood levels closely and may change your dose.
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If you are taking a blood thinner (such as warfarin), your health care team may need extra blood tests and may change your dose.
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What should I do if I feel unwell, have pain, a headache or a fever?
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Always check your temperature to see if you have a fever before taking any medications for fever or pain (such as acetaminophen (Tylenol®) or ibuprofen (Advil®)).
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Fever can be a sign of infection that may need treatment right away.
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If you take these medications before you check for fever, they may lower your temperature and you may not know you have an infection.
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How to check for fever:
Keep a digital (electronic) thermometer at home and take your temperature if you feel hot or unwell (for example, chills, headache, mild pain).
- You have a fever if your temperature taken in your mouth (oral temperature) is:
- 38.3°C (100.9°F) or higher at any time
OR
- 38.0°C (100.4°F) or higher for at least one hour.
- 38.3°C (100.9°F) or higher at any time
If you do have a fever:- Try to contact your health care team. If you are not able to talk to them for advice, you MUST get emergency medical help right away.
- Ask your health care team for the Fever pamphlet for more information.
If you do not have a fever but have mild symptoms such as headache or mild pain:
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Ask your health care team about the right medication for you. Acetaminophen (Tylenol®) is a safe choice for most people.
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Talk to your health care team before you start taking Ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or ASA (Aspirin®), as they may increase your chance of bleeding or interact with your cancer treatment.
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Talk to your health care team if you already take low dose aspirin for a medical condition (such as a heart problem). It may still be safe to take.
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What to DO while on this medication:
- DO check with your health care team before getting any vaccinations, surgery, dental work or other medical procedures.
What NOT to DO on this medication:
- DO NOT smoke or drink alcohol while on treatment without talking to your health care team first. Smoking and drinking can make side effects worse and make your treatment not work as well.
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Keep this medication in the original packaging at room temperature in a dry place, away from heat and light. Keep out of sight and reach of children and pets.
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Do not throw out any unused medications at home. Bring them to your pharmacy to be thrown away safely.
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How to safely touch oral anti-cancer medications
If you are a patient:
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Wash your hands before and after touching your oral anti-cancer medication.
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Swallow each pill whole. Do not crush or chew your pills.
If you are a caregiver:
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Wear nitrile or latex gloves when touching tablets, capsules or liquids.
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Wash your hands before putting on your gloves and after taking them off, even if your skin did not touch the oral anti-cancer medication.
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Throw out your gloves after each use. Do not re-use gloves.
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Do not touch oral anti-cancer medications if you are pregnant or breastfeeding.
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The following table lists side effects that you may have when getting capecitabine. The table is set up to list the most common side effects first and the least common last. It is unlikely that you will have all of the side effects listed and you may have some that are not listed.
Read over the side effect table so that you know what to look for and when to get help. Keep this paper during your treatment so that you can refer to it if you need to.
Very Common Side Effects (50 or more out of 100 people) | |
Side effects and what to do | When to contact health care team |
Rash on your hands and feet (hand-foot syndrome) (May be severe) What to look for?
What to do? To help prevent Hand-foot syndrome:
Also your health care team for the Hand-foot syndrome pamphlet for more information. |
Talk to your health care team if it does not improve or if it is severe |
Common Side Effects (25 to 49 out of 100 people) | |
Side effects and what to do | When to contact health care team |
Diarrhea (May be severe) What to look for?
What to do? If you have diarrhea:
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Talk to your health care team if no improvement after 24 hours of taking diarrhea medication or if severe (more than 7 times in one day) |
Nausea and vomiting What to look for?
What to do? To help prevent nausea:
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Talk to your health care team if nausea lasts more than 48 hours or vomiting lasts more than 24 hours or if severe |
Less Common Side Effects (10 to 24 out of 100 people) | |
Side effects and what to do | When to contact health care team |
Mouth sores What to look for?
To help prevent mouth sores:
Ask your health care team for the Oral Care (Mouth Care) pamphlet for more information. |
Talk to your health care team as soon as you notice mouth or lip sores or if it hurts to eat, drink or swallow |
Liver problems (May be severe) Your health care team may check your liver function with a blood test. The liver changes do not usually cause any symptoms.
If you have any symptoms of liver problems, get emergency medical help right away. |
Get emergency medical help right away |
Fatigue What to look for?
What to do?
Ask your health care team for the Fatigue pamphlet for more information. |
Talk to your health care team if it does not improve or if it is severe |
Pains or cramps in the belly What to look for?
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Talk to your health care team if it does not improve or if it is severe |
Other rare, but serious side effects are possible.
If you experience ANY of the following, speak to your cancer health care provider or get emergency medical help right away:
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Irregular heartbeat, shortness of breath, chest pain, fainting spells or swelling in your legs, ankles and belly
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Pain, swelling and hardening of a vein in an arm or leg
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Feeling confused, sudden loss of vision, trouble speaking, moving your arms or legs or problems with balancing yourself
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Severe belly pain, bloating or feeling of fullness and severe constipation
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Lower back pain, swelling, pee less than usual, unexpected weight gain
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Signs of an allergy such as fever, itchiness, rash, swollen lips, face or tongue, chest and throat tightness, usually shortly after taking the drug
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Eye problems such as dry eyes, redness, irritation, pain, tearing, sensitivity to light or blurred vision
Who do I contact if I have questions or need help?My cancer health care provider is: ________________________________________________ During the day I should contact:__________________________________________________ Evenings, weekends and holidays:________________________________________________
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Other Notes:
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April 2023 Updated information sheet
For more links on how to manage your symptoms go to www.cancercareontario.ca/symptoms.
The information set out in the medication information sheets, regimen information sheets, and symptom management information (for patients) contained in the Drug Formulary (the "Formulary") is intended to be used by health professionals and patients for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or side effects of a certain drug, nor should it be used to indicate that use of a particular drug is safe, appropriate or effective for a given condition.
A patient should always consult a healthcare provider if he/she has any questions regarding the information set out in the Formulary. The information in the Formulary is not intended to act as or replace medical advice and should not be relied upon in any such regard. All uses of the Formulary are subject to clinical judgment and actual prescribing patterns may not follow the information provided in the Formulary.