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Capecitabine
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A nucleoside metabolic inhibitor called capecitabine is prescribed to treat breast, colorectal, and colon cancer.

Other names for this medication:
Xeloda, Ecansya

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Leukeran, Ondansetron, Letrozole, Cyclophosphamide, Hydroxyurea, Femara, Cytoxan, Nolvadex, Chlorambucil, Hydrea, Zofran, Methotrexate

Description

When fluroprymidine monotherapy is preferred, patients with stage III colon cancer may receive capecitabine alone as adjuvant therapy after complete resection of the primary tumor. paclitaxel and an anthracycline-containing chemotherapy regimen are ineffective for treating patients with metastatic breast cancer. May also be combined with docetaxel to treat metastatic breast cancer in patients who have not responded to, or whose cancer has returned or progressed after anthracycline-containing chemotherapy. In advanced gastric cancer treatment, capecitabine is being studied in combination regimens.

Dosage

In patients with mild renal impairment, the dose of capecitabine must be decreased by 25%. To improve patient care, capecitabine dosage may need to be customized. Only a physician skilled in the use of anticancer medications should prescribe capecitabine. Example: A person whose body weight is 64 kg and height is 1.64 m has a body surface area of 1.7 m2 and should take 4 tablets of 500 mg and 1 tablet of 150 mg two times daily. Adjuvant therapy: Is advised for a total of 6 months (8 cycles) When used in conjunction with docetaxel, the recommended dose of capecitabine is 1250 mg/m2 twice daily orally for 2 weeks followed by a 7-day recovery period, along with docetaxel at 75 mg/m2 as a 1-hour IV infusion every 3 weeks. Tablets shouldn't be broken or crushed. As directed by the doctor, the tablets should be taken in the morning and evening. Breakfast and dinner should be consumed within 30 minutes of the end of a meal, and the tablets should be swallowed whole with water.

Missed dose

Never take two doses at once. If it's almost time for your next dose, skip the missed dose and take the medication as soon as you remember.

Overdose

However, seek immediate medical attention if an overdose is thought to have occurred. It is unlikely that an overdose will happen if capecitabine is given by a healthcare professional in a hospital setting. If you take too much capecitabine, call your doctor, the Poison Control Center in your area, or get immediate medical help if necessary.

Storage

Store below 30°C and keep in a dry location. Maintain a distance from children and shield from light.

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Side effects

If you experience any strange side effects while taking this medication, contact your doctor right away. Side effects from capecitabine are possible. The Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program is available online at http://www.fda.gov/Safety/MedWatch or by phone at 1-800-332-1088 if you or your doctor notice a serious side effect. Call your doctor right away if you experience any of the following symptoms or those mentioned in the IMPORTANT WARNING section: stomach pain or upset stomach constipation loss of appetite change in ability to taste food increased thirst unusual tiredness or weakness headache hair loss skin rash back, joint, or muscle pain red, swollen, itchy, or teary eyes trouble falling asleep or staying asleep diarrhea nausea vomiting sores in the mouth swelling, pain, redness, or pee Tell your doctor if any of these symptoms are severe or persistent, including: stomach pain or upset stomach constipation loss of appetite altered food taste increased thirst unusual tiredness or weakness headache hair loss skin rash back, joint, or muscle pain difficulty falling or staying asleep diarrhea nausea vomiting sores in the mouth swelling, pain, redness, or peeling of skin on the palms and soles of the feet

Interactions

In patients who are resistant to paclitaxel and a treatment plan containing anthracyclines as monotherapy. Adjuvant Colon Cancer: Patients with Dukes'C colon cancer. Capecitabine is a nucleoside metabolic inhibitor with antineoplastic activity. Following the failure of an earlier anthracycline-containing therapy, docetaxel should be added. When fluoropyrimidine therapy alone is preferred for treatment of metastatic colorectal cancer, it should be used as the first line of therapy.

Contraindications

Inform your doctor and pharmacist about all other prescription and over-the-counter drugs, vitamins, dietary supplements, and herbal products you are currently taking or intend to take, and ask for a list of the ingredients from your pharmacist. Be sure to mention the medications listed in the IMPORTANT WARNING section and any of the following: allopurinol (Aloprim, Lopurin, Zyloprim), leucovorin, and phenytoin (Dilantin). Inform your doctor and pharmacist if you have any allergies before taking capecitabine, fluorouracil (5-FU), other drugs, or any of the ingredients in capecitabine tablets. Tell your doctor if you are breastfeeding because capecitabine can harm the developing fetus. Talk to your doctor about whether testing for dihydropyrimidine dehydrogenase (DPD) enzyme deficiency (a lack of a naturally occurring enzyme in your body) should be done prior to starting capecitabine. Other medications may also interact with capecitabine, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list. If you've ever been told you lack the DPD enzyme or if you have, let your doctor know. During capecitabine therapy, breastfeeding is not recommended. While taking capecitabine, you should avoid planning a family. If you want to avoid getting pregnant while taking capecitabine for yourself or your partner, you should use a reliable birth control method. Your doctor might need to adjust your medication doses or keep a close eye out for any negative side effects. If you have or have ever had kidney, liver, or heart disease, or if you plan to become pregnant, let your doctor know. Your doctor may advise you not to take capecitabine.

What are side effects of capecitabine?

Nausea, vomiting, loss of appetite, constipation, tiredness, weakness, headache, dizziness, trouble sleeping, or changes in taste may occur. Nausea and vomiting can be severe. In some cases, your doctor may prescribe medication to prevent or relieve nausea and vomiting.

Is capecitabine a chemotherapy?

Capecitabine is a type of chemotherapy. It is used as a treatment for different types of cancer, including bowel cancer. You might have capecitabine on its own or with other chemotherapy drugs. You might also have it with radiotherapy.

How does capecitabine fight cancer?

The active substance in Xeloda, capecitabine, is a cytotoxic medicine (a medicine that kills rapidly dividing cells, such as cancer cells) that belongs to the group 'anti-metabolites'. Capecitabine is converted to the medicine fluorouracil in the body, but more is converted in tumour cells than in normal tissues.

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Testimonials
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chleboir Jan 1, 2010, 10:34:09 AM

DOSAGE FORMS & STRENGTHS • Oral granules: 10 gram packets Manufactured By: Wellstat Therapeutics Corporation • Prescribing Information URL: Click Here South Delhi Pharma can facilitate the supply of “VISTOGARD ® (uridine triacetate) oral granules” to all locations in India and other part of countries after fulfilling the legal requirement (if applicable). VISTOGARD® is a pyrimidine analog indicated for the emergency treatment of adult and pediatric patients: • • following a fluorouracil or capecitabine overdose regardless of the presence of symptoms, or • who exhibit early-onset, severe or life-threatening toxicity affecting the cardiac or central nervous system, and/or earlyonset, unusually severe adverse reactions (e.g., gastrointestinal toxicity and/or neutropenia) within 96 hours following the end of fluorouracil or capecitabine administration. VISTOGARD used for emergency treatment of adults and children.

olegzhirnjk Oct 3, 2017, 12:02:17 AM

Dose modifications for toxicity when capecitabine is used as a 3weekly cycle in combination with other medicinal products Dose modifications for toxicity when capecitabine is used as a 3 weekly cycle in combination with other medicinal products should be made according to Table 3 above for capecitabine and according to the appropriate summary of product characteristics for the other medicinal product(s). In patients with mild renal impairment (creatinine clearance 51-80 ml/min at baseline) no adjustment of the starting dose is recommended. For those toxicities considered by the treating physician to be unlikely to become serious or life-threatening, e.g.

Laurens van den Oever Apr 2, 2012, 11:15:36 PM

First of all, they can increase the sensitivity of tumor cells to the immunotherapy, for example, it has been shown that the tumor-cell surface receptor, mannose-6-phosphate (M6P) is upregulated by certain chemotherapies, thereby increasing the permeability of granzyme B (released by CTL) to tumor cells . Secondly, some chemotherapies such as docetaxel, paclitaxel and vinblastine promote tumor cell recognition through increasing calreticulin exposure, which in turn promotes tumor cell death. The dying tumor cells then release many tumor antigens for recognition . Finally, chemotherapies like doxorubicin, fluorouracil, gemcitabine, and cyclophosphamide are able to inhibit immunosuppressive cells like regulatory T cells and myeloid-derived suppressor cells – this enhances the activity of the cellular immunotherapy Studies have found that combining cellular immunotherapies with chemotherapies appears to have an additive or synergistic effect .

Nisha srivastava Dec 30, 2011, 11:47:37 PM

Capecitabine is an oral drug used alone or with other drugs to treat certain types of colorectal cancer and breast cancer. Going forward, I’m only going to talk about well-differentiated NETs as the established standard of care for Neuroendocrine Carcinoma (NEC), in terms of chemotherapy, is well documented in guidelines. However, I may update this post in due course with authoritative data on the use of CAPTEM for NEC. It is also being studied in the treatment of other types of cancer including in combination with a second drug.

David Lukac Jul 28, 2022, 10:14:26 PM

“Patients were randomly assigned to receive either lapatinib ditosylate 1,250 mg once daily on days 1-21 plus capecitabine 2,000 mg/m2/day on days 1-14 every 21 days, or to receive capecitabine alone at 2,500 mg/m2/day on days 1-14 every 21 days. Lapatinib ditosylate is an anti-cancer medication included in the category of kinase inhibitors and used as targeted therapy to treat patients with cancer. The median TTP [time-to-progression] based on the investigator assessment was 23.9 vs. 18.3 weeks for the lapatinib ditosylate combination and capecitabine alone arms, respectively,” explain the NCI about the first trial. Inês holds a PhD in Biomedical Sciences from the University of Lisbon, Portugal, where she specialized in blood vessel biology, blood stem cells, and cancer.

johnmcd Sep 25, 2019, 8:07:42 AM

In results presented during the 2021 Gastrointestinal Cancers Symposium, the trifluridine/tipiracil and bevacizumab arm had a median OS of 22.31 months (95% CI, 18.00-23.69) compared with 17.67 months (95% CI, 12.58-19.81) in the capecitabine and bevacizumab arm (HR, 0.78; 95% CI, 0.55-1.10). The primary end point was progression-free survival and secondary end points included OS, objective response rate (ORR), disease control rate (DCR), quality of life (QoL), and safety. The final analysis was conducted after the end of the study cutoff date of September 1, 2020.

Arnab Biswas Aug 16, 2010, 10:56:17 PM

Fractionated bilirubin and prothrombin time should also be collected during hepatotoxicity evaluation. Recommended Dose And Schedule Extended Adjuvant Treatment Of Early Stage Breast Cancer The recommended dose of Nerlynx is 240 mg (six tablets) given orally once daily, with food, continuously until disease recurrence or for up to one year. Nerlynx dose interruptions and dose reductions may also be required to manage diarrhea. No dose modifications are recommended for patients with mild to moderate hepatic impairment (Child Pugh A or B). Table 5: Dose Modifications of Nerlynx Monotherapy for Diarrhea Table 6: Dose Modifications of Nerlynx and Capecitabine for Diarrhea Dose Modifications For Hepatic Impairment Reduce the Nerlynx starting dose to 80 mg in patients with severe hepatic impairment (Child Pugh C).

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