Capecitabine

Indications
 Oral
Breast cancer
Adult: 1.25 g/m2 bid for 2 wk followed by a 1 wk rest period; therapy to be given in 3-wk cycles. Recommended treatment duration for colorectal cancer: 6 mth. May be used in combination with docetaxel at 75 mg/m2, given as a 1-hr IV infusion once every 3 wk for the treatment of breast cancer.
CrCl (ml/min)Dosage Recommendation
51-80No adjustment needed.
30-50Reduce dose to 950 mg/m2 bid when starting dose is 1.25 g/m2 bid. No dose adjustment is needed when starting dose is 1 g/m2.
<30Avoid use.

Oral
Colorectal cancer
Adult: 1.25 g/m2 bid for 2 wk followed by a 1 wk rest period; therapy to be given in 3-wk cycles. Recommended treatment duration for colorectal cancer: 6 mth. May be used in combination with docetaxel at 75 mg/m2, given as a 1-hr IV infusion once every 3 wk for the treatment of breast cancer.
CrCl (ml/min)Dosage Recommendation
51-80No adjustment needed.
30-50Reduce dose to 950 mg/m2 bid when starting dose is 1.25 g/m2 bid. No dose adjustment is needed when starting dose is 1 g/m2.
<30Avoid use.

Oral
Gastric cancer
Adult: Used in combination with a platinum-based compound, 1 g/m2 bid for 14 days, followed by a 7-day rest period. 1st dose is given on the evening of day 1 and the last dose on the morning of day 15.
CrCl (ml/min)Dosage Recommendation
51-80No adjustment needed.
30-50Reduce dose to 950 mg/m2 bid when starting dose is 1.25 g/m2 bid. No dose adjustment is needed when starting dose is 1 g/m2.
<30Avoid use.
Contraindications
 History of severe and unexpected reactions to fluoropyrimidine therapy; severe renal impairment; pregnancy, lactation. Hypersensitivity.
Warnings / Precautions
 Hepatic dysfunction, bone marrow suppression, poor nutritional status, warfarin therapy. Child, elderly, prior extensive pelvic radiation or alkylating therapy. Moderate renal impairment; CBC with differential; monitor hepatic and renal function. Discontinue use if intractable diarrhoea, stomatitis, bone marrow suppression or MI develops.
Adverse Reactions
 Diarrhoea, nausea and vomiting, stomatitis, palmar-plantar syndrome, dermatitis. Fatigue, mucosal inflammation, pyrexia, asthenia and lethargy; headache, dizziness and insomnia; lower limb oedema, anorexia, dehydration.
Potentially Fatal: Cardiotoxicity, bone-marrow depression and hyperbilirubinaemia.
Overdose Reactions
 Acute overdose may lead to nausea, vomiting, diarrhoea, GI irritation and bleeding, and bone marrow depression. Treatment includes supportive medical interventions aimed at correcting the presenting clinical manifestations.
Drug Interactions
 Antacids containing aluminum and magnesium, leucovorin, anticoagulants, phenytoin, allopurinol.
See Below for More capecitabine Drug Interactions
Lab Interactions
 Elevation in serum concentrations of alkaline phosphatase and hepatic aminotransferases.
Food Interactions
 Food reduces rate and absorption. Admin within 30 min after a meal.
Mechanism of Actions
 Capecitabine is a prodrug that is converted to fluorouracil following oral administration, which in turn inhibits thymidylate synthetase, blocking the methylation of deoxyuridylic acid to thymidylic acid, interfering with DNA, and to a lesser degree, RNA synthesis.
Administration
 Should be taken with food. (Take w/in ½ hr after meals.)
Storage Conditions
 Oral: Store at 25°C.
ATC Classification
 L01BC06 - capecitabine ; Belongs to the class of antimetabolites, pyrimidine analogues. Used in the treatment of cancer.
Storage
 Oral: Store at 25°C.
Available As
  • Capecitabine 150 mg
  • Capecitabine 250 mg
  • Capecitabine 500 mg

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