Generic Name

Capecitabine

Precaution

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.

Indication

Breast cancer, Colorectal cancer, Gastric cancer, Oesophageal cancer

Contra Indication

History of severe and unexpected reactions to fluoropyrimidine therapy; severe renal impairment; pregnancy, lactation. Hypersensitivity.

Dose

N/A

Side Effect

10% Diarrhea,Nausea,Anemia,Lymphopenia,Hand and foot syndrome,Edema,Fatigue,Fever,Headache,Pain,Paresthesia,Alopecia,Dermatitis,Abdominal pain,Anorexia,Appetite decreased,Constipation,Dyspepsia,Stomatitis,Vomiting,Neutropenia,Thrombocytopenia,Dyspnea,Bilirubin increased,Eye irritation 1-10% Chest pain,Dermatitis,Pruritus,Rash,Dizziness,Headache,Weakness,Dehydration,Dry mouth,Dyspepsia,Taste disturbance,Back pain Potentially Fatal: Cardiotoxicity, bone-marrow depression and hyperbilirubinaemia.

Pregnancy Category

Mode of Action

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.

Interaction

Antacids containing aluminum and magnesium, leucovorin, anticoagulants, phenytoin, allopurinol.

Pregnancy Category Note

Pregnancy Category: C Lactation: excretion in milk unknown; use with caution

Adult Dose

Oral Breast cancer; 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. 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.

Child Dose

N/A

Renal Dose

Renal impairment: CrCl (ml/min) 51-80 No adjustment needed. 30-50 Reduce 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. <30 Avoid use.

Administration

Swallow with water within 30 min after a meal