Health Centres - Xeloda (capecitabine)
How does it work?
Xeloda tablets contain capecitabine, which is a type of chemotherapy medicine for cancer known as a 'cytotoxic antimetabolite'. It is taken by mouth and is converted inside cancer cells to 5-fluorouracil (5-FU), the active form of the medicine.
The conversion of capecitabine to 5-FU is carried out by several compounds within the body that are called enzymes. The enzyme responsible for the final step is found mostly in tumour tissues (although it is also found in other tissues in the body). This means that higher concentrations of the active 5-FU are produced within the tumour tissues, rather than other healthy areas of the body. The medicine is said to be 'targeted' against the cancerous cells.
Cancers form when cells within the body multiply abnormally and uncontrollably. These cells spread, destroying nearby tissues. 5-FU works by stopping the cancer cells from multiplying. It does this by inhibiting the production of the cells' genetic material, DNA and RNA. Both DNA and RNA are needed for growth and multiplication of cells. 5-FU causes a deficiency of DNA and RNA in the cancer cells, and this causes the cells to grow in an unbalanced way, resulting in the death of the cells.
5-FU can also affect normal, healthy cells, particularly those that multiply quickly, such as blood cells. However, because the capecitabine is mostly converted to 5-FU only in the cancer cells, it means that side effects on normal healthy cells are less with this medicine than with traditional 'non-targeted' 5-FU given via a drip.
The most important side effect is on the bone marrow where blood cells are made. 5-FU can decrease the production of blood cells, leaving people susceptible to infection. Regular blood tests are therefore needed to monitor levels of blood cells.
What is it used for?
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Cancer of the large bowel and rectum that has spread to other parts of the body (metastatic colorectal cancer).
- To improve survival following surgery for stage III colon cancer.
- Advanced stomach cancer (in combination with platinum-based chemotherapy).
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Breast cancer that is locally advanced or has spread to other areas of the body (metastatic breast cancer).
For breast cancer, capecitabine is used as second-line treatment when previous chemotherapy has been unsuccessful. It is used either in combination with another anti-cancer medicine called docetaxol, (when previous chemotherapy included an anthracycline medicine), or on its own (when previous chemotherapy included a taxane and an anthracycline, or where further anthracycline treatment is not indicated).
Warning!
- Xeloda tablets should be swallowed with water within 30 minutes after a meal.
- This medicine may cause fatigue and dizziness. You should take care when performing potentially hazardous activites, such as driving or operating machinery, until you know how this medicine affects you and are sure you can perform such activities safely.
- Chemotherapy medicines can decrease the number of blood cells in your blood. A low white blood cell count can increase your susceptibility to infections; a low red blood cell count causes anaemia and a low platelet count can cause problems with blood clotting. For this reason, you will need regular blood tests to monitor your blood cells during treatment with this medicine. Tell your doctor immediately if you experience any of the following symptoms during your treatment, as they may indicate problems with your blood cells: unexplained bruising or bleeding, purple spots, sore mouth or throat, mouth ulcers, high temperature (fever) or other signs of infection, or suddenly feeling tired, breathless, or generally unwell.
- Side effects from this medicine can become severe, so it is important that you always contact your doctor immediately if you start to experience a side effect. Your doctor may instruct you to decrease the dose and/or temporarily stop taking this medicine.
- Stop taking this medicine immediately and contact your doctor if any of the following symptoms occur: if you have an increase of more than 4 bowel movements compared to your normal bowel movements each day or any diarrhoea at night; if you vomit more than once in a 24-hour time period; if you lose your appetite, and the amount of food you eat each day is much less than usual; if you have pain, redness, swelling or sores in your mouth; if you have pain, swelling, and redness of your hands and/or feet; if you have a temperature of 38°C or greater or any other signs of infection; or if you get chest pain, especially if it occurs during exercise.
- This medicine may be harmful to an unborn child. Women who could get pregnant should use effective contraception to prevent pregnancy, and men should use effective contraception to prevent fathering a child, both during treatment, and for at least a few months after treatment is finished. Seek medical advice from your doctor.
- Your ability to get pregnant or father a child may be affected by treatment with this medicine. It is important to discuss fertility with your doctor before starting treatment.
- The safety and efficacy of this medicine in children and adolescents under 18 years of age has not been established.
Use with caution in
- Decreased kidney function.
- Decreased liver function.
-
Diabetes mellitus.
- Disease affecting the brain or nervous system.
- History of heart disease.
- History of angina.
- History of coronary artery disease.
- History of irregular heart beats (arrhythmias).
- Imbalance of salt concentrations in the blood (electrolyte imbalance).
- High levels of calcium in the blood (hypercalcaemia).
- Low levels of calcium in the blood (hypocalcaemia).
- People over 60 years of age.
- Severe diarrhoea.
- Hand-foot skin reaction (hand-foot syndrome).
Not to be used in
- Deficiency of an enzyme in the body called dihydropyrimidine dehydrogenase (DPD).
- Allergy to fluorouracil.
- History of severe and unexpected reactions to fluoropyrimidine therapy such as fluorouracil.
- Severely decreased kidney function.
- Severely decreased liver function.
-
Severely decreased number of platelets in the blood.
- Severely decreased number of white blood cells in the blood (leucopenia).
- Severely decreased numbers of a type of white blood cell (neutrophil) in the blood (neutropenia).
-
Pregnancy.
-
Breastfeeding.
- Rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption (Xeloda tablets contain lactose).
This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.
Pregnancy and breastfeeding
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
- This medicine should not be used during pregnancy as it may be harmful to the unborn baby. Women who could get pregnant should use effective contraception to prevent pregnancy, and men should use effective contraception to prevent fathering a child, both during treatment, and for at least a few months after treatment is finished. Seek medical advice from your doctor.
- It is not known if this medicine passes into breast milk. Mothers who need to take this medicine should not breastfeed. Seek medical advice from your doctor.
Label warnings
- Take this medication with or after food.
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