Capecitabine

Other Names: Xeloda®

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About This Drug

Capecitabine is used to treat cancer. It is given orally (by mouth).

Possible Side Effects 

  • Decrease in red blood cells. This may make you feel more tired.
  • Nausea and throwing up (vomiting)
  • Pain in your abdomen
  • Diarrhea (loose bowel movements)
  • Tiredness and weakness
  • Increased total bilirubin in your blood. This may mean that you have changes in your liver function.
  • Hand-foot syndrome. The palms of your hands or soles of your feet may tingle, become numb, painful, swollen, or red. 

Note: Each of the side effects above was reported in 30% or greater of patients treated with capecitabine. Not all possible side effects are included above. 

Warnings and Precautions

  • Abnormal bleeding if you are taking blood thinners such as warfarin – symptoms may be coughing up blood, throwing up blood (may look like coffee grounds), red or black tarry bowel movements, abnormally heavy menstrual flow, nosebleeds or any other unusual bleeding.
  • Severe diarrhea
  • Changes in the tissue of the heart and/or heart attack. Some changes may happen that can cause your heart to have less ability to pump blood.
  • Increase risk of severe side effects if you have a known dihydropyrimidine dehydrogenase deficiency.
  • Dehydration (lack of water in the body from losing too much fluid), which may affect how your kidneys work which can be life-threatening.
  • Severe allergic skin reaction. You may develop blisters on your skin that are filled with fluid or a severe red rash all over your body that may be painful.
  • Decrease in the number of white blood cells, red blood cells, and platelets. This may raise your risk of infection, make you tired and weak (fatigue), and raise your risk of bleeding.
  • Patients greater than 80 years of age are at increased risk of severe and life-threatening side effects.
  • Changes in your liver function, which can cause liver failure.

Note: Some of the side effects above are very rare. If you have concerns and/or questions, please discuss them with your medical team. 

How to Take Your Medication

  • Swallow the medicine whole with water within 30 minutes after a meal. Do not break or crush it.
  • Missed dose: If you vomit or miss a dose, take your next dose at the regular time, and contact your doctor. Do not take 2 doses at the same time and do not double up on the next dose.
  • Handling: Wash your hands after handling your medicine, your caretakers should not handle your medicine with bare hands and should wear latex gloves.
  • This drug may be present in the saliva, tears, sweat, urine, stool, vomit, semen, and vaginal secretions. Talk to your doctor and/or your nurse about the necessary precautions to take during this time. 
  • Storage: Store this medicine in the original container at room temperature. Keep lid tightly closed.
  • Disposal of unused medicine: Do not flush any expired and/or unused medicine down the toilet or drain unless you are specifically instructed to do so on the medication label. Some facilities have take-back programs and/or other options. If you do not have a take-back program in your area, then please discuss with your nurse or your doctor how to dispose of unused medicine.

Important Instructions

  • Take the capecitabine tablets with food or within 30 minutes after the end of a meal.
  • Take this medicine with water. Swallow the tablets whole.
  • Missed dose: If you miss a dose of capecitabine, do not take the missed dose at all and do not double up on the next dose. Instead, go back to using your normal dosing schedule and contact your physician.

Treating Side Effects

  • Drink plenty of fluids (a minimum of eight glasses per day is recommended).
  • If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack of water in the body from losing too much fluid).
  • If you have diarrhea, eat low-fiber foods that are high in protein and calories and avoid foods that can irritate your digestive tracts or lead to cramping.
  • Ask your nurse or doctor about medicine that can lessen or stop your diarrhea.
  • To help with nausea and vomiting, eat small, frequent meals instead of three large meals a day. Choose foods and drinks that are at room temperature. Ask your nurse or doctor about other helpful tips and medicine that is available to help stop or lessen these symptoms.
  • Manage tiredness by pacing your activities for the day.
  • Be sure to include periods of rest between energy-draining activities.
  • To decrease the risk of infection, wash your hands regularly.
  • Avoid close contact with people who have a cold, the flu, or other infections.
  • Take your temperature as your doctor or nurse tells you, and whenever you feel like you may have a fever.
  • To help decrease the risk of bleeding, use a soft toothbrush. Check with your nurse before using dental floss.
  • Be very careful when using knives or tools.
  • Use an electric shaver instead of a razor.
  • Keeping your pain under control is important to your well-being. Please tell your doctor or nurse if you are experiencing pain.
  • Avoid sun exposure and apply sunscreen routinely when outdoors.
  • If you get a rash do not put anything on it unless your doctor or nurse says you may. Keep the area around the rash clean and dry. Ask your doctor for medicine if your rash bothers you. 

Food and Drug Interactions

  • There are no known interactions of capecitabine with food, however this medication should be taken within 30 minutes after a meal.
  • Check with your doctor or pharmacist about all other prescription medicines and over-the-counter medicines and dietary supplements (vitamins, minerals, herbs and others) you are taking before starting this medicine as there are known drug interactions with capecitabine. Also, check with your doctor or pharmacist before starting any new prescription or over-the-counter medicines, or dietary supplements to make sure that there are no interactions.
  • There are known interactions of capecitabine with blood thinning medicine such as warfarin. Ask your doctor what precautions you should take.

When to Call the Doctor

Call your doctor or nurse if you have any of these symptoms and/or any new or unusual symptoms: 

  • Fever of 100.4° F (38° C) or higher
  • Chills
  • Trouble breathing
  • Feeling that your heart is beating in a fast or not normal way (palpitations)
  • Pain in your chest
  • Chest pain or symptoms of a heart attack. Most heart attacks involve pain in the center of the chest that lasts more than a few minutes. The pain may go away and come back or it can be constant. It can feel like pressure, squeezing, fullness, or pain. Sometimes pain is felt in one or both arms, the back, neck, jaw, or stomach. If any of these symptoms last 2 minutes, call 911.
  • Tiredness that interferes with your daily activities
  • Feeling dizzy or lightheaded
  • Easy bleeding or bruising
  • Blood in your urine, vomit (bright red or coffee-ground) and/or stools (bright red, or black/tarry)
  • Coughing up blood
  • Decreased urine
  • Nausea that stops you from eating or drinking and/or is not relieved by prescribed medicines
  • Throwing up more than 3 times a day
  • Lasting loss of appetite or rapid weight loss of five pounds in a week
  • Diarrhea, 4 times in one day or diarrhea with lack of strength or a feeling of being dizzy
  • Pain that does not go away or is not relieved by prescribed medicines
  • Signs of possible liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired and weak, unusual itching, or yellowing of the eyes or skin
  • Painful, red, or swollen areas on your hands or feet.
  • Numbness and/or tingling of your hands and/or feet
  • A new rash or a rash that is not relieved by prescribed medicines
  • Flu-like symptoms: fever, headache, muscle and joint aches, and fatigue (low energy, feeling weak)
  • If you think you may be pregnant or may have impregnated your partner

Reproductive Warnings

  • Pregnancy warning: This drug can have harmful effects on the unborn baby. Women of childbearing potential should use effective methods of birth control during your cancer treatment and for 6 months after treatment. Men with female partners of child bearing potential should use effective methods of birth control during your cancer treatment and for 3 months after your cancer treatment. Let your doctor know right away if you think you may be pregnant or may have impregnated your partner.
  • Breastfeeding warning: Women should not breastfeed during treatment and for 2 weeks after treatment because this drug could enter the breast milk and cause harm to a breastfeeding baby.
  • Fertility warning: In men and women both, this drug may affect your ability to have children in the future. Talk with your doctor or nurse if you plan to have children. Ask for information on sperm or egg banking. 

Revised June 2019

This patient information was developed by Via Oncology, LLC © 2019. This information is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have. CLIENT acknowledges that the Via Pathways and Via Portal are information management tools only, and that Via Oncology, LLC has not represented the Via Pathways or Via Portal as having the ability to diagnose disease, prescribe treatment, or perform any other tasks that constitute the practice of medicine. The clinical information contained in the Via Pathways and Via Portal are intended as a supplement to, and not a substitute for, the knowledge, expertise, skill, and judgment of physicians, pharmacists and other healthcare professionals involved with patient care at CLIENT facilities.