Capecitabine

Capecitabine is used alone or in combination chemotherapy to treat colon cancer, breast cancer, or colorectal cancer.

It is also used to treat Esophageal, gastric, hepatobiliary, neuroendocrine, pancreatic, ovarian, fallopian tube, peritoneal or unknown primary cancers (off-label use)

Capecitabine is sometimes used when cancer has spread to other parts of the body (metastatic).

HOW CAPECITABINE IS GIVEN

• Taken as a pill by mouth.
• Take after food (within 30 minutes of a meal) with water. (Usually taken in a divided dose 12 hours apart).
• Tablets come in 2 sizes; 150mg and 500mg.
• Do not crush, chew or dissolve tablets.
• If you miss a dose, skip the missed dose and go back to your normal time. Do not take 2 doses at the same time or extra doses.

The amount of capecitabine that you will receive depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer or condition being treated. Your doctor will determine your dose and schedule.

SIDE EFFECTS

Get emergency medical help if you have signs of an allergic reaction (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).

Diarrhea may occur and could be severe. Stop taking capecitabine and tell your doctor right away if the number of bowel movements you usually have per day increases by four or more, or if you have bowel movements at night.

Stop using capecitabine and call your doctor at once if you have:

• severe diarrhea;
• bloody diarrhea with severe stomach pain and fever;
• severe nausea or loss of appetite that causes you to eat much less than usual;
• vomiting (more than once in 24 hours);
• fever above 100.5 degrees;
• sores or ulcers in your mouth, redness or swelling of your mouth or tongue, trouble eating or swallowing;
• jaundice (yellowing of the skin or eyes);
• dehydration symptoms- feeling very thirsty or hot, being unable to urinate, heavy sweating, or hot and dry skin;
• "hand and foot syndrome"- pain, tenderness, redness, swelling, blistering, or peeling skin on your hands or feet;
• heart problems- chest pain, irregular heartbeats, swelling in your lower legs, rapid weight gain, feeling lightheaded or short of breath; or
• low blood cell counts- fever, chills, tiredness, mouth sores, skin sores, easy bruising, unusual bleeding, pale skin, cold hands, and feet, feeling light-headed or short of breath.

Your cancer treatments may be delayed or permanently discontinued if you have certain side effects.

Common side effects may include:

• nausea, vomiting, diarrhea, stomach pain;
• feeling weak or tired;
• hand and foot syndrome; or
• jaundice.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

BEFORE TAKING THIS MEDICINE

You should not take capecitabine if you are allergic to capecitabine or fluorouracil, or if you have:

• severe kidney disease.

Tell your doctor if you have ever had:

• a metabolic disorder called DPD (dihydropyrimidine dehydrogenase) deficiency;
• liver or kidney disease;
• heart problems; or
• if you use a blood thinner and you have routine "INR" or prothrombin time tests.

Capecitabine can harm an unborn baby if the mother or the father is using this medicine.

• If you are a woman, you may need a pregnancy test to make sure you are not pregnant. Use birth control while using this medicine and for at least 6 months after your last dose.
• If you are a man, use birth control if your sex partner is able to get pregnant. Keep using birth control for at least 3 months after your last dose.
• Tell your doctor right away if a pregnancy occurs.

Pregnancy may be less likely to occur while the mother or the father is using this medicine. Both men and women should still use birth control to prevent pregnancy because the medicine can harm an unborn baby.

Do not breastfeed while using this medicine, and for at least 2 weeks after your last dose.

SELF-CARE TIPS

• Drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.
• You may be at risk of infection so try to avoid crowds or people with colds, and report fever or any other signs of infection immediately to your health care provider.
• Wash your hands often.
• To help treat/prevent mouth sores, use a soft toothbrush, and rinse three times a day with 1/2 to 1 teaspoon of baking soda and/or 1/2 to 1 teaspoon of salt mixed with 8 ounces of water.
• Use an electric razor and a soft toothbrush to minimize bleeding.
• Avoid contact sports or activities that could cause injury.
• To reduce nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals.
• Prevention of hand-foot syndrome. Modification of normal activities of daily living to reduce friction and heat exposure to hands and feet, as much as possible during treatment with capecitabine. (for more information see - Managing side effects: hand-foot syndrome).
• Keeps palms of hands and soles of feet moist using emollients such as Aveeno®, Udder cream, Lubriderm®, or Bag Balm®.
• Follow a regimen of anti-diarrhea medication as prescribed by your health care professional.
• Eat foods that may help reduce diarrhea.
• Avoid sun exposure. Wear SPF 30 (or higher) sunblock and protective clothing.
• You may experience drowsiness or dizziness; avoid driving or engaging in tasks that require alertness until your response to the drug is known.
• In general, drinking alcoholic beverages should be kept to a minimum or avoided completely. You should discuss this with your doctor.
• Get plenty of rest.
• Maintain good nutrition.
• If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems.