WARNING

Capecitabine is an oral chemotherapy drug used to treat various cancers, including breast, colorectal, and gastric cancers. While it can be effective, there are several risks and potential side effects associated with taking Capecitabine:

• Bone marrow suppression: Capecitabine can reduce the production of blood cells by the bone marrow, leading to anemia, neutropenia (low white blood cell count), and thrombocytopenia (low platelet count). This can increase the risk of infections, bleeding, and fatigue.
• Hand-foot syndrome: This is a common side effect where the palms of the hands and soles of the feet become red, swollen, and painful. It can affect daily activities and may require dose adjustments or treatment interruptions.
• Diarrhea: Capecitabine can cause diarrhea, which can sometimes be severe and lead to dehydration if not managed properly.
• Nausea and vomiting: These are common side effects, although they are usually mild to moderate and can be managed with anti-nausea medications.
• Fatigue: Many patients experience fatigue, which can impact daily activities and quality of life.
• Liver problems: Capecitabine can affect liver function, leading to elevated liver enzymes and, rarely, more serious liver damage.
• Cardiotoxicity: There is a risk of heart problems, including chest pain, heart palpitations, and in rare cases, heart attack or heart failure.
• Increased risk of infections: Due to bone marrow suppression, patients taking Capecitabine are more susceptible to infections.
• Allergic reactions: Some individuals may experience allergic reactions ranging from mild rash to more severe reactions.
• Increased risk of blood clots: Capecitabine may increase the risk of blood clots, which can lead to serious conditions such as deep vein thrombosis or pulmonary embolism.

It’s important for patients taking Capecitabine to be closely monitored by their healthcare team for these potential side effects and to report any symptoms promptly. Dose adjustments or changes in treatment regimen may be necessary to manage these risks effectively.

Why is this medication prescribed?

Capecitabine is a medication prescribed primarily for the treatment of certain types of cancers, including breast, colorectal, and gastric cancers. It belongs to a class of medications known as antimetabolites. Capecitabine is often used when other treatments have not been effective or are not suitable for the patient.

How should this medicine be used?

Here’s how Capecitabine is typically used:

• Dosage: The dosage of Capecitabine is individualized based on factors such as the type of cancer being treated, your body weight, overall health, and other medications you may be taking. It is typically taken orally in the form of tablets.
• Schedule: Capecitabine is usually taken twice daily (morning and evening) for a specific number of days followed by a rest period. This cycle typically lasts for 2 weeks (14 days) followed by a 1-week rest period. This 21-day cycle may vary based on your specific treatment plan.
• Administration: Take Capecitabine with water within 30 minutes after a meal (preferably within 10 minutes after eating). This helps to ensure optimal absorption and reduce the risk of gastrointestinal side effects like nausea and vomiting.
• Adherence: It is essential to take Capecitabine exactly as prescribed by your healthcare provider. Do not adjust the dosage or stop taking the medication without consulting your doctor first.
• Monitoring: Throughout treatment, your healthcare team will monitor your response to Capecitabine with regular blood tests and medical check-ups. This helps to assess its effectiveness and manage any potential side effects promptly.
• Side Effects Management: Be aware of potential side effects such as diarrhea, hand-foot syndrome, fatigue, and others mentioned earlier. Promptly report any side effects to your healthcare provider for appropriate management.
• Sun Protection: Capecitabine can increase sensitivity to sunlight, so use sunscreen with a high SPF and wear protective clothing when outdoors to prevent sunburn and skin damage.
• Pregnancy and Breastfeeding: Capecitabine can harm an unborn baby, so it should not be used during pregnancy. Adequate contraception should be used during treatment and for some time after treatment ends. It is also not recommended while breastfeeding.

By following your doctor’s instructions carefully and maintaining open communication with your healthcare team, you can maximize the benefits of Capecitabine while managing potential side effects effectively.

Other uses for this medicine

• Pancreatic Cancer: Capecitabine may be used in combination with other chemotherapy drugs to treat pancreatic cancer.
• Other Solid Tumor Cancers: There may be instances where Capecitabine is considered for the treatment of other types of solid tumor cancers, depending on individual patient factors and treatment protocols.

What special precautions should I follow?

Special Precautions for Capecitabine:

• Monitoring: Regular blood tests are necessary to monitor blood cell counts, liver function, and kidney function due to the potential for bone marrow suppression and liver toxicity.
• Hand-Foot Syndrome: Patients should be aware of the symptoms of hand-foot syndrome (redness, swelling, pain on palms and soles) and report them promptly to their healthcare provider.
• Diarrhea: Management of diarrhea is important to prevent dehydration and ensure proper nutrition. Patients may need anti-diarrheal medications or adjustments to their diet.
• Cardiotoxicity: Capecitabine can affect heart function, so monitoring for symptoms like chest pain, irregular heartbeat, or shortness of breath is crucial.
• Pregnancy and Breastfeeding: Capecitabine can harm the unborn baby and should not be used during pregnancy. It is also not recommended while breastfeeding.
• Drug Interactions: Capecitabine can interact with other medications, so it’s essential to inform healthcare providers about all medications, vitamins, and supplements being taken.
• Allergic Reactions: Allergic reactions to Capecitabine are possible. Patients should report any signs of allergic reactions, such as rash, itching, swelling, dizziness, or difficulty breathing, immediately.
• Liver and Kidney Function: Capecitabine may require dose adjustments in patients with impaired liver or kidney function to minimize the risk of toxicity.
• Sun Sensitivity: Capecitabine can increase sensitivity to sunlight, leading to sunburn or skin rash. Sun protection measures, such as sunscreen and protective clothing, are recommended.
• Neurological Effects: Although rare, Capecitabine can cause neurological side effects such as confusion or dizziness. Patients should report any unusual neurological symptoms to their doctor.

Overall, adherence to prescribed dosages and regular communication with healthcare providers are crucial for managing the risks associated with Capecitabine and maximizing its effectiveness in treating cancer.

What special dietary instructions should I follow?

• Balanced Diet: Maintain a well-balanced diet rich in fruits, vegetables, whole grains, and lean proteins to support your overall health and immune function.
• Hydration: Drink plenty of fluids to stay hydrated, especially if you experience diarrhea or other gastrointestinal side effects.
• Avoid Alcohol: Limit or avoid alcohol consumption as it may increase the risk of liver toxicity when combined with Capecitabine.

What should I do if I forget a dose?

• Take It as Soon as You Remember: If you forget to take a dose, take it as soon as you remember, unless it is almost time for your next scheduled dose.
• Do Not Double Up: Do not take a double dose to make up for a missed dose. Instead, resume your regular dosing schedule.
• Consult Your Doctor: If you are unsure about what to do, or if you have missed multiple doses, contact your healthcare provider for guidance.

What side effects can this medication cause?

Capecitabine, like all chemotherapy drugs, can cause a range of side effects. These can vary in severity from mild to severe, and their occurrence may differ from person to person. Some common side effects of Capecitabine include:

• Gastrointestinal Effects: Diarrhea: This is a common side effect and can range from mild to severe. It’s important to stay hydrated and manage diarrhea promptly to prevent complications. Nausea and vomiting: These symptoms can occur but are often manageable with anti-nausea medications.
• Hand-Foot Syndrome: Palmar-plantar erythrodysesthesia (hand-foot syndrome): This condition causes redness, swelling, and pain on the palms of the hands and soles of the feet. It can affect daily activities and may require dose adjustments or interventions.
• Fatigue: Feeling tired or weak is common with Capecitabine treatment. Adequate rest and moderate physical activity can help manage fatigue.
• Loss of Appetite: Some people may experience a decreased appetite while taking Capecitabine. Eating smaller, more frequent meals and choosing nutritious foods can help maintain energy levels.
• Hair Loss: Capecitabine can cause thinning or loss of hair, although this is usually mild compared to some other chemotherapy drugs.
• Skin Reactions: Mild skin reactions such as dryness, itching, or rash can occur. More severe reactions are less common but can include dermatitis or allergic skin reactions.
• Bone Marrow Suppression: Capecitabine can suppress bone marrow function, leading to decreased production of blood cells. This can result in anemia (low red blood cells), neutropenia (low white blood cells), and thrombocytopenia (low platelets), increasing the risk of infections, bleeding, and fatigue.
• Liver Toxicity: Capecitabine can affect liver function, causing elevated liver enzymes. Regular monitoring of liver function is necessary during treatment.
• Cardiotoxicity: Rarely, Capecitabine can affect heart function, leading to symptoms such as chest pain, palpitations, or shortness of breath.
• Neurological Effects: Some patients may experience neurological side effects such as headache, dizziness, or tingling sensations.
• Other Rare Side Effects: Less common side effects may include eye irritation, changes in taste, and mood changes.

It’s important for patients receiving Capecitabine to communicate any side effects to their healthcare team promptly. Many side effects can be managed with supportive care, dose adjustments, or medications to improve quality of life during treatment.

What should I know about storage and disposal of this medication?

Storage of Capecitabine:

• Temperature: Store Capecitabine tablets at room temperature, between 20-25°C (68-77°F).
• Moisture and Light: Keep the medication in its original packaging to protect it from moisture and light.
• Child Safety: Store Capecitabine out of reach of children and pets, preferably in a locked cabinet or high shelf.

Disposal of Capecitabine:

• Unused Medication: Dispose of any unused Capecitabine tablets according to local guidelines or through a medication take-back program.
• Do Not Flush: Do not flush Capecitabine down the toilet or pour it into a drain unless instructed to do so by healthcare professionals or local disposal guidelines.

In case of emergency/overdose

• Symptoms: In case of overdose or accidental ingestion of a higher-than-prescribed dose, symptoms may include severe diarrhea, vomiting, nausea, and possibly increased severity of other side effects.
• Seek Immediate Medical Attention: If you suspect an overdose or experience severe symptoms, contact emergency medical services (911 in the US and Canada) or a poison control center immediately.

What other information should I know?

• Regular Monitoring: Regular blood tests and medical check-ups are necessary during Capecitabine treatment to monitor blood cell counts, liver function, and overall health.
• Sun Protection: Capecitabine can increase sensitivity to sunlight. Use sunscreen with a high SPF and wear protective clothing when outdoors to reduce the risk of sunburn and skin damage.
• Pregnancy and Breastfeeding: Capecitabine can harm an unborn baby, so it should not be used during pregnancy. It is also not recommended while breastfeeding. Adequate contraception should be used during treatment and for some time after treatment ends.
• Drug Interactions: Inform healthcare providers about all medications, vitamins, and supplements you are taking, as Capecitabine can interact with other drugs.
• Patient Support: Seek support from healthcare professionals or support groups if you have questions or concerns about your treatment with Capecitabine. They can provide guidance and resources to help manage side effects and optimize treatment outcomes.

By following these guidelines for storage, disposal, emergency procedures, and other relevant information, you can help ensure the safe and effective use of Capecitabine as part of your cancer treatment regimen.