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Capecitabine, sold under the brand name Xeloda among others, is a chemotherapy medication used to treat breast cancer, gastric cancer and colorectal cancer.
Common side effects include abdominal pain, vomiting, diarrhea, weakness, and rashes.
Capecitabine was patented in 1992 and approved for medical use in 1998.
Contents
1 Medical uses
2 Adverse effects
2.1 Contraindications
2.2 Drug interactions
2.3 Pharmacogenetics
3 Mechanism of action
4 Society and culture
5 References
6 External links
Medical uses
It is used in the treatment of the following cancers:
Colorectal cancer (either as neoadjuvant therapy with radiation, adjuvant therapy or for metastatic cases)
Breast cancer (metastatic or as monotherapy/combotherapy; this is licensed as a second-line treatment in the UK)
Gastric cancer (off-label in the US; this is a licensed indication in the UK)
Oesophageal cancer (off-label in the US)
Adverse effects
Adverse effects by frequency:
Very common (>10% frequency)
Appetite loss
Diarrhea
Vomiting
Nausea
Stomatitis
Abdominal pain
Fatigue
Weakness
Hand-foot syndrome
Oedema
Fever
Pain
Headache
Hair loss
Dermatitis
Indigestion
Shortness of breath
Eye irritation
Myelosuppression
Notes on adverse effects:
^ Includes: anaemia, lymphopenia, neutropenia and thrombocytopenia
Contraindications
Contraindications include:
History of hypersensitivity to fluorouracil, capecitabine or any of its excipients
DPD deficiency (see Pharmacogenetics )
Pregnancy and lactation
Severe leucopenia, neutropenia, or thrombocytopenia
Severe hepatic impairment or severe renal impairment
Treatment with sorivudine or its chemically related analogues, such as brivudine
Drug interactions
Drugs it is known to interact with include:
Sorivudine or its analogues, such as, brivudine.
CYP2C9 substrates, including, warfarin and other coumarin-derivatives anticoagulants
Phenytoin, as it increases the plasma concentrations of phenytoin.
Calcium folinate may enhance the therapeutic effects of capecitabine by means of synergising with its metabolite, 5-FU. It may also induce more severe diarrhoea by means of this synergy.
Pharmacogenetics
The dihydropyrimidine dehydrogenase (DPD) enzyme is responsible for the detoxifying metabolism of fluoropyrimidines, a class of drugs that includes capecitabine, 5-fluorouracil and tegafur.
Mechanism of action
Click on genes, proteins and metabolites below to link to respective articles.
[[File:
|{{{bSize}}}px|alt=Fluorouracil (5-FU) Activity edit ]]
Fluorouracil (5-FU) Activity edit
^ The interactive pathway map can be edited at WikiPathways: “FluoropyrimidineActivity_WP1601”.
Capecitabine is metabolised to 5-FU which in turn is a thymidylate synthase inhibitor, hence inhibiting the synthesis of thymidine monophosphate (ThMP), the active form of thymidine which is required for the de novo synthesis of DNA.
Society and culture
One of the brandnames is Xeloda, marketed by Genentech.

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