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Xeloda for Metastatic Breast Cancer

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Updated August 12, 2012

Xeloda 150

Xeloda 150

Photo © Gold Standard

What Is Xeloda (capecitabine):

Xeloda (capecitabine) is an oral chemotherapy drug, approved by the U.S. Food and Drug Administration in 1998 for the treatment of metastatic colorectal cancer, Dukes’ C colon cancer (with complete removal of the tumor), and metastatic breast cancer that has not responded to Taxol (paclitaxel) and anthracycline-containing chemotherapy such as Adriamycin.

Uses for Breast Cancer:

Xeloda can be given alone or with other drugs to treat metastatic breast cancer. If you have already been treated with paclitaxel and Adriamycin and had no response, you may take Xeloda by itself. If you have had no reponse from treatment with anthracyclines, you may take Xeloda along with Taxotere.

How Xeloda Works:

Once Xeloda is in your digestion, it combines with enzymes and changes into compounds that are then taken up by cancer cells where it might be activated into the drug 5-fluorouracil (5-FU).

How Xeloda Is Given:

Xeloda is given as 150mg and 500mg peach-colored oblong tablets, by prescription only. Once your doctor decides on the dosage that you need, you will take it twice a day, once in the morning and again in the evening, for a two-week period. You will then take a one-week break from Xeloda, after which you go back to taking it for two weeks. Xeloda should be taken with water, on a full stomach, about half an hour after a meal.

Some Common Side Effects:

  • Diarrhea
  • Nausea
  • Vomiting
  • Oral mucositis (sores in your mouth, tongue, and throat)
  • Stomach pain
  • Low appetite, eating little
  • Anemia
  • Dehydration
  • Skin rash or dry, itchy skin
  • Dizziness
  • Fatigue
  • Headache
  • Swelling of the feet, ankles or hands (hand and foot syndrome)
  • Neuropathy (tingling of fingers and toes)

Side Effects If Taken With Taxotere:

The side effects of Xeloda may be different if you are taking it along with Taxotere or other chemotherapy drugs. Be sure to report all of your side effects to your doctor. Note the dates and times they occur, and rank the severity of each symptom (say, from 1 to 10).

Call Your Doctor And Stop Taking Xeloda Immediately if You Have These Symptoms:

  • Severe diarrhea (4 or more bowel movements a day, or night-time diarrhea)
  • Severe vomiting (2-5 times or more in a day)
  • Painful sores in your mouth and tongue
  • Fever - contact your doctor if you have a fever of 100.5°F or higher

Possible Risks of Using Xeloda:

  • If you use coumadin or warfarin blood thinning medications, Xeloda can cause your blood to thin more, and puts you in danger of extensive bleeding. Tell your doctor if you take any coumarin-derived blood thinner. You may need to take a lower dose of Xeloda.
  • If you are 80 years old or older, Xeloda may cause more diarrhea, nausea, and vomiting than patients under 80 will experience.

Do Not Take Xeloda If:

  • You are allergic to 5-fluorouracil (5-FU)
  • You have kidney or liver problems
  • You are breastfeeding, because Xeloda can seep into breast milk, and may harm the baby
  • You are pregnant, because Xeloda can harm your fetus
  • About 1 in 20 people have specific liver metabolism enzymes that lead to slower breakdown of the drug. These people can have severe side effects like severe diarrhea and extensive palmar-plantar erythrodesesthesia (sores on palms and feet). These people should not take Xeloda.

Recommendations During Treatment:

  • Do not become pregnant while taking Xeloda, and use contraception.
  • If you are taking coumadin or warfarin blood thinners, you must have your anticoagulant response checked regularly. Xeloda can increase the effectiveness of blood thinners, and if you get a cut or bruise, you may suffer extensive bleeding.
Self-Care Tips While Taking Xeloda:
  • Men and women should use contraception while taking Xeloda, because this drug can pass into an unborn child and cause it harm.
  • Stay well-hydrated by drinking two or three quarts of fluids every 24 hours.
  • If you are neutropenic, avoid crowds, and wash your hands often, to help prevent infections.
  • Use a soft toothbrush if you are having mouth or tongue sores.
  • To avoid bleeding, use an electric razor.
  • Eat small meals throughout the day to help avoid nausea.
  • Use moisturizers to soothe dry, itchy skin on hands and feet.
  • Avoid sun exposure and use sunblock (SPF 15 or higher) if you spend much time outside.
  • Avoid drinking alcohol, which dries your tissues.
  • If needed, take your anti-nausea medications as directed.
  • Some patients experience dizziness and drowsiness, so take it easy until these symptoms subside.
  • Rest as much as you can.
  • Eat a good, nutritious diet.
Source: FDA. Patient Information Sheet. Capecitabine (marketed as Xeloda).Approved: April 30, 1998
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