capecitabine


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Related to capecitabine: Oxaliplatin

capecitabine

 [kap″ĕ-si´tah-bēn]
an oral antimetabolite used in treatment of metastatic breast or colorectal carcinoma; administered orally.

capecitabine

Xeloda

Pharmacologic class: Fluoropyrimidine, antimetabolite (pyrimidine analog)

Therapeutic class: Antineoplastic

Pregnancy risk category D

FDA Box Warning

• In patients receiving concomitant oral coumarin-derivative anticoagulants (such as warfarin and phenprocoumon), monitor International Normalized Ratio (INR) or prothrombin time (PT) frequently to allow appropriate anticoagulant dosage adjustment. Altered coagulation parameters, bleeding, and death have occurred in patients taking this drug combination. Postmarketing reports show significant INR and PT increases in patients stabilized on anticoagulants when capecitabine therapy began. Age older than 60 and cancer diagnosis independently increase coagulopathy risk.

Action

Enzymatically converts to 5-fluorouracil, which injures cells by interfering with DNA synthesis, cell division, RNA processing, and protein synthesis

Availability

Tablets: 150 mg, 500 mg

Indications and dosages

Metastatic breast cancer resistant to both paclitaxel and a chemotherapy regimen that includes anthracycline; metastatic colorectal cancer when treatment with fluoropyrimidine therapy alone is preferred

Adults: Initially, 2,500 mg/m2/day P.O. in two divided doses for 2 weeks, followed by a 1-week rest period; administered in 3-week cycles

Dosage adjustment

• Renal impairment
• Hepatic impairment
• Elderly patients

Contraindications

• Hypersensitivity to drug
• Severe renal impairment
• Pregnancy or breastfeeding

Precautions

Use cautiously in:
• mild to moderate renal impairment, hepatic impairment, severe diarrhea, coronary artery disease, intestinal disease, infection, coagulopathy
• children younger than age 18.

Administration

• Give with water within 30 minutes after a meal.
• If dosage must be lowered because of toxicity, don't increase dosage later.

Adverse reactions

CNS: dizziness, fatigue, headache, insomnia, paresthesia

CV: edema

EENT: eye irritation

GI: nausea, vomiting, diarrhea, constipation, abdominal pain, dyspepsia, anorexia, stomatitis, intestinal obstruction

Hematologic: anemia, lymphopenia, neutropenia, thrombocytopenia

Metabolic: dehydration

Musculoskeletal: myalgia, limb pain

Skin: dermatitis, alopecia, nail disorder, hand and foot syndrome (palmarplantar erythrodysesthesia)

Other: fever

Interactions

Drug-drug.Antacids: increased capecitabine blood level

Leucovorin: increased cytotoxicity

Live-virus vaccines: impaired ability to mount an immune response to vaccine

Phenytoin: increased phenytoin blood level

Warfarin: increased risk of bleeding

Drug-diagnostic tests.Bilirubin: increased level

Hemoglobin, neutrophils, platelets, white blood cells: decreased levels

Patient monitoring

• Monitor patient for signs and symptoms of toxicity. Be prepared to reduce dosage or withhold drug when indicated.
• Stay alert for signs and symptoms of infection.
• Carefully assess fluid and electrolyte status if patient has severe diarrhea.
• Monitor weight, CBC, International Normalized Ratio, prothrombin time, and kidney and liver function test results.
• Evaluate closely for adverse reactions in patients older than age 80.

Patient teaching

• Advise patient to take drug with water within 30 minutes after a meal.

Instruct patient to immediately report nausea, vomiting, diarrhea, mouth ulcers, swollen joints, temperature above 100.5 °F (38 °C), and other signs or symptoms of infection.
• Tell patient to expect dosage adjustments during therapy.
• Urge patient to use reliable birth control method because drug may harm fetus if she becomes pregnant.
• Caution patient not to breastfeed during therapy.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.

capecitabine

(kap-e-sit'ă-bēn),
A prodrug converted to 5-fluorouracil.

capecitabine

/cap·e·ci·ta·bine/ (kap″ĕ-si´tah-bēn) an antineoplastic used in the treatment of metastatic breast or colorectal carcinoma.

capecitabine

(kăp′ə-sī′tə-bēn′)
n.
An antineoplastic drug that is converted into 5-fluorouracil in the body, used in the treatment of colorectal cancer and metastatic breast cancer.

capecitabine

an antineoplastic and antimetabolite.
indications It is used to treat metastatic colorectal and breast cancers.
contraindications Pregnancy and known hypersensitivity to 5-fluorouracil prohibit its use. It also should not be used in infants.
adverse effects Life-threatening effects include neutropenia, lymphopenia, thrombocytopenia, and myelosuppression. Other serious adverse effects include anemia, hyperbilirubinemia, and edema. Common side effects include nausea, vomiting, anorexia, diarrhea, and stomatitis.

capecitabine

An anticancer drug used especially in treatment of cancers of the rectum or colon that have been found to have spread. The drug is noticeably less liable to produce undesirable side effects than other forms of anticancer chemotherapy. It is also used in the treatment of breast cancer with some success. A brand name is Xeloda.
References in periodicals archive ?
The researchers - at the Cancer Research UK Edinburgh Centre and The Institute of Cancer Research in London - found that those patients taking capecitabine had fewer side effects and a better quality of life, and it was as effective at preventing cancer's return as CMF.
Capecitabine and trastuzumab have been widely used in advanced breast cancer treatments, Liu explained.
Study 301 was an open-label, randomized, two-parallel-arm, multicenter study designed to evaluate Halaven versus capecitabine in 1,102 women with locally advanced or metastatic breast cancer who had up to three prior chemotherapy regimens in the (neo)adjuvant setting, and no more than two prior regimens for locally advanced and/or metastatic disease.
In the trial, 1,608 patients with resectable stage II or III recta] cancer received neoadjuvant chemoradio-therapy consisting of radiation plus either capecitabine or fluorouracil, each with or without oxaliplatin.
The inclusion criteria were 1) pathologically confirmed recurrent or metastatic breast cancer; 2) Karnofsky performance status (KPS) score of 80-100 and expected survival time > 6 months; 3) detectable response evaluation criteria in solid tumors (RECIST) (17); 4) treated with a capecitabine combination chemotherapy; 5) good compliance with the prescribed medication and regular follow-up; 6) signed informed consent.
Some of the subjects received the standard drug protocol of capecitabine and lapatinib.
In this "all-oral" chemotherapy program, all patients receive capecitabine, and they are randomly assigned to receive tesetaxel or placebo.
Physicians are sorely in need of additional tools to protect organ transplant recipients from NMSC--and capecitabine could fill the bill, he said at the seminar.
Erlotinib in combination with capecitabine and docetaxel has been investigated in a small dose-escalation study.
Two new cancer treatments have been approved for NHS patients: capecitabine for advanced gastric cancer and gefitinib for metastatic non-small-cell lung cancer.
When used in combination with capecitabine, studies have shown that lapatinib improves time to disease progression by 43%.