Treatment Name: Capecitabine (Xeloda®)
Capecitabine (Xeloda®) is a Chemotherapy Regimen for Breast Cancer - metastatic
How does capecitabine work?
Capecitabine is designed to slow the growth of and kill breast cancer cells by preventing DNA synthesis inside cancer cells. Capecitabine may also prevent cancer cells from making certain proteins needed for their survival by interfering with RNA.
Goals of therapy:
Capecitabine is taken to shrink tumors and decrease symptoms of breast cancer. If breast cancer is early stage (cancer is limited to breast tissue or surrounding lymph nodes), capecitabine is commonly given with the goal of cure. If breast cancer is advanced or metastatic (cancer has spread to other areas of the body), capecitabine is not commonly given with the goal of cure, but rather to shrink breast tumors, and decrease symptoms from breast cancer.
- Usual starting dose: 3 - 5 tablets (depending upon your height, weight, and kidney function) by mouth twice daily for 14 days every 21 days
Capecitabine is usually taken at home. Several tablets will need to be taken with each dose to equal the total dose prescribed. The number of tablets will vary depending on the dose and strength of the tablets prescribed.
Click here for common starting doses
Capecitabine is taken every day, TWICE Daily, for 14 days then is NOT taken for 7 days. This is known as one Cycle. Each cycle is 21 days (3 weeks) and may be repeated until it no longer works or until unacceptable side effects are seen.
In clinical studies, the most commonly reported side effects with capecitabine are shown here. Side effects sometimes have percentage ranges [example 37 – 47%] because they differed between in clinical studies:
- Skin reaction on the palms of hands and soles of feet (37 - 47%)
- Nausea (33 - 44%)
- Fatigue (20 - 47%)
- Diarrhea (18 - 30%)
- Mouth sores (17%)
- Vomiting (13 - 16%)
- Shortness of breath (7 - 20%)
- Pain (9 - 17%)
- Low white blood cells (7 - 11%)
- Increased bleeding risk [low platelets] (3 - 5%)
- Anemia [low red blood cells] (3%)
How often is monitoring needed?
Labs (blood tests) may be checked before treatment (every 21 days), or periodically during treatment until stable. Labs often include: Complete Blood Count (CBC), Comprehensive Metabolic Panel (CMP), plus any others your doctor may order.
How often is imaging needed?
Imaging may be checked before treatment, periodically during treatment, and at the end of treatment. Imaging may include: computerized tomography (CT) scans or positron emission tomography (PET) scans.
How might blood test results/imaging affect treatment?
Depending upon the results, your doctor may advise to continue capecitabine as planned, or delay or switch therapy
- May cause painful redness, blistering, and peeling skin reaction on the palms of your hands and on the soles of your feet. This is known as Hand-Foot Syndrome. Ways to help reduce the risk of experiencing Hand-Foot Syndrome include using a non-alcoholic moisturizer daily on your hands and feet, avoid wearing gloves, avoid prolonged exposure to hot water, and avoid activities that put pressure or friction on your hands and feet such as golf or tennis while taking capecitabine
- Nausea and mouth sores may be more common in patients with kidney problems. Dose reductions may be necessary if your kidneys are not working well
- If an accidental overdose occurs, contact your doctor and go to the emergency room immediately. In severe cases, an antidote called uridine triacetate (Vistogard®) may be given to protect healthy cells and decrease side effects
- A pharmacist should ALWAYS review your medication list to ensure that drug interactions are prevented or managed appropriately
- Clinical trials may exist for breast cancer. Ask your doctor if any studies are currently enrolling in your area. If not, go to clinicaltrials.gov to search for other centers offering study medications
Patient Assistance & Co-payment Coverage
Patients under the age of 65 years, or those with private insurance plans:
If you have insurance and are looking for patient assistance or copay assistance for Capecitabine (Xeloda®), we have provided links that may help.
Visit our Patient Assistance page and click the links to various patient assistance programs for help paying for Capecitabine (Xeloda®). Depending upon your income, they may be able to help cover the cost of:
For Branded medications (may be available for generic medications too), check with the manufacturer to determine if a co-pay card is offered and if it could reduce your monthly copay.
- If you are uninsured, check with the manufacturer to determine if you are eligible to receive medication at no cost.
Medicare and Medicaid patients (Patients 65 years or older):
The clinic providing treatment will likely pre-authorize medications and immune therapies such as Capecitabine (Xeloda®) and are the best source to help you understand drug cost.
- Ask to speak with a patient assistance technician or financial counselor at the clinic or hospital administering this therapy.
What is Emotional Wellness?
Emotional wellness is having a positive outlook balanced with a realistic understanding of current life events. This requires both an awareness and acceptance of your emotions. It is with this knowledge that you can develop a plan to take the necessary actions to positively impact your life.
Emotional wellness uses an ongoing process to continually reflect on the stressors of life in a constructive manner to move forward and create happiness.
Because emotional wellness is deeply connected with physical, social, and spiritual wellness, pursuing it often becomes particularly difficult in times of major illness. Despite this difficulty, working toward emotional wellness has been connected to improved treatment outcomes and a higher likelihood of achieving goals of therapy.
Learn more about pursuing emotional wellness while receiving treatment with Capecitabine (Xeloda®)