Capecitabine (Xeloda ®)
Capecitabine is a chemotherapy drug used to treat different cancers, including breast, colon, rectal, stomach, oesophageal and pancreatic cancers.
This information should ideally be read with our general information about chemotherapy and the type of cancer you have.
How capecitabine is givenBack to top
You usually have capecitabine as an outpatient. During treatment, you usually see a cancer doctor, a chemotherapy nurse or a specialist nurse. This is who we mean when we mention doctor or nurse in this information.
Before or on the day of treatment, a nurse or a person trained to take blood (phlebotomist) will take a blood sample from you. This is to check that it is okay for you to have chemotherapy.
You will also see a doctor or nurse before you have chemotherapy. They will ask you how you have been feeling. If your blood results are alright on the day of your treatment, the pharmacist will prepare your chemotherapy. Your nurse will tell you when your treatment is likely to be ready.
Taking your capecitabine tablets
Capecitabine is taken as tablets. The nurse or pharmacist gives you the capecitabine tablets to take when you are at home. Always take your tablets exactly as explained. This is important to make sure they work as well as possible for you. They will also give you anti-sickness drugs to take.
You take capecitabine tablets twice a day. Swallow them whole with a glass of water within half an hour after eating a meal. This is because capecitabine works best if it's broken down in the stomach with food. Take the tablets in the morning after breakfast and then after your evening meal. The doses should be spaced 10–12 hours apart.
If you find it difficult to swallow the tablets, tell your doctor. They may suggest that you dissolve the capecitabine tablets in water. In this case, dissolve the tablets in a 200ml glass of warm water, stir with a spoon until the tablets are completely dissolved and then drink it immediately. You should wash and keep the glass and spoon separate from your other crockery and cooking utensils.
If you are sick just after taking the tablets, contact the hospital. You may need to take another dose. If you forget to take a tablet, do not take a double dose. Keep to your regular schedule and let your doctor or nurse know.
Here are some other things to remember about your tablets:
- Keep them in the original package at room temperature and away from heat and direct sunlight.
- Keep them safe and out of children’s reach.
- If your treatment is stopped, return any remaining tablets to the pharmacist.
Your course of chemotherapy
You usually have capecitabine as a course of several sessions (cycles) of treatment over a few months. A cycle of capecitabine often takes 21 days. You take the tablets for days 1–14 of each cycle. However, this can vary depending on the type of cancer you have. It is important to take the tablets as directed by your doctor, nurse or pharmacist.
Capecitabine may be given on its own, or with other chemotherapy drugs. Your doctor or nurse will tell you more about this and the number of cycles you are likely to have.
Possible side effects of capecitabineBack to top
We explain the most common side effects of capecitabine here. But we don’t include all the rare ones that are unlikely to affect you.
You may get some of the side effects we mention, but you are very unlikely to get all of them. If you are having other chemotherapy drugs as well, you may have some side effects that we don’t list here. Always tell your doctor or nurse about the side effects you have.
Your doctor can prescribe drugs to help control some side effects. It is very important to take them exactly as your nurse or pharmacist has explained. This means they will be more likely to work better for you.
Your nurse will give you advice about managing your side effects. After your treatment is over, the side effects will start to improve.
Serious and life-threatening side effects
Sometimes, cancer drugs can result in very serious side effects, which rarely may be life-threatening. Your cancer doctor and nurse can explain the risk of these side effects to you.
Contact the hospital
Your nurse will give you telephone numbers to call the hospital if you feel unwell or need advice at any time of day or night. Save these numbers in your mobile phone or keep them somewhere safe.
More Information about this drug
We are not able to list every side effect for this treatment here, particularly the rarer ones. For more detailed information, you can visit the electronic Medicines Compendium (eMC).
Risk of infection
Capecitabine can reduce the number of white blood cells in your blood. This will make you more likely to get an infection. When the number of white blood cells is low, it’s called neutropenia.
Contact the hospital straight away on the contact number you’ve been given if:
- your temperature goes over 37.5°C (99.5°F) or over 38°C (100.4°F), depending on the advice given by your chemotherapy team
- you suddenly feel unwell, even with a normal temperature
- you have symptoms of an infection – these can include feeling shaky, a sore throat, a cough, diarrhoea or needing to pass urine a lot.
The number of white blood cells usually increases steadily and returns to normal before your next treatment. You will have a blood test before having more chemotherapy. If your number of white blood cells is still low, your doctor may delay your treatment for a short time. Sometimes your doctor may reduce the dose of your treatment.
Anaemia (low number of red blood cells)
Capecitabine can reduce the number of red blood cells in your blood. These cells carry oxygen around the body. If the number of red blood cells is low, you may be tired and breathless. If you feel like this, tell your doctor or nurse. If you are very anaemic, you may need a drip to give you extra red blood cells (blood transfusion).
Bruising and bleeding
Capecitabine can reduce the number of platelets in your blood. Platelets are cells that help the blood to clot. If you have any bruising or bleeding you can’t explain, tell your doctor. This includes nosebleeds, bleeding gums, blood spots or rashes on the skin. Some people may need a drip to give them extra platelets.
This may happen in the first few days after chemotherapy. Your doctor will prescribe anti-sickness (anti-emetic) drugs to help prevent or control sickness. Take the drugs exactly as your nurse or pharmacist explains to you. It is easier to prevent sickness than to treat it after it has started.
If you still feel sick or are vomiting, contact the hospital as soon as possible. They can give you advice and change the anti-sickness drug to one that works better for you.
Diarrhoea can sometimes be severe. Your doctor can prescribe anti-diarrhoea drugs to control it. You may be given these before you leave hospital. It is important to take them exactly as your nurse or pharmacist explains. If you have diarrhoea, make sure you drink at least two litres (three and a half pints) of fluids every day.
If you have diarrhoea at night, or more than 4–6 times a day, contact the hospital straight away on the number your nurse gave you. Your doctor may ask you to stop taking capecitabine. When the diarrhoea is better, they will tell you if you can start taking it again. Sometimes they reduce the dose.
Capecitabine may make you constipated and cause tummy pain. Drinking at least two litres (three and a half pints) of fluids every day will help. Try to eat more foods that contain fibre, such as fruit, vegetables and wholemeal bread. Also try to do some regular, gentle exercise.
Loss of appetite
You may lose your appetite during your treatment. Try to eat small meals regularly. Don’t worry if you don’t eat much for a day or two. If your appetite doesn’t improve after a few days, let your nurse or dietitian know. They can give you advice on getting more calories and protein in your diet. They may give you food supplements or meal replacement drinks to try. Your doctor can prescribe them. You can also buy them from chemists.
Your mouth may become sore and you may get ulcers. This can make you more likely to get an infection in your mouth. Gently clean your teeth or dentures in the morning, at night and after meals. Use a soft-bristled or children’s toothbrush. Your nurse might ask you to rinse your mouth regularly or use mouthwashes. It is important to follow any advice you are given and to drink plenty of fluids.
If you have any problems with your mouth, tell your nurse or doctor. They can prescribe medicines to prevent or treat mouth infections and reduce any soreness.
Soreness and redness of palms of hands and soles of feet
This is called palmar-plantar or hand-foot syndrome. It gets better when treatment ends. Your doctor or nurse can give you advice and prescribe creams to improve the symptoms. It can help to keep your hands and feet cool and to avoid tight-fitting socks, shoes and gloves.
Feeling very tired is a common side effect. It is often worse towards the end of treatment and for some weeks after it’s over. Try to pace yourself and get as much rest as you need. It helps to balance this with some gentle exercise, such as short walks. If you feel sleepy, don’t drive or operate machinery.
Less common side effects of capecitabineBack to top
Your hair may thin but you’re unlikely to lose all the hair from your head. This usually starts after your first or second cycle of chemotherapy. It is almost always temporary and your hair will grow back after treatment ends. Your nurse can give you advice about coping with hair loss.
Your eyes may become watery and feel sore. Your doctor can prescribe eye drops to help with this. If your eyes get red and inflamed (conjunctivitis), tell your doctor. This is because you may need antibiotic eye drops.
Capecitabine may cause headaches. If this happens, let your doctor or nurse know. They can give you painkillers.
Sometimes capecitabine may cause dizziness. Let your doctor know if you feel dizzy. It is important not to drive or operate machinery if you notice these effects.
You may get pain or discomfort in your tummy (abdomen), feel bloated or have indigestion or wind. Your doctor can prescribe drugs to help improve these symptoms. Tell them if the pain doesn’t improve or if it gets worse.
Changes in the way the heart works
This treatment can affect the way the heart works. You may have tests to see how well your heart is working before, during and sometimes after treatment.
Tell a doctor straight away if you have any of these symptoms at any time during or after treatment:
- pain or tightness in your chest
- changes to your heartbeat.
These symptoms can be caused by other conditions, but it’s important to get them checked by a doctor.
It is important to tell your doctor or nurse straight away if you feel ill or have severe side effects. This includes any we don’t mention here.
Other information about capecitabineBack to top
Blood clot risk
Cancer increases the chances of a blood clot (thrombosis) and chemotherapy can add to this risk. A clot can cause symptoms such as:
- pain, redness and swelling in a leg
- chest pain.
If you have any of these symptoms, contact your doctor straight away. A blood clot is serious, but your doctor can treat it with drugs that thin the blood. Your doctor or nurse can give you more information.
Some medicines can interact with chemotherapy or be harmful when you are having chemotherapy. This includes medicines you can buy in a shop or chemist. Capecitabine may affect the way drugs such as warfarin work. Folinic acid may increase the side effects of capecitabine. Tell your doctor about any medicines you are taking, including over-the-counter drugs, complementary therapies and herbal drugs.
Capecitabine can affect your fertility (being able to get pregnant or father a child). If you are worried about this, you can talk to your doctor before treatment starts.
Your doctor will advise you not to become pregnant or father a child during treatment. This is because the drugs may harm a developing baby. It is important to use contraception during and for a few months after chemotherapy. You can talk to your doctor or nurse about this.
Women are advised not to breastfeed during treatment and for a few months after. This is in case there is chemotherapy in their breast milk.
Medical and dental treatment
If you need to go into hospital for any reason other than cancer, always tell the doctors and nurses that you are having chemotherapy. Explain you are taking chemotherapy tablets that no one should stop or restart them without advice from your cancer doctor. Give them contact details for your cancer doctor.
If you think you need dental treatment, talk to your cancer doctor or nurse. Always tell your dentist you are having chemotherapy.
This page has been compiled using information from a number of reliable sources, including the electronic Medicines Compendium (eMC; medicines.org.uk). If you’d like further information on the sources we use, please feel free to contact us.
This information was reviewed by a medical professional.
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