Capecitabine in Cancer Treatment

Generic Name: Capecitabine
Brand Names: Ecansya, Xeloda
Groups: Approved, Investigational


Capecitabine is an orally administered chemotherapeutic agent used in the treatment of metastatic breast and colorectal cancers. Capecitabine is a prodrug, that is enzymatically converted to fluorouracil (antimetabolite) in the tumor, where it inhibits DNA synthesis and slows growth of tumor tissue.

What is Capecitabine, and How Does it Work?

Capecitabine, marketed as Xeloda or Ecansya, belongs to a class of drugs used in advanced breast cancer treatment, particularly when resistance to standard therapies like paclitaxel (Taxol) and anthracycline drugs such as doxorubicin (Adriamycin) occurs. This medication undergoes conversion within the body, transforming into 5-fluorouracil (5-FU), a chemotherapy agent administered intravenously for several cancer types. In essence, Capecitabine and 5-FU inhibit cancer cell growth by impeding the production of DNA and essential proteins required for cell division. Approved by the FDA in 1998 for breast cancer and later in 2005 for colorectal cancer, Capecitabine has emerged as a vital weapon in the fight against cancer.

Brand Names and Prescription Requirements

Capecitabine is commercially available as Xeloda and Ecansya, and as of now, no generic alternatives exist. It is a prescription-only medication, necessitating consultation with a healthcare provider for use.

Understanding the Uses of Capecitabine

Capecitabine plays a crucial role in treating various conditions:

  1. Colon Cancer: It’s employed to manage colon cancer that has spread to nearby lymph nodes (Dukes’ C stage) post-surgery.
  2. Metastatic Colorectal Cancer: Capecitabine combats colorectal cancer that has metastasized to other body parts.
  3. Metastatic Breast Cancer: In combination with docetaxel, Capecitabine aids in treating metastatic breast cancer, especially when previous treatments have proven ineffective.
  4. Advanced Breast Cancer: It is also used for advanced breast cancer cases that haven’t improved after paclitaxel and other treatments or when no further treatment options are available.

Potential Side Effects

Capecitabine may lead to several side effects, including:

  • Diarrhea
  • Nausea
  • Vomiting
  • Mouth sores
  • Fatigue
  • Skin rash and swelling of the extremities
  • Low white blood cell counts (increased infection risk)
  • Low blood platelet counts (higher risk of bleeding)
  • Anemia
  • Heart issues like chest pain, abnormal heartbeats, or heart attacks

Appropriate Dosage

Typically, Capecitabine is prescribed at a dose of 1250 mg/m2, taken twice daily, approximately 12 hours apart. It’s essential to take the tablets 30 minutes after a meal.
Treatment usually occurs in 3-week cycles: two weeks on the medication followed by one week without. Some patients might require dose adjustments or delays if they experience side effects.

Drug Interactions

Capecitabine interacts with blood-thinning medications like warfarin (Coumadin), potentially causing severe bleeding. This risk is elevated for cancer patients, especially those over 60. If you’re taking warfarin or a similar blood thinner while using Capecitabine, your doctor should conduct frequent blood tests to monitor clotting speed and adjust the blood thinner dosage if necessary.

Capecitabine can interact with various other drugs, including over-the-counter medications and herbal supplements. It’s crucial to inform your healthcare provider of all substances you’re taking.

Pregnancy and Breastfeeding

Capecitabine can harm a developing fetus and should not be used during pregnancy. Whether it passes into breast milk is unknown, so breastfeeding is not recommended while taking this medication.


In the fight against cancer, Capecitabine shines as a powerful ally, especially when other treatments show resistance. With proper medical guidance and understanding of its uses, potential side effects, and interactions, patients can navigate the complexities of this medication more effectively, enhancing their chances of successful cancer management.

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