Capecitabine


Capecitabine, sold under the brand name Xeloda among others, is a chemotherapy medication used to treat breast cancer, gastric cancer and colorectal cancer. For breast cancer it is often used together with docetaxel. It is taken by mouth.
Common side effects include abdominal pain, vomiting, diarrhea, weakness, and rashes. Other severe side effects include blood clotting problems, allergic reactions, heart problems such as cardiomyopathy, and low blood cell counts. It is not recommended in people with kidney problems. Use during pregnancy may result in harm to the baby. Capecitabine, inside the body, is converted to 5-fluorouracil through which it acts. It belongs to the class of medications known as fluoropyrimidines, which also includes 5-fluorouracil and tegafur.
Capecitabine was patented in 1992 and approved for medical use in 1998. It is on the World Health Organization's List of Essential Medicines.

Medical uses

It is used in the treatment of the following cancers:
Adverse effects by frequency:
;Very common :
Notes on adverse effects:

Contraindications

Contraindications include:
Drugs it is known to interact with include:
The dihydropyrimidine dehydrogenase enzyme is responsible for the detoxifying metabolism of fluoropyrimidines, a class of drugs that includes capecitabine, 5-fluorouracil and tegafur. Genetic variations within the DPD gene can lead to reduced or absent DPD activity, and individuals who are heterozygous or homozygous for these variations may have partial or complete DPD deficiency; an estimated 0.2% of individuals have complete DPD deficiency. Those with partial or complete DPD deficiency have a significantly increased risk of severe or even fatal drug toxicities when treated with fluoropyrimidines; examples of toxicities include myelosuppression, neurotoxicity and hand-foot syndrome.

Mechanism of action

Capecitabine is metabolised to 5-FU which in turn is a thymidylate synthase inhibitor, hence inhibiting the synthesis of thymidine monophosphate, the active form of thymidine which is required for the de novo synthesis of DNA.

Society and culture

One of the brandnames is Xeloda, marketed by Genentech.
Others include Xitabin, Capcibin, and Kapetral.