Xeloda (Capecitabine) - Oral

Warning:

Using Xeloda (capecitabine) with oral coumarin-derivative anticoagulants (e.g., warfarin) at the same time can result in altered coagulation parameters, bleeding, and death. People taking Xeloda with these medications

should be monitored frequently by a healthcare provider for their anticoagulant response. People aged 60 years and older who have cancer are at an increased risk.

What Is Xeloda?

Xeloda (capecitabine) is an oral chemotherapy known as an antimetabolite used to treat certain types of colon cancer, colorectal cancer, and breast cancer. When Xeloda is taken orally, it is processed by the body and changed into chemotherapy called 5-fluorouracil.

Xeloda is available only by prescription in tablet form.

Drug Facts

Generic Name: Capecitabine

Brand Name(s): Xeloda

Drug Availability: Prescription

Administration Route: Oral

Therapeutic Classification: Antineoplastic agent

Available Generically: Yes

Controlled Substance: N/A

Active Ingredient: Capecitabine

Dosage Form(s): Tablet

What Is Xeloda Used For?

Xeloda is used to treat certain types of colorectal, colon, and breast cancer, such as:

  • Dukes' C colon cancer, or colon cancer that has spread to the lymph nodes near the colon, after having surgery
  • Metastatic colorectal cancer, meaning the cancer has spread to the other areas of the body
  • Metastatic breast cancer (either in combination with other chemotherapies or alone)

How to Take Xeloda

Xeloda is often prescribed to be taken twice a day, within 30 minutes of finishing a meal. Take the tablets whole with water. If necessary, the tablet may be crushed or broken, but should only be done so by a trained professional in a safe handling environment.

Storage

Store Xeloda at room temperature and keep it tightly sealed. As it contains chemotherapy, it should only be handled by the person who is supposed to be taking it and kept away from any children or pets.

Off-Label Uses

There are times when Xeloda is prescribed for cancers other than colon or breast cancer. 

Xeloda may be given in combination with other chemotherapy medications or used alone when prescribed for the following cancers:

How Long Does It Take Xeloda to Work?

How long it will take Xeloda to work will vary from person to person. Your healthcare team will monitor your condition and advise you on how long you need to take it.

What Are the Side Effects of Xeloda?

Like other medications, Xeloda can cause side effects. Tell your healthcare provider about any side effects you experience while taking this medication, especially if they persist or worsen.

This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the Food and Drug Administration (FDA) at fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

There are some common side effects that may develop while taking Xeloda. These common side effects include:

Severe Side Effects

There are some severe side effects that may be caused by Xeloda. If you develop severe side effects, call your healthcare team right away. If you feel that your symptoms are life-threatening or if you’re having a medical emergency, call 911.

Serious side effects and their symptoms can include the following:

  • Diarrhea: Diarrhea can be severe when using Xeloda. Untreated diarrhea can lead to severe dehydration and abnormal electrolytes.
  • Dehydration: This can lead to the development of kidney failure if not treated.
  • Skin toxicity: There have been cases of severe skin reactions to Xeloda, which could occur in the mouth, or in other areas of the skin, such as hand-foot syndrome
  • Heart problems: Xeloda has the possibility of causing problems, such as decreased blood flow to the heart, chest pain, irregular heartbeat, or shortness of breath. It can also cause heart attack, electrocardiogram changes, and heart failure.
  • Blood abnormalities: Sometimes Xeloda can cause a severe decrease in white blood cells (leukopenia), red blood cells (anemia), or platelets (thrombocytopenia). 
  • Bleeding: People taking warfarin along with Xeloda may require more frequent blood monitoring and dose adjustment of warfarin as Xeloda may increase the risk of bleeding.

Report Side Effects

Xeloda may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Xeloda Should I Take?

Drug Content Provided and Reviewed by IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For metastatic breast and colorectal cancer:
      • For patients receiving this medicine alone:
        • Adults—Dose is based on body size and must be determined by your doctor. At first, 2500 milligrams (mg) per square meter (m(2)) of body size per day, divided in 2 doses and taken about 12 hours apart. These doses are taken for 2 weeks, followed by 1 week rest, given as 3 weeks cycle. Your doctor may adjust your dose if needed.
        • Children—Use and dose must be determined by your doctor.
      • For patients receiving this medicine with docetaxel:
        • Adults—Dose is based on body surface and must be determined by your doctor. At first, 2500 milligrams (mg) per square meter (m(2)) of body surface area per day, divided in 2 doses and taken about 12 hours apart. These are taken for 2 weeks, followed by 1 week rest, given as 3 weeks cycle Your doctor may adjust your dose if needed.
        • Children—Use and dose must be determined by your doctor.

Modifications

You may need a dose adjustment if you are experiencing significant or severe side effects. Be sure to be in communication with your healthcare team and notify them if any severe side effects occur.

Missed Dose

If you miss a dose of Xeloda, skip the missed dose and resume with the next scheduled dose. Do not double up to make up for the missed dose.

Overdose: What Happens If I Take Too Much Xeloda?

Taking too much Xeloda can cause: 

  • Severe diarrhea
  • Nausea and vomiting
  • Severely low blood counts

What Happens If I Overdose on Xeloda?

If you think you or someone else may have overdosed on Xeloda, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or stops breathing after taking Xeloda, call 911 immediately.

Precautions

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It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly and to check for unwanted effects.

Your doctor may request that you have a test to determine if your blood is clotting properly, and may preform this test frequently if you are also taking a blood thinner.

Using this medicine while you are pregnant can harm your unborn baby. Female patients must use effective birth control during treatment and for 6 months after your treatment ends. Male patients with partners of childbearing potential should also use effective contraception during treatment and for 3 months after the last dose. Tell your doctor right away if you think you have become pregnant.

This medicine may cause heart problems. Check with your doctor right away if you have chest pain that may spread to your arms, jaw, back, or neck, faintness, nausea, swelling in your hands, ankles, or feet, trouble breathing, or unusual sweating.

Check with your doctor right away if any of the following symptoms occur:

  • Diarrhea, moderately severe (four to six stools a day more than usual, or during the night).
  • Nausea that is severe enough to cause you to eat less than usual.
  • Vomiting two or more times in a 24-hour period.
  • Pain and redness, swelling, or sores or ulcers in your mouth or on your lips that are severe enough to interfere with eating.

If vomiting occurs less often than mentioned above, or if nausea does not cause you to eat less than usual, it is not necessary for you to stop taking the medicine or to check with your doctor (unless these effects are particularly bothersome). Also, you do not need to stop taking the medicine if diarrhea occurs less often than mentioned above or if the other side effects listed are not severe enough to interfere with eating or other daily activities. However, check with your doctor as soon as possible if they occur.

Serious skin reactions can occur with this medicine. Check with your doctor right away if you have blistering, peeling, or loose skin, red skin lesions, pain, swelling, or blisters on the palms of your hands or soles of your feet, loss of fingerprints, severe acne or skin rash, sores or ulcers on the skin, or fever or chills while you are using this medicine.

While you are being treated with capecitabine, and after you stop treatment with it, do not have any immunizations (vaccines) without your doctor's approval. Capecitabine may lower your body's resistance and the vaccine may not work as well or you might get the infection the vaccine is meant to prevent. In addition, you should not be around other persons living in your household who receive live virus vaccines because there is a chance they could pass the virus on to you. Some examples of live vaccines include measles, mumps, influenza (nasal flu vaccine), poliovirus (oral form), rotavirus, and rubella. Do not get close to them and do not stay in the same room with them for very long. If you have questions about this, talk to your doctor.

Capecitabine can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:

  • If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.
  • Check with your doctor immediately if you notice any unusual bleeding or bruising, black, tarry stools, blood in the urine or stools, or pinpoint red spots on your skin.
  • Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.
  • Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.
  • Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.
  • Avoid contact sports or other situations where bruising or injury could occur.

What Are Reasons I Shouldn’t Take Xeloda?

You should not take this medication if you:

  • Are pregnant or breastfeeding: It is recommended to stop breastfeeding during treatment and for two weeks after the final dose.
  • Have severe kidney disease
  • Are allergic to Xeloda or a chemotherapy agent called 5-fluorouracil (5-FU)

What Other Medications Interact With Xeloda?

Although it does not require complete avoidance, Xeloda should be used cautiously in people who take the blood thinner warfarin, as this combination can cause increased bleeding. Dose adjustment of warfarin may be required.

Another drug that may need to be adjusted if taken along with Xeloda is Dilantin (phenytoin)

The medication Zyloprim (allopurinol) should not be taken with Xeloda as it can decrease the effectiveness of Xeloda.

Be sure to tell your healthcare team about all of your medications, including prescription and over-the-counter products, vitamins, and herbal supplements.

What Medications Are Similar?

A medication similar to Xeloda is another chemotherapy agent called 5-FU. Once digested, Xeloda converts into 5-FU in the body. 5-FU is given through an IV infusion, usually over a period of 48 hours.

Frequently Asked Questions

  • What is Xeloda used for?

    Xeloda is used to treat cancer, specifically colorectal and metastatic breast cancer. There are times when Xeloda may be used to treat other cancers, such as stomach cancer.

  • What drugs may interact with Xeloda?

    Warfarin and phenytoin may require dose adjustments because of interactions with Xeloda, but they can still be taken. However, the medication allopurinol should not be taken along with Xeloda.

  • What are the side effects of Xeloda?

    The common side effects of Xeloda include diarrhea, nausea or vomiting, abdominal pain, redness, or peeling to the hands or feet. Severe side effects can include diarrhea, dehydration, or heart problems.

  • How should I stop taking Xeloda?

    Do not stop taking Xeloda unless instructed by the prescribing healthcare provider. However, if you’re experiencing severe side effects from the medication, notify the healthcare provider immediately.

How Can I Stay Healthy While Taking Xeloda?

Receiving a cancer diagnosis and undergoing chemotherapy can be an overwhelming process. Taking care of yourself during this time is imperative. Try to maintain a healthy diet and incorporate exercise if you can. This doesn't have to be a strenuous workout but can include walking, yoga, swimming, and more. Joining a cancer support group, whether in person or through an online resource, may also be beneficial for some people.

Taking good care of yourself and staying as healthy as possible while taking Xeloda is important. If you develop side effects from the medication, ask your healthcare team what you can do to lessen the side effects or find other ways to help manage them. Communication with your healthcare team is important to make sure you’re tolerating the medication given to help treat your cancer

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

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3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Food and Drug Administration. Xeloda prescribing information.

  2. Elsevier Gold Standard. Oncology off-label indications and recommendations.

  3. Redman JM, Rhea LP, Brofferio A, et al. Successful 5-fluorouracil (5-fu) infusion re-challenge in a metastatic colorectal cancer patient with coronary artery disease who experienced symptoms consistent with coronary vasospasm during first 5-FU infusion. J Gastrointest Oncol. 2019;10(5):1010-1014. doi:10.21037/jgo.2019.07.04