Xeloda: Targeted Oral Chemotherapy for Gastrointestinal and Breast Cancers
| Product dosage: 500mg | |||
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| 50 | $15.89
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Synonyms | |||
Xeloda (capecitabine) is an innovative oral chemotherapeutic agent designed to deliver targeted, tumor-activated treatment for specific gastrointestinal and breast cancers. As a prodrug, it is selectively converted to its active form—5-fluorouracil (5-FU)—primarily within cancer cells, maximizing efficacy while potentially minimizing systemic exposure. This mechanism allows for convenient home-based administration, offering a flexible and patient-centered alternative to traditional intravenous chemotherapy. Supported by extensive clinical evidence, Xeloda is indicated both as monotherapy and in combination regimens, providing a valuable option within modern oncology treatment protocols.
Features
- Active ingredient: Capecitabine
- Pharmaceutical form: Film-coated tablets in strengths of 150 mg and 500 mg
- Prodrug activation: Enzymatically converted to 5-fluorouracil (5-FU) preferentially in tumor tissue
- Administration: Oral, taken with water within 30 minutes after a meal
- Dosing schedule: Typically administered for 14 days followed by a 7-day rest period (21-day cycle)
Benefits
- Delivers targeted chemotherapy directly to cancer cells, potentially reducing damage to healthy tissues
- Offers the convenience of oral administration, allowing treatment to be managed outside clinical settings
- Provides flexibility in dosing, adaptable within evidence-based protocols and combination regimens
- Supported by robust clinical data demonstrating efficacy in adjuvant and metastatic settings
- May improve quality of life for suitable patients by reducing clinic visits for infusion therapy
Common use
Xeloda is indicated for:
- Adjuvant treatment of patients with Dukes’ C colon cancer who have undergone complete resection of the primary tumor when fluoropyrimidine therapy alone is preferred
- First-line treatment of metastatic colorectal cancer
- Treatment of metastatic breast cancer, either as monotherapy or in combination with docetaxel, after failure of prior anthracycline-containing chemotherapy
Dosage and direction
The recommended dose of Xeloda is based on body surface area (BSA). The standard dose is 1250 mg/m² administered orally twice daily (morning and evening) for 14 days followed by a 7-day rest period, repeated in 21-day cycles. Tablets should be swallowed whole with water within 30 minutes after a meal. Dose modifications are required based on toxicity, renal function, and specific patient factors. Treatment should be administered under the supervision of a physician experienced in cancer chemotherapy.
Precautions
- Patients should be monitored for diarrhea, which can be severe; dehydration must be promptly managed
- Hand-foot syndrome (palmar-plantar erythrodysesthesia) may occur and often requires dose modification
- Complete blood counts should be monitored regularly; patients with pre-existing bone marrow suppression may require closer observation
- Cardiac monitoring is advised, particularly in patients with a history of coronary artery disease
- Use with caution in elderly patients due to possible decreased renal function and increased incidence of adverse events
- Patients with dihydropyrimidine dehydrogenase (DPD) deficiency may experience severe toxicity; testing may be considered
Contraindications
- Known hypersensitivity to capecitabine, 5-fluorouracil, or any excipients
- Severe renal impairment (creatinine clearance below 30 mL/min)
- Known complete absence of dihydropyrimidine dehydrogenase (DPD) activity
- Pregnancy and breastfeeding
- Concomitant administration with sorivudine or its chemically related analogues
Possible side effects
Very common (≥1/10):
- Diarrhea
- Nausea, vomiting
- Stomatitis
- Hand-foot syndrome
- Fatigue
- Anorexia Common (≥1/100 to <1/10):
- Neutropenia, thrombocytopenia, anemia
- Hyperbilirubinemia
- Rash, dry skin
- Fever
- Constipation, abdominal pain Uncommon (≥1/1,000 to <1/100):
- Dehydration
- Cardiotoxicity (angina, myocardial infarction, arrhythmias)
- Severe skin reactions Rare (<1/1,000):
- Leukoencephalopathy
- Severe ocular toxicity
Drug interaction
- Anticoagulants: Xeloda may enhance the effect of warfarin; frequent INR monitoring is required
- Phenytoin: Capecitabine may increase phenytoin levels; monitor phenytoin concentration
- Allopurinol: Concomitant use may decrease efficacy of capecitabine; generally not recommended
- Metronidazole: May increase capecitabine toxicity; avoid combination
- Live vaccines: Should be avoided during treatment due to immunosuppression
Missed dose
If a dose is missed, it should not be taken later in the day. The next dose should be taken at the regularly scheduled time. Patients should not double the dose to make up for a missed dose. Any missed doses should be discussed with the treating oncology team.
Overdose
Overdose may lead to severe nausea, vomiting, diarrhea, gastrointestinal irritation and bleeding, bone marrow suppression, and acute neurological toxicity. There is no specific antidote for capecitabine overdose. Treatment should consist of general supportive measures, including antiemetics, antidiarrheals, and hematological support. Hemodialysis has not been shown to be effective in removing capecitabine or its metabolites.
Storage
Store at room temperature (15–30°C or 59–86°F) in the original container. Keep tightly closed and protect from moisture. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging. Unused medication should be disposed of properly according to local regulations for cytotoxic drugs.
Disclaimer
This information is provided for educational purposes only and does not replace professional medical advice. Treatment decisions must be made by qualified healthcare professionals based on individual patient characteristics. Dosage and administration may vary based on clinical context, and patients should always follow their prescribing physician’s instructions. Serious adverse events should be reported to the appropriate regulatory authorities.
Reviews
“Xeloda has transformed our approach to manageable chemotherapy in appropriate gastrointestinal cancer patients. The oral administration and favorable toxicity profile in selected populations make it an important option in our armamentarium.” — Oncology Specialist, Academic Medical Center
“In our clinical experience, patients appreciate the flexibility of home-based treatment with Xeloda. While monitoring for hand-foot syndrome and diarrhea remains crucial, many patients maintain good quality of life during treatment cycles.” — Oncology Nurse Practitioner, Comprehensive Cancer Center
“Based on phase III trial data and real-world evidence, Xeloda demonstrates non-inferiority to intravenous 5-FU in adjuvant colon cancer with the advantage of oral administration. It remains a valuable component of combination regimens in metastatic settings.” — Clinical Researcher, Oncology Institute