CAPECITABINE

Capecitabine may interact with “blood thinners” (anticoagulants such as warfarin or phenprocoumon) and cause serious, rarely fatal bleeding.

If you are using an anticoagulant, your laboratory tests (INR/PT) will be closely monitored.

Notify your doctor if any of these effects continue or worsen:

• nausea
• vomiting
• loss of appetite
• constipation
• tiredness
• weakness
• back/joint/muscle pain
• headache
• dizziness
• trouble sleeping
• skin darkening
• dry/itchy skin

Temporary hair loss may occur. Normal hair growth should return after treatment has ended.

Temporary nail changes may occur, which may rarely include fungal infections in the nail beds.

Diarrhea is a common side effect of this medication.

Stop taking capecitabine and tell your doctor immediately if you have severe nausea/vomiting (vomiting 2 or more times per day, inability to eat or keep food/fluids in your stomach) or painful redness/swelling/sores in mouth or throat.

Treatment with capecitabine may sometimes cause your hands/feet to develop a skin reaction called hand-foot syndrome (palmar-plantar erythrodysesthesia).

This medication can lower your ability to fight an infection.

Tell your doctor right away if you have any serious side effects, including:

• abdominal/stomach pain
• unusual bruising or bleeding
• extreme tiredness
• mental/mood changes (e.g.,depression)
• swelling of the ankles/feet
• vision changes
• shortness of breath
• change in the amount of urine
• dark urine
• yellowing of the eyes/skin
• fast/irregular heartbeat

Get medical help right away if you have chest/jaw/left arm pain or fainting.

A very serious allergic reaction to this drug is rare.

This is not a complete list of possible side effects. If you notice other side effects not listed above, contact your doctor or pharmacist.

Precautions

• Allergic reaction to this medication.
• Patients with medical history of:
  • a certain enzyme deficiency (dihydropyrimidine dehydrogenase deficiency)
  • blood disorders (e.g., bone marrow suppression)
  • heart problems (e.g.,coronary artery disease, heart failure)
  • kidney disease
  • liver problems
• Do not have immunizations/vaccinations without the consent of your doctor.
• Avoid contact with people who have recently received oral polio vaccine.
• Tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products) before having surgery.
• Avoid prolonged sun exposure, tanning booths, and sunlamps. Use an effective sunscreen and wear protective clothing when outdoors.
• Use caution with sharp objects like safety razors and nail cutters, and avoid activities such as contact sports.
• Use a soft-bristle toothbrush.
• Elderly may be more sensitive to nausea, vomiting, and diarrhea.
• This medication is not recommended for use during pregnancy.
• Breast-feeding while using this drug is not recommended.

Consult your doctor regarding the precautions mentioned above.

Interactions

Some products that may interact with this drug include:

• folic acid (including multivitamins with folic acid)
• leucovorin
• metronidazole
• tinidazole

This medication may affect how other drugs work. Examples of affected drugs include:

• “blood thinners” (such as warfarin)
• fosphenytoin
• phenytoin

Do not use medications containing fluorouracil while using capecitabine.

Overdose

If overdose is suspected, contact a poison control center or emergency room immediately.

Notes: Do not share this medication with others.

Laboratory and/or medical tests (e.g., bilirubin levels, complete blood counts, kidney and liver function tests) should be performed regularly to monitor your progress and check for side effects.

Missed Dose: If you miss a dose, do not take the missed dose and do not double the next dose. Continue your regular dosing schedule and check with your doctor.

Storage: Store at room temperature in a tightly closed container away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Brands

Available brands

• Capetero [ InnoGen Pharmaceuticals ]
• Capvex 500 [ VE Pharma ]
• Caxeta 500 [ Sun Pharma ]
• Xeloda [ Roche ]
• Xeltabine [ Korea United Pharma ]

Also marketed as

• Naprocap [ Naprod ]