What is Xeloda Uses, warnings & interactions
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Xeloda (capecitabine) is an oral chemotherapy drug that is manufactured by Genentech, Inc. It was approved in 1998 by the U.S. Food and Drug Administration (FDA) to treat adults with breast cancer and colorectal cancer that have spread to other parts of the body. Xeloda is a pro-drug that your body converts to an active drug called fluorouracil, which slows down the growth and spread of certain types of cancer cells.
If your doctor has prescribed Xeloda to you, you may want to know more about what it is and how it works. Here we’ll explain what Xeloda is used for, how it works, its side effects, and more.
What is Xeloda used for?
Xeloda (capecitabine) is a cancer treatment that is indicated to be:
- Adjuvant therapy for Dukes’ C colon cancer.
- First-line monotherapy for metastatic colorectal cancer.
- Used in combination with docetaxel for metastatic breast cancer after failure of anthracycline-based chemotherapy.
How does Xeloda work?
Xeloda contains a pro-drug capecitabine that is a nucleoside metabolic inhibitor. Following oral administration, it is converted into an active chemotherapy drug called 5-fluorouracil (5-FU) by enzymes in your body. This happens mainly in cancerous tissues as they tend to contain more of these activating enzymes than healthy tissues. Once activated, 5-FU stops cancer cell growth by interfering with the production of their genetic material (DNA and RNA). This prevents them from producing proteins that are necessary for them to survive.
What are the most commonly prescribed doses of Xeloda?
- 150mg tablet
- 500mg tablet
Before taking Xeloda
Before beginning Xeloda, tell your healthcare provider if you have any of the following medical conditions:
- Heart problems
- Liver or kidney problems
- DPD (dihydropyrimidine dehydrogenase) deficiency
- Are pregnant, plan on becoming pregnant
- Are breastfeeding or plan to breastfeed
How to take Xeloda
- Read the Full Prescribing Information including the Boxed Warning, Instructions for Use, and Medication Guide that comes with this medication.
- Take Xeloda exactly as your doctor prescribes it to you. Do not change your dose or stop taking this medication without discussing it with them first.
- Xeloda is typically taken twice a day, once in the morning and once in the evening. You should take Xeloda within 30 minutes after eating a meal.
- Swallow Xeloda tablets whole with water. Do not cut, chew, or crush Xeloda tablets. If you miss a dose, you should skip it and wait until your next scheduled dose. You should not an extra dose to make up for the missed dose.
- If you think you have taken too much Xeloda, call your doctor right away or go to the nearest emergency room.
- You should store Xeloda in a tightly closed container at room temperature between 68°F to 77°F (20°C to 25°C).
You should not use Xeloda if you:
- are allergic to capecitabine, 5-fluorouracil, or any other ingredients in this product.
- have severe renal impairment.
- Xeloda use affects how fast your blood clots and may result in severe bleeding or even death. You should be monitored closely if you are on blood thinners or anti-platelets.
- May cause severe diarrhea. Your doctor may stop treatment until it resolves. You should start treatment with an antidiarrheal medication such as Imodium (loperamide) at the first sign of loose stools.
- Patients with a history of coronary artery disease (CAD) are at an increased risk for cardiotoxicity.
- Patients with low or absent dihydropyrimidine dehydrogenase (DPD) activity are at risk of serious or fatal drug-related toxicity from Xeloda. There is no dose of Xeloda that was shown to be safe if you have no DPD activity.
- If you become dehydrated while on Xeloda, you should stop treatment until it is resolved.
- Xeloda may cause fetal harm. Females should use an effective form of contraception to avoid this risk.
- Severe skin reactions such as Steven-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN), have been reported with the use of this medication. Xeloda should be permanently stopped if these occur.
- Xeloda may also cause a skin rash called hand-foot syndrome (Palmar-plantar erythrodysesthesia). Treatment should be interrupted until it resolves.
- Patients with low platelet, red blood cell, or white blood cell counts should not be treated with Xeloda until it is corrected.
- You should not be immunized with live vaccines while on Xeloda and for up to 12 months afterward.
Xeloda drug interactions
When Xeloda is taken with other medications, it may change the way they work or increase the frequency and severity of side effects. Discuss with your doctor whether any of the prescription drugs, over-the-counter medications, vitamins, and herbal supplements you take may interact with this medication, including:
- Anticoagulants such as Coumadin (warfarin)
- CYP2C9 substrates such as Prozac (fluoxetine) and Cozaar (losartan)
- Dilantin (phenytoin)
- Wellcovorin (leucovorin)
- Zyloprim (allopurinol)
- Food reduces both how much and how fast Xeloda is absorbed
Xeloda side effects
Some common side effects of Xeloda include:
- Abdominal pain
- Extreme tiredness
- Loss of appetite
- Mouth sores or ulcers
- Increased bilirubin levels (hyperbilirubinemia)
- Hair loss
- Sore throat
Xeloda can sometimes cause more serious possible side effects, including:
- Severe, life-threatening hypersensitivity reactions (hives, angioedema, and shortness of breath)
- Severe skin reactions (skin rash, peeling, and blisters)
- Heart problems (chest pain, irregular heartbeats, and swelling)
- Kidney dysfunction
- Liver dysfunction
Contact your doctor for medical advice about any adverse effects you experience while taking Xeloda. You can report your side effects to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
Your healthcare professional can prescribe other medications for your condition if Xeloda is not right for you. These other treatment options will vary by different factors such as side effects and costs. Some FDA-approved alternatives to Xeloda include:
- Alimta (pemetrexed)
- Adrucil (fluorouracil)
- Mavenclad (cladribine)
- Cytostar U (cytarabine)
- Gemzar (gemcitabine)
- Purinethol (mercaptopurine)
- Trexall (methotrexate)
Can you take Xeloda while you are pregnant or breastfeeding?
Xeloda may harm your unborn baby. You should have a pregnancy test done prior to starting Xeloda treatment. Notify your doctor immediately if you become pregnant or think you are pregnant while on Xeloda. Females who may become pregnant while on Xeloda should use an effective birth control method during treatment and for 6 months after their last dose. Males who have female partners who may become pregnant should use an effective birth control method during treatment and for 3 months after their last dose.
It is not known if Xeloda is found in breast milk. You should not breastfeed while taking Xeloda and for 2 weeks after your last dose.
You should always discuss the risks and benefits of any medication with your healthcare provider if you are pregnant, plan on becoming pregnant, or are breastfeeding.
How long does Xeloda stay in your system?
Xeloda has a short half-life of around 45 minutes so it will be in your system for about 4 hours. However, the effects of Xeloda will last much longer and side effects can occur well after 4 hours have passed.
How long can you be on Xeloda?
Xeloda is a medication you take long-term. You will typically stay on Xeloda when treating metastatic breast and colorectal cancer for as long as it is effective and you are tolerating it. When taking it as adjuvant therapy for colorectal cancer, you will typically take Xeloda for 6 months, or eight 3-week treatment cycles.
How effective is Xeloda for breast cancer?
In a phase II trial of 163 patients with metastatic breast cancer who failed paclitaxel, the overall response rate with Xeloda was 20% and the average survival was 12.8 months.
What is the cost of Xeloda?
The average cost of #84, 500mg generic Xeloda tablets is around $1000.
Is there a generic for Xeloda?
Currently, there is a generic Xeloda available on the market. However, you can still save on brand-name drugs like Xeloda through NiceRx if eligible for assistance.