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Xeloda (Capecitabine) Buyer and Patient Handbook in South Africa

What is Xeloda?

Xeloda (Capecitabine) is an oral chemotherapy agent that belongs to the antimetabolite class and is used to treat certain solid tumours, notably colorectal and Breast Cancer. It works by mimicking nucleotides, disrupting DNA synthesis in rapidly dividing cells. In South Africa, the product is authorised by the MCC and supplied as a 500 mg film-coated tablet.

Who Should Use Xeloda?

• Adults diagnosed with metastatic or adjuvant Colorectal Cancer.
• Adults with HER2-negative metastatic breast Cancer when other treatments are unsuitable.
• Patients whose physician has deemed an oral fluoropyrimidine appropriate.

How Does It Work?

Capecitabine is a pro-drug that is absorbed in the gut and converted step-wise to 5-fluorouracil (5-FU) inside tumour cells. Think of it as a “Trojan horse” that reaches the cancer site before being activated, allowing higher local drug concentrations while sparing most normal tissues. Because the activation relies on enzymes more abundant in tumour tissue, the drug preferentially attacks cancer cells. Abuse potential is negligible; however, strict adherence is essential to avoid resistance or toxicity.

Why Choose Xeloda?

• Convenient oral dosing eliminates the need for frequent hospital infusions.
• Established efficacy in landmark trials for colorectal and breast cancer.
• Generic alternatives (capecitabine tablets) are available at lower cost with comparable bio-equivalence.
• Off-label use (e.g., gastric or Pancreatic Cancer) should only be considered after specialist consultation.

Dosage, Administration, Lifestyle and Dietary Recommendations

Recommended Dosage

• Standard tablet strength: 500 mg.
• Typical regimen: two tablets (1 g) taken twice daily for 14 days, followed by a 7-day rest period (21-day cycle). Dosage may be adjusted based on body surface area, renal function, and treatment response.

How to Take

1. Swallow tablets whole with a full glass of water.
2. Take with food to minimise gastrointestinal upset.
3. Do not crush or chew the tablets.

Missed Dose

• If you realise a dose was missed within 12 hours, take it as soon as possible and continue with the next scheduled dose.
• If more than 12 hours have passed, skip the missed dose and resume your regular schedule. Do not double-dose.

Overdose

• Seek emergency care immediately if you suspect an overdose (e.g., taking more than the prescribed tablets).
• Symptoms may include severe nausea, vomiting, diarrhoea, or confusion.

Special Populations

• Elderly: Start at the lower end of the dosing range; monitor renal function closely.
• Renal impairment: Reduce dose by 25-50 % for creatinine clearance <50 mL/min.
• Pregnancy & lactation: Contra-indicated; discuss contraception with your healthcare provider.

Lifestyle & Diet

• Avoid large quantities of grapefruit as it can increase capecitabine levels.
• Maintain adequate hydration (≥2 L water per day).
• Limit alcohol to moderate amounts; excessive intake may exacerbate liver toxicity.

Precautions and Warnings

• Monitor complete blood counts every 1-2 weeks; neutropenia and thrombocytopenia are possible.
• Watch for signs of hand-foot syndrome (redness, swelling, Pain on palms/soles).
• Regular liver function tests are advised; hepatitis-related hepatotoxicity can occur.
• Use effective contraception during treatment and for at least 3 months after the last dose.

Drug Interactions

Potential Side Effects

Common Side Effects

• Nausea, vomiting
• Diarrhoea
• Fatigue
• Hand-foot syndrome (palmar-plantar erythrodysesthesia)

Less Common Side Effects

• Mouth sores (stomatitis)
• Mild rash or itching
• Anemia, leukopenia

Serious Side Effects

• Severe neutropenia (infection risk) - call a doctor immediately
• Liver dysfunction (jaundice, elevated enzymes) - seek urgent medical advice
• Severe hand-foot syndrome limiting daily activities - consult your clinician

Who Should Avoid This Medication?

• Known hypersensitivity to capecitabine or any component of the tablet.
• Severe renal impairment (creatinine clearance <30 mL/min).
• Active uncontrolled infections.
• Pregnant or breastfeeding women.

Storage Instructions

• Keep tablets in the original container, tightly closed.
• Store at room temperature (15-30 °C), away from moisture and direct sunlight.
• Keep out of reach of children and pets.

Xeloda Alternatives

Frequently Asked Questions

How long does a treatment cycle last?

Each cycle is 21 days (14 days of medication followed by 7 days off).

Can I drink coffee while on Xeloda?

Moderate coffee intake is fine; avoid excessive caffeine that may worsen dehydration.

What should I do if I develop hand-foot syndrome?

Apply gentle moisturisers, avoid friction, and report symptoms to your clinician for possible dose reduction.

Is it safe to vaccinate while taking Xeloda?

Live vaccines are generally avoided; inactivated vaccines can be given but discuss timing with your healthcare team.

Will Xeloda affect my blood sugar?

Capecitabine is not known to cause significant changes in glucose levels, but monitor if you have Diabetes.

Can I take over-the-counter anti-diarrhoeal medication?

Loperamide may be used for mild diarrhoea; severe cases require medical review.

Why am I experiencing nausea despite taking with food?

Chemotherapy-induced nausea can vary; anti-emetic agents prescribed by your clinician may help.

How often should blood tests be performed?

Typically every 1-2 weeks during the first two cycles, then as directed by your clinician.

Glossary

• Antimetabolite: A drug that mimics normal molecules, disrupting DNA/RNA synthesis in rapidly dividing cells.
• Hand-foot syndrome: Redness, swelling, and pain on the palms and soles caused by certain chemotherapy agents.
• Pro-drug: An inactive compound that is converted in the body to an active drug.

Disclaimer

The information provided here is for general education only and does not replace professional medical advice. Off-label uses should be discussed with a qualified healthcare provider. Our service offers medication information and ordering assistance; it does not prescribe or dispense medication. Always consult your doctor or pharmacist before starting, stopping, or changing any treatment.