Find information on thousands of medical conditions and prescription drugs.

Capecitabine

Capecitabine (brand name: Xeloda®) is an orally-administered chemotherapeutic agent used in the treatment of metastatic breast and colorectal cancers. It is enzymatically converted to fluorouracil in the body, where it inhibits DNA synthesis and slows growth of tumor tissue. more...

Home
Diseases
Medicines
A
B
C
Cabergoline
Caduet
Cafergot
Caffeine
Calan
Calciparine
Calcitonin
Calcitriol
Calcium folinate
Campath
Camptosar
Camptosar
Cancidas
Candesartan
Cannabinol
Capecitabine
Capoten
Captohexal
Captopril
Carbachol
Carbadox
Carbamazepine
Carbatrol
Carbenicillin
Carbidopa
Carbimazole
Carboplatin
Cardinorm
Cardiolite
Cardizem
Cardura
Carfentanil
Carisoprodol
Carnitine
Carvedilol
Casodex
Cataflam
Catapres
Cathine
Cathinone
Caverject
Ceclor
Cefacetrile
Cefaclor
Cefaclor
Cefadroxil
Cefazolin
Cefepime
Cefixime
Cefotan
Cefotaxime
Cefotetan
Cefpodoxime
Cefprozil
Ceftazidime
Ceftriaxone
Ceftriaxone
Cefuroxime
Cefuroxime
Cefzil
Celebrex
Celexa
Cellcept
Cephalexin
Cerebyx
Cerivastatin
Cerumenex
Cetirizine
Cetrimide
Chenodeoxycholic acid
Chloralose
Chlorambucil
Chloramphenicol
Chlordiazepoxide
Chlorhexidine
Chloropyramine
Chloroquine
Chloroxylenol
Chlorphenamine
Chlorpromazine
Chlorpropamide
Chlorprothixene
Chlortalidone
Chlortetracycline
Cholac
Cholybar
Choriogonadotropin alfa
Chorionic gonadotropin
Chymotrypsin
Cialis
Ciclopirox
Cicloral
Ciclosporin
Cidofovir
Ciglitazone
Cilastatin
Cilostazol
Cimehexal
Cimetidine
Cinchophen
Cinnarizine
Cipro
Ciprofloxacin
Cisapride
Cisplatin
Citalopram
Citicoline
Cladribine
Clamoxyquine
Clarinex
Clarithromycin
Claritin
Clavulanic acid
Clemastine
Clenbuterol
Climara
Clindamycin
Clioquinol
Clobazam
Clobetasol
Clofazimine
Clomhexal
Clomid
Clomifene
Clomipramine
Clonazepam
Clonidine
Clopidogrel
Clotrimazole
Cloxacillin
Clozapine
Clozaril
Cocarboxylase
Cogentin
Colistin
Colyte
Combivent
Commit
Compazine
Concerta
Copaxone
Cordarone
Coreg
Corgard
Corticotropin
Cortisone
Cotinine
Cotrim
Coumadin
Cozaar
Crestor
Crospovidone
Cuprimine
Cyanocobalamin
Cyclessa
Cyclizine
Cyclobenzaprine
Cyclopentolate
Cyclophosphamide
Cyclopropane
Cylert
Cyproterone
Cystagon
Cysteine
Cytarabine
Cytotec
Cytovene
Isotretinoin
D
E
F
G
H
I
J
K
L
M
N
O
P
Q
R
S
T
U
V
W
X
Y
Z

Indications

Capecitabine is FDA-approved for:

Metastatic Colorectal Cancer

  • Used as first-line monotherapy, if appropriate.

Metastatic Breast Cancer

  • Used in combination with docetaxel, after failure of anthracycline-based treatment.
  • Used as monotherapy, if the patient has failed paclitaxel-based treatment, and if anthracycline-based treatment has either failed or cannot be continued for other reasons (i.e., the patient has already received the maximum lifetime dose of an anthracycline).

Dose

The usual starting dose is 2,500 mg/m2/day in two divided doses, 12 hours apart. One cycle includes two weeks of treatment followed by one week without treatment. Cycles can be repeated every three weeks.

Dose Adjustments

  • For mild renal dysfunction (creatinine clearance 30-50 mL/min), it is recommended to reduce dose by 25%.
  • For severe renal dysfunction (creatinine clearance <30 mL/min), treatment is not recommended.
  • There is no recommendation for hepatic dysfunction.
  • For elderly patients, lower doses may be required due to higher incidences of serious adverse reactions.

Administration

Take orally with water, within 30 minutes after a meal.

Potential Adverse Reactions (Major)

  • Cardiovascular: EKG changes, myocardial infarction, angina (these may be more common in patients with pre-existing coronary artery disease)
  • Dermatological: Hand-foot syndrome (numbness, tingling, pain, redness, or blistering of the palms of the hands and soles of the feet)
  • Gastrointestinal: Diarrhea (sometimes severe), nausea, stomatitis
  • Hematological: Neutropenia, anemia, thrombocytopenia
  • Hepatic: Hyperbilirubinemia

Drug Interactions

  • Capecitabine may interact with warfarin and increase bleeding risk. It is recommended to watch coagulation levels (INR) closely and adjust warfarin doses appropriately.
  • Capecitabine may inhibit cytochrome CYP2C9 enzyme, and therefore increase levels of substrates such as phenytoin. It is recommended to monitor phenytoin levels in patients taking both medications. Other substrates of CYP2C9 may also be affected. Evaluate according to clinical judgment.
  • Much as fluorouracil, the concomitant use of leucovorin may increase both the efficacy and the toxicity of capecitabine.

Pregnancy / Lactation Information

  • Capecitabine is pregnancy category D. Women of childbearing potential are advised to avoid becoming pregnant while using capecitabine.
  • Significant amounts of capecitabine may be excreted into the breast milk. It is recommended to discontinue nursing while using capecitabine.

Read more at Wikipedia.org


[List your site here Free!]


Urinary gems: Acyclovir crystalluria
From Archives of Pathology & Laboratory Medicine, 6/1/02 by Lyon, Andrew W

Images in Pathology

A 53-year-old woman with a history of metastatic breast cancer was admitted 12 days following her sixth cycle of capecitabine and docetaxel chemotherapy because of hypokalemia, hypocalcemia, and dehydration. Prolonged diarrhea followed the chemotherapy and may have contributed to the development of hypokalemia. The chemotherapy protocol was suspended, and the patient received fluid support, potassium, and calcium carbonate supplements. Urine microscopy detected yeast, subsequently identified as Candida glabrata by urine culture, and the patient was treated with fluconazole.

Four days later, this immunosuppressed patient developed a sore swollen tongue. An oral infection by herpes simplex virus was presumed, and treatment with acyclovir was initiated as follows: day 1, 200 mg oral every 5 hours; days 2 through 4, 400 mg intravenous every 8 hours. On the fourth day of acyclovir treatment, a random urine specimen was submitted for chemical and microscopic urinalysis. The urine was cloudy and yellow with a high specific gravity level (>1.030), low pH (5.5), and a glucose level of 0.1 g/dL (5.5 mmol/L); there was a strong reaction for blood (+++) and protein (100 mg/dL), but no reaction for ketones, nitrite, or leukocyte esterase (Multistix 8 SG, Bayer Inc, Etobicoke, Ontario, Canada). Microscopy of the urine sediment revealed abundant, colorless, transparent, fine-needle-- shaped crystals and a few red blood cells and yeast cells (Figure 1). The crystals had either sharp ends or blunt ends and had red-green birefringence in polarized light (Figure 2). The large quantity of crystals caused the cloudy appearance of the fluid and suggested radiographic contrast material or drug-associated crystalluria. The laboratory medical staff was consulted when the ward staff denied that the patient had had recent radiology studies or antibiotic therapy. Following review of pharmaceutical use and patient history, the possibility of acyclovir crystalluria was considered likely.

This case presented 2 teaching points. First, acyclovir crystalluria is a rare side effect of a very commonly used drug. While there are few published reports that specifically describe this crystalluria, acyclovir-induced renal failure was observed in 58 of 354 patients following intravenous drug administration.1 It is surprising that acyclovir crystalluria is seldom observed. Drug-induced crystalluria is frequently observed in tertiary-care centers, and it is important to remember that prompt attention to this urine microscopy observation can help avoid drug-associated renal toxicity.

The second teaching point was that desktop electronic access to medical literature had a positive influence on this patient's care. A quick search of the National Library of Medicine's PubMed database for acyclovir crystalluria identified 4 previous reports and also indicated that acyclovir treatment has a risk of nephrotoxicity due to renal tubular damage by crystals.2-5 The shape and properties of the crystals we observed were consistent with acyclovir but were not sufficiently unique to allow identification.2-4 The suspicion of acyclovir crystalluria was noted on the urinalysis report and in consultation with the attending physician. Two days later, the patient's medical chart contained a review article on drug-- induced crystalluria and renal failure obtained via electronic access to medical journals by the oncology staff; acyclovir treatment for this patient was discontinued and the crystalluria resolved within 24 hours with no indication of renal toxicity based on the creatinine levels. This scenario of using desktop access to medical literature to rapidly and conveniently research unusual observations is becoming routine practice among many pathologists, clinicians, and patients.

References

1. Brigden D, Rosling AE, Woods NC. Renal function after acyclovir intravenous injection. Am I Med. 1982;73:182-185.

2. Potter JL, Krill CE. Acyclovir crystalluria. Pediatr Infect Dis. 1986;5:710-711.

3. Perazella MA. Crystal-induced acute renal failure. Am J Med. 1999;106: 459-465.

4. Peterslund NA, Larsen ML, Mygind H. Acyclovir crystalluria. Scand Infect Dis. 1988;20:225-228.

5. Sawyer MH, Webb DE, Balow JE, Straus SE. Acyclovir-induced renal failure. Am J Med. 1988;84:1067-1071.

Andrew W. Lyon, PhD; Adnan Mansoor, MD; Martin J. Trotter, MD, PhD

Accepted for publication January 22, 2002.

From the Department of Pathology and Laboratory, Faculty of Medicine, University of Calgary and Calgary Laboratory Services, Calgary, Alberta.

Reprints: Andrew W. Lyon, PhD, Calgary Laboratory Services, 1638 10th Ave SW, Calgary, Alberta, Canada T3C OJ5 (e-mail: alyon@ ucalgary.ca).

Copyright College of American Pathologists Jun 2002
Provided by ProQuest Information and Learning Company. All rights Reserved

Return to Capecitabine
Home Contact Resources Exchange Links ebay