Capecitabine (Xeloda)

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General information

Class/mechanism: Pyrimidine analog, antimetabolite, inhibitor of thymidylate synthase. Converted in vivo to fluorouracil (5-FU), which is metabolized to 5-fluoro-2'-deoxyuridine monophosphate (FdUMP) and 5-fluorouridine triphosphate (FUTP). FdUMP inhibits DNA synthesis by binding to thymidylate synthase and inhibiting production of thymidylate; FUTP interferes with RNA processing when it is mistakenly incorporated in place of uridine triphosphate (UTP).[1][2][3]
Route: PO
Extravasation: n/a

For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as Micromedex, Lexicomp, Medscape, UpToDate (courtesy of Lexicomp), or the prescribing information.[1]

Metabolism

DPYD intermediate or poor metabolizers: Results in higher adverse reaction risk (severe, life-threatening, or fatal toxicities). No dosage has proven safe in poor metabolizers, and insufficient data are available to recommend a dosage in intermediate metabolizers. Withhold or discontinue in the presence of early-onset or unusually severe toxicity.[4]

Diseases for which it is used

Patient drug information

History of changes in FDA indication

Breast cancer

Colorectal cancer

  • 4/30/2001: New indication as first-line treatment of patients with metastatic colorectal carcinoma when treatment with fluoropyrimidine therapy alone is preferred.
  • 6/15/2005: New indication as a single agent for adjuvant treatment in patients with Dukes’ C colon cancer who have undergone complete resection of the primary tumor when treatment with fluoropyrimidine therapy alone is preferred.

Also known as

  • Code name: Ro 09-1978/000
  • Generic names: capecitabine RDT, kapesitabin
  • Brand names: Cabita, Capebin, Capegard, Capnat, Caposib, Capsy, Caxeta, Citabin, Flagoda, Naprocap, Skemca, Xeloda, Xlotabin

References