`
`Capecitabine
`
`Sign In Register
`
`Sign Up for Email
`
`Español
`
` Asian & Pacific Languages
`
`
`
`
`
`
`
`How can we help you?
`
` search cancer.org
`
`
`
` SEARCH
`
`
`
` Live Chat
`
` 8002272345
`
`Home
`
`
`
`Learn About Cancer
`
`
`
`Stay Healthy
`
`
`
`Find Support & Treatment
`
`
`
`Explore Research
`
`
`
`Get Involved
`
`
`
`Find Local ACS
`
`Find Support & Treatment » Treatments and Side Effects » Guide to Cancer Drugs » Capecitabine
`
`
`
`
` SHARE
`
`
`
` SAVE
`
`Your Local Offices
`
`Close
`
`+
`
`Capecitabine
`(kapesiteuhbean)
`
`Text Size
`
`Trade/other name(s): Xeloda
`Why would this drug be used?
`Capecitabine is used to treat breast, colon, or rectal cancer. It may also be used to treat other types of cancer.
`
`How does this drug work?
`
`Capecitabine belongs to a group of chemotherapy drugs known as antimetabolites. It keeps cells from making DNA
`and RNA, which stops cancer cells from growing. Capecitabine is converted to the drug 5fluorouracil (5FU) in your
`body, letting more of the active drug get to the tumor.
`
`Before taking this medicine
`
`http://www.cancer.org/treatment/treatmentsandsideeffects/guidetocancerdrugs/capecitabine
`
`1/6
`
`IMMUNOGEN 2246, pg. 1
`Phigenix v. Immunogen
`IPR2014-00676
`
`
`
`12/18/2014
`
`Capecitabine
`
`Tell your doctor…
`If you are allergic to anything, including medicines, dyes, additives, or foods.
`
`If you have any medical conditions such as kidney disease, liver disease (including hepatitis), diabetes, gout, or
`infections. These conditions may require that your medicine dose, regimen, or timing be changed.
`
`If you have heart disease, congestive heart failure, or any other heart problem. This drug may damage the heart,
`which may be worse if you already have a heart problem.
`
`If you have ever been told you have a dihydropyrimidine dehydrogenase (DPD) deficiency. DPD is an enzyme
`the body uses to process this drug. This inborn genetic abnormality can cause extreme side effects if you use 5FU
`(even on your skin) or capecitabine. DPD deficiency can be present without symptoms, so you may not know you
`have it until you get one of these drugs or are tested for it.
`
`If you are pregnant, trying to get pregnant, or if there is any chance of pregnancy. This drug may cause birth
`defects if either the male or female is taking it at the time of conception or during pregnancy. Check with your
`doctor about what kinds of birth control can be used with this medicine.
`
`If you are breastfeeding. It is not known whether this drug passes into breast milk. If it does, it could harm the
`baby.
`
`If you think you might want to have children in the future. Some drugs can cause sterility. Talk with your doctor
`about the possible risk with this drug and the options that may preserve your ability to have children.
`
`About any other prescription or overthecounter medicines you are taking, including vitamins and herbs. In
`fact, keeping a written list of each of these medicines (including the doses of each and when you take them) with
`you in case of emergency may help prevent complications if you get sick.
`
`Interactions with other drugs
`The drug leucovorin can cause severe diarrhea and damage to the intestine if taken with capecitabine.
`
`Talk with your doctor if you are taking folic acid or multiple vitamins. This may affect the way capecitabine works.
`
`Antacids may slightly raise the amount of capecitabine your body absorbs if they are taken within an hour or two of
`this drug. Tell your doctor if you take antacids.
`
`If you are taking warfarin (Coumadin) this drug can interfere with the breakdown of warfarin and increase the risk of
`bleeding. Your doctor will need to check your blood more often during and for some time after treatment and may need
`to adjust your warfarin dose.
`
`This drug can lower platelet counts, which increases the risk of bleeding. If your platelet count is low, drugs or
`supplements that interfere with blood clotting can raise the risk of bleeding further. These include:
`
`Vitamin E
`
`Aspirin and other nonsteroidal antiinflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin), naproxen (Aleve,
`Naprosyn), and many others
`
`Ticlopidine (Ticlid)
`
`Clopidogrel (Plavix)
`
`Rivaroxaban (Xarelto)
`
`Apixaban (Eliquis)
`
`Dabigatran (Pradaxa)
`
`Fondaparinux (Arixtra)
`
`Any type of heparin injections, such as enoxaparin (Lovenox), dalteparin (Fragmin), or tinzaparin (Innohep)
`
`Note that many cold, flu, fever, and headache remedies contain aspirin or ibuprofen. Ask your pharmacist if you aren't
`sure what's in the medicines you take.
`
`http://www.cancer.org/treatment/treatmentsandsideeffects/guidetocancerdrugs/capecitabine
`
`2/6
`
`IMMUNOGEN 2246, pg. 2
`Phigenix v. Immunogen
`IPR2014-00676
`
`
`
`Capecitabine
`12/18/2014
`This drug can increase the amount of the antiseizure drug phenytoin (Dilantin) in your body. Drug levels must be
`watched closely while taking capecitabine.
`
`Check with your doctor, nurse, or pharmacist about other medicines, vitamins, herbs, and supplements, and whether
`alcohol can cause problems with this medicine.
`
`Interactions with foods
`Capecitabine must be taken with food to slow down its absorption into the body. If taken without food, it reaches
`higher levels in the body, which may cause worsened and more dangerous side effects.
`
`Tell all the doctors, dentists, nurses, and pharmacists you visit that you are taking this drug.
`
`How is this drug taken or given?
`
`This medicine is taken once in the morning and once in the evening. Take the pills with a glass of water just after a
`meal (within 30 minutes). Try to take the pills at the same time each day. The pills are usually given for 14 days, then
`no pills for 7 days. This cycle is repeated every 3 weeks if you have no serious problems.
`
`The dose depends upon your size, your blood counts, and whether you have serious side effects. If you have certain
`side effects, your doctor will probably stop medicine for a while and may restart the pills at a lower dose. This does
`not mean the medicine will not work as well, but people may need different doses.
`
`Take this drug exactly as your doctor tells you to. Be sure you know how much of each type of pill you are supposed
`to take at each dose. If your dose changes, be sure to find out exactly how to take the right amount. If you do not
`understand the directions, ask your doctor or nurse can explain them to you.
`
`Store the medicine in a closed container, and protect it from light. Keep it away from children and pets.
`Precautions
`Do not get any immunizations (vaccines), either during or after treatment with capecitabine without your doctor's OK.
`Capecitabine may affect your immune system. This could make vaccinations ineffective, or could even lead to serious
`infections if you get a live virus vaccine during or soon after treatment. Try to avoid contact with people who have
`recently received a live virus vaccine, such as the oral polio vaccine or smallpox vaccine. Check with your doctor about
`this.
`
`Your doctor will likely test your blood throughout your treatment, looking for possible effects of the drug on blood
`counts (described below) or on other body organs. Based on the test results, you may be given medicines to help
`treat any effects. Your doctor may also need to reduce or delay your next dose of this drug, or even stop it
`completely. Keep all your appointments for lab tests and doctor visits.
`
`Taking this drug with warfarin (Coumadin) increases the risk of serious bleeding (see “Interactions with other drugs”
`above).
`
`This drug can lower your white blood cell count, especially in the weeks after the drug is given. This can increase your
`chance of getting an infection. Be sure to let your doctor or nurse know right away if you have any signs of infection,
`such as fever (100.5° or higher), chills, pain when passing urine, a new cough, or bringing up sputum.
`
`This drug may lower your platelet count in the weeks after it is given, which can increase your risk of bleeding.
`Speak with your doctor before taking any drugs or supplements that might affect your body's ability to stop bleeding
`(see “Interactions with other drugs” above). Tell your doctor right away if you have unusual bruising, or bleeding such
`as nosebleeds, bleeding gums when you brush your teeth, or black, tarry stools.
`
`This drug may lower your red blood cell count. If this occurs, it is usually a few months after starting treatment. A low
`red blood cell count (known as anemia) can cause shortness of breath, or make you to feel weak or tired all the time.
`Your doctor may give you medicines to help prevent or treat this condition, or you may need to get blood transfusions.
`
`This drug can cause a condition known as handfoot syndrome, in which a person may experience pain, numbness,
`tingling, reddening, or swelling in the hands or feet. If severe, the skin may blister and peel, and open sores may
`develop in these areas. Let your doctor know right away if you notice any of these symptoms.
`
`This drug can rarely cause severe skin problems which can even be fatal. Let your doctor know if you develop a rash
`
`http://www.cancer.org/treatment/treatmentsandsideeffects/guidetocancerdrugs/capecitabine
`
`3/6
`
`IMMUNOGEN 2246, pg. 3
`Phigenix v. Immunogen
`IPR2014-00676
`
`
`
`Capecitabine
`12/18/2014
`with blisters, skin peeling, or sores in your mouth, especially if it gets worse over time.
`
`This drug can cause diarrhea, which is sometimes severe. Let your doctor know if you develop diarrhea with more
`than 4 loose bowel movements per day, have nighttime diarrhea, have bloody stools, or are unable to control your
`stools (have incontinence). Your doctor may need to stop this drug for a time to prevent serious problems.
`
`Patients with problems eating and drinking, nausea, vomiting, and/or diarrhea from this drug can become dehydrated.
`If left untreated, this can lead to kidney failure. Let your doctor know if you are having any of these problems or if you
`have symptoms of dehydration, such as feeling weak, dizzy, or lightheaded. You may need treatment for these
`problems and dehydration before taking more capecitabine.
`
`Patients taking this drug can develop high bilirubin levels and other abnormal blood tests that indicate possible liver
`problems. High bilirubin levels can lead to yellowing of the skin and the whites of the eyes and darkened urine. Your
`doctor will check your blood tests to see if this drug may be affecting the liver. If it is, the drug may need to be
`stopped for a time.
`
`Men and women should avoid conceiving a child during and for a few months after treatment. Talk with your doctor
`about birth control.
`
`Possible side effects
`
`You will probably not have most of the following side effects, but if you have any talk to your doctor or nurse. They can
`help you understand the side effects and cope with them.
`
`Common
`Diarrhea, which is sometimes severe*
`
`Nausea
`
`Vomiting
`
`Sores in mouth or on lips
`
`Tiredness or weakness
`
`Numbness, tingling, itching of hands or/and feet*
`
`Skin redness, rash, dryness
`
`Low red blood cell count (anemia) with increased risk of tiredness (fatigue)*
`
`Skin irritation
`
`Less common
`Low white blood cell count with increased risk of infection*
`
`Low platelet count with increased risk of bleeding*
`
`Pain in the belly, back, or joints
`
`Constipation
`
`Poor appetite
`
`Heartburn after eating
`
`Fever
`
`Feelings of pins and needles in hands and/or feet
`
`Headache
`
`Dizziness
`
`Trouble sleeping
`
`http://www.cancer.org/treatment/treatmentsandsideeffects/guidetocancerdrugs/capecitabine
`
`4/6
`
`IMMUNOGEN 2246, pg. 4
`Phigenix v. Immunogen
`IPR2014-00676
`
`
`
`Capecitabine
`
`12/18/2014
`Cough or trouble breathing
`
`Eye irritation
`
`Skin color changes
`
`Hair loss or thinning (including face and body hair)
`
`Bleeding from the bowel
`
`Abnormal blood tests which suggest that the drug is affecting the liver (Your doctor will discuss the importance of
`this finding, if any.)*
`
`Rare
`Dehydration, sometimes with kidney failure*
`
`Depression
`
`Bowel damage (necrotizing typhlitis)
`
`Heart damage with swelling of ankles, chest pain, abnormal heartbeat
`
`Handfoot syndrome or severe skin problems*
`
`Allergic reaction
`
`Death due to bleeding, heart failure, heart attack, infection, skin problems, or other causes
`
`*See "Precautions" section for more detailed information.
`
`There are other side effects not listed above that can also occur in some patients. Tell your doctor or nurse if you
`develop these or any other problems.
`FDA approval
`Yes – first approved in 1998
`
`Disclaimer: This information does not cover all possible uses, actions, precautions, side effects, or interactions. It is
`not intended as medical advice, and should not be relied upon as a substitute for talking with your doctor, who is
`familiar with your medical needs.
`
`Last Medical Review: 02/01/2010
`Last Revised: 10/28/2014
`
`Find Support & Treatment
`Topics
`
`Understanding Your Diagnosis
`
`Finding and Paying for Treatment
`
`Treatments and Side Effects
`
`Survivorship: During and After
`Treatment
`
`Children and Cancer
`
`Caregivers and Family
`
`Nearing the End of Life
`
`Find Support Programs and
`Services in Your Area
`
`http://www.cancer.org/treatment/treatmentsandsideeffects/guidetocancerdrugs/capecitabine
`
`5/6
`
`IMMUNOGEN 2246, pg. 5
`Phigenix v. Immunogen
`IPR2014-00676
`
`
`
`12/18/2014
`
`Capecitabine
`
`CANCER INFORMATION
`
`PROGRAMS & SERVICES
`
`ACS EVENTS
`
`Cancer Basics
`
`Breast Cancer Support
`
`Cancer Prevention & Detection
`
`Signs & Symptoms of Cancer
`
`Treatments & Side Effects
`
`Cancer Facts & Statistics
`
`News About Cancer
`
`Expert Voices Blog
`
`TLC Hair Loss & Mastectomy
`Products
`
`Making Strides Against Breast
`Cancer Walks
`
`Coaches vs. Cancer
`
`Hope Lodge® Lodging
`
`Relay For Life Events
`
`Rides To Treatment
`
`College Relay For Life
`
`Online Support Communities
`
`Relay Recess
`
`WhatNext
`
`Donate a Car
`
`ABOUT ACS
`
`About Us
`
`Contact Us
`
`Local Offices
`
`Volunteer
`
`Employment
`
`MORE ACS SITES
`
`Bookstore
`
`ACS CAN
`
`Gift Shop
`
`Cancer Atlas
`
`Global Health
`
`Become a Supplier
`
`Finish the Fight
`
`Report Fraud or Abuse
`
`Press Room
`
`Mobile Site
`
`Help
`
`
`
`Site Map
`
`
`
`Privacy
`
`
`
`Accessibility
`
`
`
`Terms of Use
`
`
`
`State Fundraising Notices
`
`
`
`Site Comments
`
` Better Business Bureau
`
` Health On The Net
`
`
`
` National Health Council
`
`© 2014 American Cancer Society, Inc. All rights
`reserved. The American Cancer Society is a qualified
`501(c)(3) taxexempt organization. Cancer.org is
`provided courtesy of the Leo and Gloria Rosen family.
`
`http://www.cancer.org/treatment/treatmentsandsideeffects/guidetocancerdrugs/capecitabine
`
`6/6
`
`IMMUNOGEN 2246, pg. 6
`Phigenix v. Immunogen
`IPR2014-00676