Capecitabine

Capecitabine is a prodrug that is converted to Huorouracil in body tissue. Fluorouracil, an analogue of the pyrimidine uracil is an antineoplastic that acts as an antimetabolite.

Indications

It is used alone or in combination in the adjuvant and palliative treatment of gastrointestinal cancer & breast cancer.

Dosage

Adult: 2.5 g/m2 body surface in 2 divided doses daily, 12 hrs apart wih food for 2 weeks followed by a 1-week rest period; therapy to be given in 3-week cycles. In combination with docetaxel: 1250 mg/m2 bid for 2 weeks followed by a 1-week rest period. Courses of therapy to be given in 3-week cycles.

Contra-Indications

History of severe and unexpected reactions to fluoropyrimidine therapy; severe renal impairment; pregnancy, lactation. Hypersensitivity.

Special Precautions

Hepatic dysfunction, bone marrow suppression, poor nutritional status, on warfarin therapy. Child, elderly, patients who received extensive pelvic radiation or alkylating therapy. Moderate renal impairment; CBC with differential; hepatic and renal function should be monitored. Discontinue use if intractable diarrhoea, stomatitis, bone marrow suppression or myocardial ischaemia develops.

Side Effects

Diarrhoea, nausea and vomiting, stomatitis, palmar-plantar syndrome (erythema and desquamation of hands and feet), dermititis. Fatigue, mucosal inflammation, pyrexia, asthenia and lethargy; headache, dizziness and insomnia; lower limb oedema, anorexia, dehydration.

Drug Interactions

Antacids containing aluminum and magnesium, leucovorin, anticoagulants, phenytoin, allopurinol.