Capecitabine

Capecitabine may cause serious, life-threatening reactions in people with an inherited condition called DPD deficiency (a lack of a naturally occurring enzyme in the body). Your doctor will probably test you to see if you have this condition before starting treatment. If you experience any of the following symptoms, call your doctor immediately: sores in your mouth, tongue, or throat; diarrhea; fever, chills, sore throat, or other signs of an infection; changes in mood or mental status; problems with thinking, concentrating, memory, or sleep; difficulty walking; or loss of balance or coordination.

Capecitabine may cause serious or life-threatening bleeding when taken along with certain blood thinners medicines such as warfarin. Tell your doctor if you are taking a blood thinner. Your doctor may order laboratory tests to monitor how fast your blood clots and may need to change your blood thinner dose. If you experience any of the following symptoms, call your doctor immediately: unusual bleeding; vomiting or spitting up blood or brown material that resembles coffee grounds; bloody or black, tarry stools; blood in urine; red or dark-brown urine; or easy bruising.

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your body's response to capecitabine.

Capecitabine is used to treat certain types of breast cancer, colon or rectal cancer (cancer that begins in the large intestine), pancreatic cancer, and stomach or esophageal (tube that connects the throat with the stomach) cancers. Capecitabine is in a class of medications called antimetabolites. It works by stopping or slowing the growth of cancer cells.

Capecitabine comes as a tablet to take by mouth. Take twice a day (about 12 hours apart). Take within 30 minutes after a meal. The schedule and length of treatment depends on your condition and how you respond to treatment. Take capecitabine at around the same times every day.

Take capecitabine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. 

Swallow the tablets whole with water; do not split, chew, or crush them. Exposure to crushed tablets may cause eye irritation, rash, nausea, vomiting, diarrhea, stomach pain, eye irritation, headache, and feeling of pins and needles in your hands. If you cannot swallow the tablets whole, tell your doctor.

If you vomit after taking a dose of capecitabine, do not take another dose. Continue your regular dosing schedule.

Your doctor may adjust your dose or pause or permanently stop your treatment. This depends on how well the medication works for you and the side effects you experience. Talk to your doctor about how you are feeling during your treatment.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Before taking capecitabine,

• tell your doctor or pharmacist if you are allergic to this drug, any part of this drug, or any other drugs, foods or substances. Tell your doctor or pharmacist about the allergy and what symptoms you had.
• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take while taking capecitabine. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor if you have or have ever had kidney, liver, or heart disease.
• tell your doctor if you or your partner are pregnant or plan to become pregnant. You or your partner should not become pregnant while you are taking capecitabine. If you can become pregnant, you will need to take a pregnancy test before you start treatment and use birth control to prevent pregnancy during your treatment and for 6 months after your final dose. If your partner can become pregnant, you should use birth control during your treatment and for 3 months after your final dose. Talk to your doctor about what birth control would work best for you and your partner. If you or your partner become pregnant while taking capecitabine, call your doctor immediately. Capecitabine may harm the fetus.
• tell your doctor if you are breast-feeding. Do not breast-feed during your treatment and for 1 week after your final dose.
• you should know that this medication may decrease fertility in men and women. Talk to your doctor about the risks of taking capecitabine.

Unless your doctor tells you otherwise, continue your normal diet.

Skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Capecitabine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• stomach pain or upset stomach
• constipation
• loss of appetite, change in ability to taste food
• increased thirst
• unusual tiredness or weakness
• headache
• hair loss
• rash
• back, joint, or muscle pain
• red, swollen, itchy, or teary eyes
• trouble falling asleep or staying asleep

Some side effects can be serious. If you experience any of these symptoms or those listed in the IMPORTANT WARNING section, call your doctor immediately or get emergency medical treatment:

• nausea, vomiting, sores in the mouth
• bloody diarrhea, severe stomach pain, and fever
• swelling, pain, redness, blistering, or peeling of skin on the palms and soles of the feet
• rash, redness, itching, hives; swelling of the hands, feet, ankles, or lower legs; trouble breathing or swallowing
• chest pain or pressure, fast or irregular heartbeat, shortness of breath, dizziness, or lightheadedness
• dark urine, yellowing of skin or eyes

Capecitabine may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (https://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Keep all medication out of sight and reach of children as many containers are not child-resistant. Always lock safety caps. Place the medication in a safe location – one that is up and away and out of their sight and reach. https://www.upandaway.org

Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Do not flush this medication down the toilet. Use a medicine take-back program. Talk to your pharmacist about take-back programs in your community. Visit the FDA's Safe Disposal of Medicines website https://goo.gl/c4Rm4p for more information.

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines, vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies.

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