Capecitabine, Oral

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KEY POINTS

• This medicine is taken by mouth to treat breast cancer or colorectal cancer. Take it exactly as directed.
• This medicine may increase your risk of bleeding if you take blood thinner medicines.
• You may get infections more easily when you are taking this medicine.
• This medicine may cause unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: antineoplastic (anticancer)

Generic and brand names: capecitabine, oral; Xeloda

What is this medicine used for?

This medicine is taken by mouth to treat metastatic (spreading) breast cancer or colorectal cancer.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine
• A weakened immune system due to illness or medicines
• Dihydropyrimidine dehydrogenase (DPD) deficiency
• Heart problems or coronary artery disease
• Kidney or liver disease

Tell your provider if you take warfarin (Coumadin).

Females of childbearing age: This medicine is not usually given to pregnant women because it can harm the baby. If you are pregnant, tell your healthcare provider. Do not become pregnant during treatment with this medicine. Talk with your healthcare provider about effective birth control. If you become pregnant, contact your healthcare provider right away. Do not breast-feed while you are receiving this medicine.

Males: Use effective birth control because this medicine may affect sperm. Talk with your healthcare provider about this.

How do I take it?

Usually you will take this medicine 30 minutes after breakfast and dinner. Do not crush, chew, or dissolve the tablets. Swallow them whole with a glass of water. You will take the medicine for 2 weeks, followed by 1 week without the medicine. Continue these 3-week cycles as long as your healthcare provider tells you to do so. Do not stop taking this medicine without your healthcare provider's approval. Your healthcare provider may adjust your dosage according to your response to the medicine. Follow your healthcare provider's directions exactly.

Check with your healthcare provider before using this medicine in children under age 18.

What if I miss a dose?

If you miss a dose, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: nausea, vomiting, diarrhea, unusual bruising or bleeding.

What should I watch out for?

This medicine may increase the effect of blood thinners such as warfarin (Coumadin). If you take blood thinners during and after treatment with this medicine, you need to have blood tests to see how fast your blood clots. Your provider may need to change the dose of your blood thinner. You are more at risk of bleeding problems if you are over the age of 60 or if you have cancer.

Diarrhea is common with this medicine and can sometimes be severe. Stop taking this medicine and call your healthcare provider right away if you have constant or severe bloody diarrhea with severe stomach pain and fever. Ask your healthcare provider what medicines you can take to treat your diarrhea.

You may get infections more easily when you are taking this medicine. Stay away from people with colds, flu, or other infections. Also, do not have any vaccines without getting your healthcare provider's approval first.

You will need to have blood tests regularly to see how this medicine affects you. Keep all appointments.

If you develop hives, an itchy rash, or peeling skin, stop taking the medicine and contact your provider right away.

This medicine may make your mouth sore. Use a soft bristle brush or mouth swab to brush your teeth.

This medicine may cause your eyes to be dry and more sensitive. Wearing contacts may be uncomfortable.

This medicine may increase your risk of dehydration. The risk may be higher if you already have kidney problems or you take medicines that affect your kidneys. Be careful when exercising, especially in hot weather. Contact your healthcare provider if you develop severe vomiting or diarrhea while you are taking this medicine.

This medicine may make you dizzy or drowsy. Do not drive or operate machinery unless you are fully alert.

Adults over the age of 65 may be at greater risk of side effects. Talk with your healthcare provider about this.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you are taking this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; trouble breathing; chest pain or tightness in your chest; swelling of your lips, tongue, and throat).

Serious (Report these to your healthcare provider right away.): Fever over 100.4°F, or 38°C; severe or bloody diarrhea, severe stomach pain; severe nausea, vomiting, or diarrhea; mouth sores, problems eating or drinking; numbness, tingling, redness, pain, or swelling of your hands or feet; yellowing of your skin or eyes; trouble breathing; chest pain or tightness; severe dizziness or fainting; fast or irregular heartbeat; unexplained swelling or sudden weight gain; unexplained tiredness or weakness; decreased urination; unusual bruising or bleeding; confusion; seizures; vision problems; severe skin redness, rash, peeling, or blistering.

Other: Mild stomach pain or nausea, mild diarrhea, constipation, mild rash, itchy or dry skin, mild tiredness, eye irritation, headache, mild dizziness, trouble sleeping, loss of appetite, change in sense of taste, hair loss, nail changes.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• Antacids
• Antibiotics such as dapsone and metronidazole
• Bosentan (Tracleer)
• Cimetidine (Tagamet)
• Diabetes medicines such as chlorpropamide, glimepiride (Amaryl), glipizide (Glucotrol), glyburide (Glynase), nateglinide (Starlix), and tolbutamide
• Fluoxetine (Prozac)
• Heart medicines such as carvedilol (Coreg) and losartan (Cozaar)
• Leucovorin
• Mestranol/norethindrone (Necon, Norinyl)
• Ospemifene (Osphena)
• Pain medicines such as celecoxib (Celebrex), diclofenac (Cambia, Voltaren, Zipsor), meloxicam (Mobic), and piroxicam (Feldene)
• Phenytoin (Dilantin, Phenytek)
• Ramelteon (Rozerem)
• Sulfa antibiotics such as sulfadiazine, sulfamethoxazole/trimethoprim (Bactrim, Septra), and sulfasalazine (Azulfidine)
• Tamoxifen
• Torsemide (Demadex)
• Vaccines
• Voriconazole (Vfend)
• Warfarin (Coumadin)
• Zafirlukast (Accolate)

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.