Capecitabine: Uses, Dosing, Side Effects

Capecitabine (brand name Xeloda) is an oral chemotherapy pill that turns into 5‑fluorouracil (5‑FU) inside the body. Doctors use it for colorectal cancer, some breast cancers, and other cancers where a tablet is easier than IV treatment. Because it’s a prodrug, it targets tumors more than normal tissue, but it still has real side effects you should watch for.

How to take capecitabine

Typical dosing for adults is 1250 mg/m2 taken twice a day for 14 days, then 7 days off (a 3‑week cycle). Your oncologist will calculate the exact tablet count based on body surface area. If you have moderate kidney problems (creatinine clearance 30–50 mL/min) your dose is usually cut by about 25%. Capecitabine is not recommended if creatinine clearance is under 30 mL/min.

Take capecitabine within 30 minutes after a meal and swallow tablets whole with water. Keep a calendar of doses so you don’t miss the 14‑day schedule. If you vomit soon after a dose, tell your care team — they’ll tell you whether to repeat it. Never change your dose without asking your doctor.

Side effects, monitoring and safety tips

Common side effects include hand‑foot syndrome (red, sore, peeling palms/soles), diarrhea, nausea, mouth sores, fatigue, low blood counts, and mild liver enzyme bumps. Severe reactions can happen, especially if you have DPD (dihydropyrimidine dehydrogenase) deficiency — a genetic issue that raises toxicity risk. Many centers now test for DPYD variants before starting treatment.

Your care team will monitor blood counts, kidney and liver tests regularly — often weekly during the first cycles. If you’re on warfarin, expect frequent INR checks because capecitabine can increase bleeding risk. Use reliable sun protection; sunburn and skin reactions can be worse while on chemo.

For hand‑foot syndrome, try thick emollients, cool compresses, and avoid tight shoes or hot water. For diarrhea, sip fluids and report severe cases early — dehydration can force dose delays. If you notice fever, severe mouth sores, sudden bleeding, or new confusion, contact your clinic right away.

Pregnancy and breastfeeding are big no‑nos with capecitabine. It can harm a fetus and pass into breast milk. Use effective contraception during treatment and for a period after — your oncologist will give exact timing.

Buying tips: capecitabine requires a prescription. Do not use unverified online pharmacies. If cost is an issue, ask about generic capecitabine, patient assistance programs, or hospital pharmacy help. Always confirm any pharmacy is licensed and ask your oncologist or pharmacist if a price or supplier seems off.

If you have questions about side effects, interactions, or how this drug fits your plan, talk to your oncology nurse or pharmacist. They can help you manage symptoms, adjust doses, and stay safe while on treatment.