Capecitabine

Xeloda is indicated for the treatment of metastatic breast cancer (often used in combination with other chemotherapy agents like docetaxel), adjuvant treatment of colon cancer following surgery, and advanced gastric or gastroesophageal junction adenocarcinoma. It may also be used for other cancers as determined by an oncologist.

Xeloda is a prodrug that is orally administered and converted to its active form (5-fluorouracil) primarily within tumor cells through an enzyme called thymidine phosphorylase, which is often more concentrated in cancer cells than in normal tissues. The active metabolite inhibits thymidylate synthase, a critical enzyme for DNA synthesis, and is also incorporated into RNA and DNA, leading to cell death in rapidly dividing cancer cells.

Xeloda carries a BLACK BOX WARNING for severe and potentially fatal adverse reactions including cardiotoxicity, severe skin reactions, and hyperammonemic encephalopathy. Common side effects include hand-foot syndrome (palmar-plantar erythrodysesthesia), diarrhea, nausea, vomiting, and myelosuppression. Patients with known DPD (dihydropyrimidine dehydrogenase) deficiency are at increased risk for severe toxicity. It is contraindicated in pregnancy (Category D) and should not be used with sorivudine or brivudine due to fatal drug interactions. Regular blood monitoring and monitoring for cardiac symptoms are essential during treatment.