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Xeloda

Cancer Xeloda (Generic) Generic drugs, marketed without brand names, contain the exact same active ingredients used in their brand-name counterparts, but cost significantly less. The drugs are required to meet US Food and Drug Administration (FDA) standards for safety, purity and effectiveness.
Xeloda

Antimetabolite is another name for Xeloda, its generic form. It achieves its effect by inhibiting the synthesis of proteins that are required for the survival and multiplication of cancer cells. Providing treatment for people suffering from certain forms of breast, colon, or colorectal cancer.

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Generic Xeloda (Capecitabine): A Comprehensive Overview

Introduction

Generic Xeloda, known by its generic name capecitabine, is an oral chemotherapy drug used primarily in the treatment of various cancers. It is a prodrug of 5-fluorouracil (5-FU), which means it is converted into its active form, 5-FU, within the body. This conversion allows for targeted delivery of the chemotherapy agent to cancer cells, thereby minimizing damage to healthy cells. Capecitabine is widely used in the treatment of breast cancer, colorectal cancer, and gastric cancer, among others. This article provides an in-depth look at generic Xeloda, including its mechanism of action, indications, dosage, side effects, and more.

Mechanism of Action

Capecitabine is a fluoropyrimidine carbamate that is enzymatically converted to 5-fluorouracil (5-FU) in the body. The conversion occurs in three steps:

  1. First Pass Metabolism: Capecitabine is absorbed through the gastrointestinal tract and is first converted to 5'-deoxy-5-fluorocytidine (5'-DFCR) by carboxylesterase in the liver.

  2. Second Conversion: 5'-DFCR is then converted to 5'-deoxy-5-fluorouridine (5'-DFUR) by cytidine deaminase, primarily in the liver and tumor tissues.

  3. Final Activation: 5'-DFUR is finally converted to 5-fluorouracil (5-FU) by thymidine phosphorylase, an enzyme that is found in higher concentrations in tumor tissues compared to normal tissues.

Once converted to 5-FU, the drug inhibits thymidylate synthase, an enzyme crucial for DNA synthesis. By inhibiting this enzyme, 5-FU disrupts the production of thymidine, a nucleotide required for DNA replication and repair. This leads to the inhibition of cancer cell proliferation and ultimately induces apoptosis (programmed cell death) in cancer cells.

Indications

Generic Xeloda (capecitabine) is indicated for the treatment of several types of cancer, including:

  1. Breast Cancer:

    • Adjuvant Treatment: Capecitabine is used as adjuvant therapy in patients with early-stage breast cancer who have undergone surgery and may have a high risk of recurrence.

    • Metastatic Breast Cancer: It is also used in the treatment of metastatic breast cancer, either as a single agent or in combination with other chemotherapy drugs.

  2. Colorectal Cancer:

    • Adjuvant Treatment: Capecitabine is used as adjuvant therapy in patients with stage III colon cancer who have undergone complete resection of the primary tumor.

    • Metastatic Colorectal Cancer: It is used in the treatment of metastatic colorectal cancer, often in combination with other chemotherapy agents such as oxaliplatin (XELOX regimen).

  3. Gastric Cancer:

    • Capecitabine is used in the treatment of advanced or metastatic gastric cancer, often in combination with other chemotherapy drugs like cisplatin.

  4. Other Cancers:

    • Capecitabine has also been investigated for use in other cancers, including pancreatic cancer, esophageal cancer, and head and neck cancers, either as a single agent or in combination with other therapies.

Dosage and Administration

The dosage of capecitabine varies depending on the type of cancer being treated, the patient's body surface area, and the specific treatment regimen. It is typically administered orally in the form of tablets, which should be taken with water within 30 minutes after a meal.

  1. Breast Cancer:

    • Adjuvant Treatment: The usual dose is 1250 mg/m² twice daily (morning and evening) for 14 days, followed by a 7-day rest period, repeated every 21 days.

    • Metastatic Breast Cancer: The dose may vary, but it is often similar to the adjuvant treatment regimen.

  2. Colorectal Cancer:

    • Adjuvant Treatment: The usual dose is 1250 mg/m² twice daily for 14 days, followed by a 7-day rest period, repeated every 21 days.

    • Metastatic Colorectal Cancer: The dose may be adjusted based on the combination therapy being used.

  3. Gastric Cancer:

    • The usual dose is 1000 mg/m² twice daily for 14 days, followed by a 7-day rest period, repeated every 21 days, often in combination with cisplatin.

Side Effects

Like all chemotherapy drugs, capecitabine can cause a range of side effects, which can vary in severity depending on the individual patient and the dosage administered. Common side effects include:

  1. Gastrointestinal Effects:

    • Diarrhea: One of the most common side effects, which can range from mild to severe.

    • Nausea and Vomiting: These symptoms can often be managed with antiemetic medications.

    • Stomatitis: Inflammation of the mouth and lips, which can lead to painful sores.

    • Abdominal Pain: Some patients may experience abdominal discomfort or pain.

  2. Hematologic Effects:

    • Neutropenia: A decrease in the number of neutrophils, a type of white blood cell, which can increase the risk of infection.

    • Anemia: A reduction in red blood cells, leading to fatigue and weakness.

    • Thrombocytopenia: A decrease in platelets, which can increase the risk of bleeding.

  3. Dermatologic Effects:

    • Hand-Foot Syndrome (Palmar-Plantar Erythrodysesthesia): A condition characterized by redness, swelling, and pain on the palms of the hands and soles of the feet.

    • Rash: Some patients may develop a rash or other skin reactions.

  4. Fatigue:

    • Many patients experience fatigue, which can range from mild to severe and may impact daily activities.

  5. Other Side Effects:

    • Hyperbilirubinemia: Elevated levels of bilirubin in the blood, which can lead to jaundice.

    • Cardiotoxicity: Although rare, capecitabine can cause cardiotoxicity, including chest pain and myocardial infarction.

Precautions and Contraindications

Capecitabine should be used with caution in certain patient populations, and there are specific contraindications to its use:

  1. Precautions:

    • Renal Impairment: Capecitabine is excreted by the kidneys, so patients with renal impairment may require dose adjustments.

    • Hepatic Impairment: Patients with liver dysfunction may also require dose adjustments, as the drug is metabolized in the liver.

    • Elderly Patients: Older patients may be more susceptible to the side effects of capecitabine, particularly diarrhea and hand-foot syndrome.

    • Pregnancy and Lactation: Capecitabine is contraindicated in pregnant women due to the risk of fetal harm. It is also not recommended for use in breastfeeding mothers.

  2. Contraindications:

    • Severe Renal Impairment: Capecitabine is contraindicated in patients with severe renal impairment (creatinine clearance < 30 mL/min).

    • Known Hypersensitivity: Patients with a known hypersensitivity to capecitabine or any of its components should not use the drug.

    • Dihydropyrimidine Dehydrogenase (DPD) Deficiency: Patients with known DPD deficiency should not receive capecitabine, as they are at increased risk of severe toxicity.

Drug Interactions

Capecitabine can interact with other medications, which may alter its effectiveness or increase the risk of side effects. Some notable drug interactions include:

  1. Warfarin: Capecitabine can increase the anticoagulant effect of warfarin, leading to an increased risk of bleeding. Patients on warfarin should be closely monitored, and dose adjustments may be necessary.

  2. Phenytoin: Capecitabine can increase the levels of phenytoin, an anticonvulsant, leading to an increased risk of toxicity.

  3. Leucovorin: When used in combination with leucovorin, capecitabine may have increased efficacy but also an increased risk of side effects.

  4. Other Chemotherapy Agents: Capecitabine is often used in combination with other chemotherapy drugs, such as oxaliplatin or cisplatin. These combinations can enhance efficacy but may also increase the risk of side effects.

Monitoring and Management of Side Effects

Patients receiving capecitabine should be closely monitored for side effects, and appropriate management strategies should be implemented:

  1. Diarrhea: Patients should be advised to stay hydrated and may be prescribed antidiarrheal medications. Severe diarrhea may require dose reduction or discontinuation of capecitabine.

  2. Hand-Foot Syndrome: Patients should be advised to avoid tight-fitting shoes and to keep their hands and feet moisturized. Dose adjustments may be necessary for severe cases.

  3. Neutropenia: Regular blood counts should be monitored, and patients should be advised to report any signs of infection, such as fever or chills.

  4. Fatigue: Patients should be encouraged to rest and conserve energy. Severe fatigue may require dose adjustments.

Conclusion

Generic Xeloda (capecitabine) is a valuable oral chemotherapy agent used in the treatment of various cancers, including breast, colorectal, and gastric cancers. Its mechanism of action, which involves the targeted delivery of 5-fluorouracil to cancer cells, makes it an effective treatment option with a relatively favorable side effect profile compared to traditional intravenous chemotherapy. However, like all chemotherapy drugs, capecitabine is associated with a range of side effects that require careful monitoring and management. With appropriate dosing, monitoring, and supportive care, capecitabine can be an effective component of cancer treatment regimens, offering hope and improved outcomes for many patients.

Capecitabine What kind of medication is this? Antimetabolite is the best way to describe CAPECITABINE. It achieves its effect by inhibiting the synthesis of proteins that are required for the survival and multiplication of cancer cells. Providing treatment for people suffering from certain forms of breast, colon, or colorectal cancer. In some circumstances, it can be used on its own or in combination with other medications. What is the correct way to take this medication? Take capecitabine exactly as prescribed by your healthcare provider. For specific directions on how much of the medication to take, consult the label on the bottle. Capecitabine comes with an additional patient leaflet for their convenience. If you still have questions after reading this information, you should consult with your pharmacist. Capecitabine should be taken either while you are eating or within 30 minutes of finishing a meal. Take the capecitabine pill as a whole with some water. Before ingesting, do not break, crush, or chew the medication. In the event that a tablet breaks, it is advisable to use gloves and safety glasses to protect oneself from any exposure. In the event that powder from a broken tablet makes contact with the skin, wash the area thoroughly with soap and water as soon as possible. In the event that powder gets into your mouth, nose, or eyes, you should thoroughly rinse those areas with water. If you forget to take a dosage of capecitabine, you should not take it and should instead return to your usual dosing plan. Do not take both of your dosages at the same time. If you think you may have missed a dosage, talk to your healthcare provider. Talk to your doctor about any concerns or questions you may have regarding the correct administration of capecitabine. Before I start using this medication, what should I discuss with my primary care physician? Capecitabine may induce dizziness. If you combine this medication with alcohol or other drugs, the side effects may be more severe. Caution should be exercised when using capecitabine. Do not drive or engage in any other activities that might put your safety at risk until you have determined how you will react to it. It is possible that capecitabine will lessen your body's capacity to fight against infections. Stay away from those who have the flu or other contagious illnesses. If you have not fully cleansed your hands before touching your eyes or the inside of your nose, you should not contact those areas. Notify your primary care physician as soon as possible if you develop symptoms of an infection, such as a high temperature, a sore throat, a rash, or chills. The anticancer medication capecitabine has the potential to lower the amount of clot-forming cells, often known as platelets, in your blood. Stay away from anything that might cause you to get cut or bruised. If you see any odd bruising or bleeding, you should consult your doctor. If you notice that your stools are red, tarry, or black in color, you should consult your doctor. During the time that you are taking capecitabine, you should avoid getting any immunizations that contain live viruses, such as those for measles, mumps, or oral polio. It's possible that vaccinations will be less effective. Before you get any kind of medical or dental care, including emergency care or surgery, you should let your doctor or dentist know that you take capecitabine. Throughout your treatment with capecitabine, you may be subjected to a variety of laboratory tests, such as total blood cell counts and blood electrolytes. Your condition could be monitored using these tests, or they might be used to look for any adverse effects. Make careful to keep all of your appointments with the doctor and the lab. When you are taking capecitabine, it is important to discuss with your healthcare provider the possibility of utilizing an effective form of birth control. Caution should be exercised while administering capecitabine to the elderly, since this population may be more vulnerable to the drug's side effects, including nausea, vomiting, and diarrhea, as well as soreness, redness, and swelling of the hands or feet. The safety and efficacy of capecitabine in children have not been established, thus this medication should only be used with great caution in this patient population. It has been demonstrated that capecitabine is harmful to the developing fetus and should not be used during pregnancy or while breastfeeding. It is important that you avoid becoming pregnant while you are taking it. If you are taking capecitabine, it is important to discuss with your healthcare provider the use of reliable birth control techniques. Talk to your physician if you have any concerns that you could be pregnant. When you are pregnant, you should talk to your doctor about the potential advantages and dangers of taking capecitabine. It is still unknown if capecitabine is passed through breast milk or not. When you are on capecitabine, you should not breastfeed your child. What can I expect if I forget to take a dose? When you realize you missed a dosage, take it as soon as you can. If it is almost time for your next scheduled dosage, you should skip the dose that you missed. It is not necessary to take additional medication in order to make up for a missed dosage. What happens if I overdose? Immediately go to the hospital for treatment or dial the poison control hotline. Symptoms may include vomiting, nausea, stomach discomfort and bleeding, diarrhea, and diarrhea, and vomiting. What side effects should I be on the lookout for when using this medication? There is a possibility that capecitabine will interact with certain medical problems. If you have any preexisting medical problems, especially if any of the following apply to you, you should inform your doctor or pharmacist before using this medication: if you are pregnant, trying to become pregnant, or are currently breastfeeding and are taking any prescription or nonprescription drug (especially blood thinners), herbal preparation, or nutritional supplement, you should see your doctor before continuing to use the medication (vitamin E, aspirin, ibuprofen, naproxen) if you have a history of problems with your heart, kidneys, or liver; bone marrow; or pain, redness, swelling, tingling, or tenderness in the palms of your hands or soles of your feet. if you have allergies to medicines, foods, or other substances. if you have a history of problems with bone marrow. if you have a history of problems with bone marrow (hand-and-foot syndrome) if you are getting chemotherapy or radiation therapy, if you are taking folic acid or pills that contain folic acid, or if you have nausea, vomiting, diarrhea, irritation or ulcers in the mouth, or if you have an infection if you are undergoing any of these treatments: It's possible that capecitabine will interact with other medications. Notify your primary care physician if you are taking any other medications, particularly if you are taking any of the following: Anticoagulants such as warfarin since there is a possibility that capecitabine will increase the risk of bleeding. Leucovorin because there is a potential rise in the risk of severe gastrointestinal issues, diarrhea, and loss of body water. Hydantoins, such as phenytoin, since capecitabine may make the adverse effects of the hydantoins more severe. It's possible that this is not an exhaustive list of all the possible interactions that might take place. Inquire with your doctor about the possibility of capecitabine interacting negatively with any of the other medications that you take. Always double check with your primary care physician before beginning, stopping, or altering the dosage of any medication. What potential negative reactions may I have to this medication? Although some people have no side effects or just mild ones from their medication, this is not always the case. In the event if any of the following most Frequent adverse effects continue or become troublesome, it is important that you consult with your physician: Pain in the back, joints, or muscles; constipation; dizziness; eye irritation; headache; itchy or dry skin; lack of appetite; moderate nausea, vomiting, or diarrhea; stomach discomfort; taste changes; fatigue; difficulty sleeping; upset stomach; and weakness are some of the side effects of this medication. If you experience any of the following SEVERE adverse effects, seek immediate medical attention: Extremely severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); black, tarry stools; bloody diarrhea; chest, jaw, or left arm pain; decreased amount of urine; discolored skin; dry mouth or eyes; fainting; rapid or irregular heartbeat; fever higher than 100.5 degrees Fahrenheit, chills, or sore throat; hair loss; increased thirst; leg pain or swelling; moderate to severe This list of potential adverse effects is not exhaustive; more symptoms may present themselves. Get in touch with your health care practitioner if you have any inquiries regarding the potential for adverse effects. The correct way to store capecitabine is as follows: Store capecitabine at 77 degrees F (25 degrees C). It is permissible to temporarily store the product at temperatures ranging from 59 to 86 degrees Fahrenheit (15 and 30 degrees Celsius). Place in a location that is protected from heat, light, and moisture. Keep away from the restroom at all costs. It is important to keep capecitabine out of the reach of both children and animals.

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