Adult Dosing
Metastatic colorectal cancer
- 1,250 mg/m2 PO bid for 2 wks followed by 7-day rest period; given as 3-wk cycles, administer 30 mins after meals
Metastatic breast cancer
- 1,250 mg/m2 PO bid for 2 wks followed by 7-day rest period; given as 3-wk cycles, administer 30 mins after meals
Dukes' C colon, adjuvant treatment for patients undergone complete resection
- 1,250 mg/m2 PO bid for 2 wks followed by 7-day rest period. Repeat cycles of 2 wks on and 1 wk off therapy for 6 months, administer 30 mins after meals
- Note: Refer to institution protocols and package insert prior to prescribing and for toxicity-related dose adjustments
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
[Outline]
Renal Dose Adjustment (Based on CrCl):
- 30-50 mL/min: Dose reduction to 75% of the starting dose is recommended
- < 30 mL/min: Contraindicated
Hepatic Dose Adjustment
- Mild to moderate impairment: No dose adjustments
- Severe impairment: Dose adjustments not defined
- Increased risk of altered coagulation parameters and/or bleeding, including death, especially in patients receiving concomitant coumarin-derivative anticoagulants such as warfarin and phenprocoumon. Monitor caogulation profile frequently and adjust dose accordingly [U.S. Black Box Warning]
- The level of phenytoin should be carefully monitored and phenytoin dose may need to be reduced. Postmarketing reports indicate that some patients receiving capecitabine and phenytoin had toxicity associated with elevated phenytoin levels.
- Monitor patients with mild to moderate renal impairment at baseline; reduce dose appropriately
- Patients
60 yrs on combination therapy with docetaxel are more prone to grade 3 or 4 treatment-related adverse events, serious adverse events and discontinuance of therapy - Capecitabine can induce diarrhea, sometimes severe. Discontinue therapy until resolution of grade 2, 3 or 4 diarrhea or events have decreased in intensity to grade 1. On re-occurrence of grade 2, 3 or 4 diarrhea, decrease dose appropriately and provide standard antidiarrheal treatment
- Necrotizing enterocolitis may occur
- Fetal harm has occurred on administration to pregnant woman. Women of childbearing potential must use effective contraception before initiating therapy and during treatment
- Avoid concomitant use with irinotecan
- Hand-and-foot syndrome with severity ranging from garde 1-3 has occurred. Interrupt dose on occurrence of grade 2 - 3 hand-and-foot syndrome, discontinue dose until resolution or decrease in severity to grade 1
- Cardiotoxicity has occurred in patients with a prior history of coronary artery disease
- Rare unexpected, severe toxicity manifesting as stomatitis, diarrhea, neutropenia, neurotoxicity, associated with 5-fluorouracil may occur
- Hematologic toxicity manifesting as grade 3 or 4 neutropenia, thrombocytopenia or decreases in hemoglobin count has occurred
- Monitor CrCl at baseline and then periodically; monitor CBC with differential count and LFTs during therapy
Cautions: Use cautiously in
- Hepatic impairment (monitor patients for adverse events)
- Renal impairment (monitor patients for adverse events)
- Coronary artery disease
- Hx of cardiac disease
- Bone marrow depression
- Geriatric population
Pregnancy Category:D
Breastfeeding: Unsafe; discontinue breastfeeding while receiving therapy
Pricing data from www.DrugStore.com in U.S.A.
- Xeloda 500 MG TABS [Bottle] (GENENTECH)
120 mg = $3697.83
240 mg = $7295.9 - Xeloda 150 MG TABS [Bottle] (GENENTECH)
60 mg = $557.98
180 mg = $1588.01
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
