Uses of Xitabin: - Breast cancer - Cancer of colon and rectum Breast cancer, Colorectal cancer, Gastric cancer, Oesophageal cancer History of severe and unexpected reactions to fluoropyrimidine therapy; severe renal impairment; pregnancy, lactation. Hypersensitivity.

Cytotoxic Chemotherapy

Capecitabine is a prodrug of fluorouracil, a pyrimidine antimetabolite, which is metabolised into 5-fluoro-2′-deoxyuridine-5′monophosphate (FdUMP) and 5-fluorouridine triphosphate (FUTP). FdUMP covalently binds to thymidylate synthase, inhibiting the formation of thymidilate, thus interfering with DNA synthesis. Additionally, FUTP interferes with RNA synthesis.

How to use Capecitabine: Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Capecitabine is to be taken with food. Administration: Swallow with water within 30 min after a meal Adult Dose: Oral Breast cancer; Colorectal cancer Adult: 1.25 g/m2 bid for 2 wk followed by a 1 wk rest period; therapy to be given in 3-wk cycles. Recommended treatment duration for colorectal cancer: 6 mth. May be used in combination with docetaxel at 75 mg/m2, given as a 1-hr IV infusion once every 3 wk for the treatment of breast cancer. Gastric cancer Adult: Used in combination with a platinum-based compound, 1 g/m2 bid for 14 days, followed by a 7-day rest period. 1st dose is given on the evening of day 1 and the last dose on the morning of day 15. Renal Dose: Renal impairment: CrCl (ml/min) 51-80 No adjustment needed. 30-50 Reduce dose to 950 mg/m2 bid when starting dose is 1.25 g/m2 bid. No dose adjustment is needed when starting dose is 1 g/m2. <30 Avoid use.

Antacids containing aluminum and magnesium, leucovorin, anticoagulants, phenytoin, allopurinol.

History of severe and unexpected reactions to fluoropyrimidine therapy; severe renal impairment; pregnancy, lactation. Hypersensitivity.

Common - Vomiting - Weakness - Nausea - Abdominal pain - Diarrhea - Blisters on fingers/feet 10% Diarrhea,Nausea,Anemia,Lymphopenia,Hand and foot syndrome,Edema,Fatigue,Fever,Headache,Pain,Paresthesia,Alopecia,Dermatitis,Abdominal pain,Anorexia,Appetite decreased,Constipation,Dyspepsia,Stomatitis,Vomiting,Neutropenia,Thrombocytopenia,Dyspnea,Bilirubin increased,Eye irritation 1-10% Chest pain,Dermatitis,Pruritus,Rash,Dizziness,Headache,Weakness,Dehydration,Dry mouth,Dyspepsia,Taste disturbance,Back pain Potentially Fatal: Cardiotoxicity, bone-marrow depression and hyperbilirubinaemia.

Pregnancy Category D. There is positive evidence of human fetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).

Precaution: Hepatic dysfunction, bone marrow suppression, poor nutritional status, warfarin therapy. Child, elderly, prior extensive pelvic radiation or alkylating therapy. Moderate renal impairment; CBC with differential; monitor hepatic and renal function. Discontinue use if intractable diarrhoea, stomatitis, bone marrow suppression or MI develops.

The manifestations of acute overdose include nausea, vomiting, diarrhea, mucositis, gastrointestinal irritation and bleeding, and bone marrow depression. Medical management of overdose should include customary therapeutic and supportive medical interventions aimed at correcting the presenting clinical manifestations and preventing their possible complications.

Keep in a dry place and store below 30°C. Protect from light and keep out of the reach of children.

Cytotoxic Chemotherapy

Capecitabine is a prodrug that is converted to fluorouracil following oral administration, which in turn inhibits thymidylate synthetase, blocking the methylation of deoxyuridylic acid to thymidylic acid, interfering with DNA, and to a lesser degree, RNA synthesis.

Pregnancy Category: C Lactation: excretion in milk unknown; use with caution