Drug Notebook

FDA Alerts

    Alterations in Anticoagulant Effects
  • Altered coagulation parameters (e.g., increased PT, increased INR) and/or bleeding, sometimes fatal, reported in patients, with or without liver metastases, receiving capecitabine concomitantly with coumarin-derivative anticoagulants. Generally occurs within several days to months following initiation of therapy, but has been reported within 1 month following discontinuance of therapy. (See Coagulopathy under Cautions and also see Specific Drugs under Interactions.)
  • Age >60 years and diagnosis of cancer may independently increase risk of coagulopathy.
  • Monitor anticoagulant response (PT or INR) frequently in patients receiving concomitant capecitabine and oral coumarin-derivative therapy; adjust anticoagulant dosage accordingly.

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capecitabine
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(cah peh SIGH tah bean)

How should I take capecitabine?

Capecitabine should only be prescribed by a qualified healthcare provider experienced in the use of cancer chemotherapeutic agents.

Take capecitabine exactly as directed by your doctor. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you.

Each dose of capecitabine should be swallowed with water. Take capecitabine within 30 minutes after the end of a meal (usually breakfast and dinner).

If the dose of capecitabine prescribed for you requires a combination of different strength tablets, it is very important that you correctly identify the tablets to ensure the correct dose. Contact your doctor or pharmacist if you have questions regarding a dose.

Capecitabine is usually taken for 14 days followed by a 7 day rest period (no drug given), in a 21 day cycle. Follow your doctor's instructions.

Take all of the capecitabine that has been prescribed for you. Store capecitabine at room temperature away from moisture and heat.

What happens if I miss a dose?

If you miss a dose of capecitabine, do not take the missed dose at all and do not double the next one. Instead, continue your regular dosing schedule and check with your doctor.

What happens if I overdose?

Seek emergency medical attention.

Symptoms of a capecitabine overdose include nausea, vomiting, diarrhea, stomach upset, and bleeding.

What should I avoid while taking capecitabine?

There are no restrictions on foods, beverages, or activities while taking capecitabine, unless otherwise directed by your doctor.

What are the possible side effects of capecitabine?

If you experience any of the following serious side effects, stop taking capecitabine and seek emergency medical attention or contact your doctor immediately:
  • an allergic reaction (shortness of breath; closing of your throat; difficulty breathing; swelling of your lips, face, or tongue; or hives);

  • diarrhea (more than 4 bowel movements each day or any diarrhea at night);

  • vomiting (more than once in 24 hours);

  • nausea or a loss of appetite (if the amount of food you eat each day is much less than usual or if you are only able to eat at certain times);

  • fever (temperature greater than 100.5 degrees) or other signs of infection;

  • tingling, numbness, pain, swelling, or redness of the hands and/or feet (hand-and-foot syndrome); or

  • pain, redness, swelling, or sores in or around the mouth.

Other less serious side effects may occur more frequently. Continue to take capecitabine and talk to your doctor if you experience:

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

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