Side Effects of Xeloda: What You Need to Know

If you have a certain kind of cancer, your doctor might suggest Xeloda as a treatment option.

Xeloda is a prescription medication that’s used in adults with certain types of:

• breast cancer
• colon cancer
• colorectal cancer

The active ingredient in Xeloda is capecitabine. (An active ingredient is what makes a drug work.) Xeloda comes as tablets that you swallow. They’re available in two strengths: 150 milligrams (mg) and 500 mg.

How long you’ll take Xeloda may depend on:

• the type of cancer you have
• your cancer treatment plan
• any side effects you experience

For more information about Xeloda, including details about its uses, see this in-depth article on the drug.

Like other drugs, Xeloda can cause mild to serious side effects. Keep reading to learn more.

Some people may experience mild or serious side effects during their Xeloda treatment.

Examples of Xeloda’s commonly reported side effects include:

• mild diarrhea
• hand-foot syndrome*
• nausea and vomiting*
• belly (stomach) pain
• feeling tired or weak

* To learn more about this side effect, see the “Side effects explained” section below.

Like most medications, Xeloda can cause mild side effects. Most people who took Xeloda in studies had at least one mild side effect.

Examples of mild side effects that have been reported with Xeloda include:

• decreased appetite
• belly (stomach) pain
• blood cell problems, including:
  • low levels of neutrophils (a type of white blood cell)
  • low levels of platelets (cells that help with blood clotting)
  • low levels of red blood cells (cells that carry iron)
• constipation
• feeling tired or weak
• fever
• headache
• mild diarrhea
• mouth sores
• pain, including pain in your back, arms, or legs
• eye-related side effects*
• hair loss*
• nausea and vomiting*
• skin-related side effects*

* To learn more about this side effect, see the “Side effects explained” section below.

In most cases, these side effects should be temporary. And some may be easily managed, too. But if you have any symptoms that are ongoing or bother you, talk with your doctor or pharmacist. And don’t stop taking Xeloda unless your doctor recommends it.

Xeloda may cause mild side effects other than the ones listed above. See the Xeloda prescribing information for details.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Xeloda, visit MedWatch.

Some people may have serious side effects of Xeloda.

Serious side effects that people taking this drug have reported include:

• dehydration, which may lead to sudden kidney failure
• heart problems, including
  • abnormal heartbeat
  • chest pain
  • heart attack
  • heart failure
• severe blood cell problems, including
  • severely low levels of neutrophils (a type of white blood cell)
  • severely low levels of platelets (cells that help with blood clotting)
  • severely low levels of red blood cells (cells that carry iron)
• high levels of bilirubin (a substance that forms when red blood cells break down)
• severe diarrhea or nausea and vomiting*
• severe mouth sores
• severe skin reactions, including:
  • Stevens-Johnson syndrome
  • toxic epidermal necrolysis
• hand-foot syndrome*
• allergic reaction*†

If you develop serious side effects while taking Xeloda, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

* To learn more about this side effect, see the “Side effects explained” section below.

Learn more about some of the side effects that Xeloda may cause.

Hand-foot syndrome

Some people taking Xeloda may develop hand-foot syndrome. This was among the drug’s most common side effects in studies.

Hand-foot syndrome is a severe skin reaction caused by some chemotherapy drugs, including Xeloda. It affects the soles of your feet, the palms of your hands, or both. Symptoms can include:

• blisters or thick calluses with no known cause
• burning, prickling, or tingling sensation
• cracking or peeling skin
• skin discoloration
• discomfort, pain, or numbness
• sores on your skin
• swelling

What might help

The following tips may help prevent hand-foot syndrome:

• avoid prolonged exposure to hot water when washing the dishes or taking showers or baths
• keep pressure off your hands and feet as much as possible
• avoid using handheld tools, such as screwdrivers or gardening tools
• avoid using knives

Stop taking Xeloda and call your doctor right away if you notice symptoms of hand-foot syndrome. In severe cases, hand-foot syndrome can cause you to lose your fingerprints. So it’s important to get care as soon as possible.

Your doctor will likely have you stop taking Xeloda until your symptoms go away. Depending on how serious your symptoms are, the doctor may lower your Xeloda dosage if you restart the treatment.

Some ways to ease symptoms of hand-foot syndrome can include:

• applying ice packs
• keeping your hands and feet elevated when possible
• patting your skin dry with a towel, instead of rubbing it
• wearing loose-fitting shoes
• avoiding harsh chemicals, such as those in some laundry detergents and other cleaning products

Hair loss

Xeloda is a type of chemotherapy. Like many chemotherapy drugs, it may cause hair loss in some people.

Hair loss wasn’t common in Xeloda studies. But it was more common in people who took Xeloda with the chemotherapy drug Taxotere (docetaxel) to treat breast cancer.

What might help

If you need help managing Xeloda’s side effects, such as hair loss, talk with your doctor. They may suggest ways to treat your symptoms. If your symptoms are severe or bother you, they may suggest trying an alternative to Xeloda.

Skin-related side effects

Skin-related side effects can occur during treatment with Xeloda. In studies, reported skin-related side effects included:

• hand-foot syndrome
• itchiness
• nail problems, including nail discoloration
• skin discoloration
• skin rash
• skin sores
• severe skin reactions, including:
  • Stevens-Johnson syndrome (SJS)
  • toxic epidermal necrolysis (TEN)

These side effects can range from mild to severe. In rare cases, severe skin reactions, such as SJS and TEN, can be fatal. If you’re concerned about your risk of severe skin reactions with Xeloda, talk with your doctor.

Symptoms of SJS and TEN can include:

• widespread skin rash
• skin blistering
• skin peeling
  

Some of these skin-related side effects are more common than others. For example, hand-foot syndrome is one of the most common side effects of Xeloda. (For more about this condition, see “Hand-foot syndrome” above.) But severe skin reactions such as SJS and TEN are rare.

What might help

If you experience a skin-related side effect that bothers you, talk with your doctor. They can suggest ways to treat your symptoms. In some cases, your doctor may have you stop taking Xeloda and switch to a different treatment.

If your symptoms feel severe, and include blistering or peeling skin, for example, call 911 or your local emergency number, or seek emergency medical care. This may be a sign of a severe, life threatening skin reaction such as SJS or TEN.

Eye-related side effects

Some people may have eye-related side effects while taking Xeloda. Symptoms vary, depending on the specific side effect.

Eye-related side effects reported in Xeloda’s studies included:

• pink eye
• eye irritation
• vision problems
• increased tear production

What might help

If you experience eye-related side effects that bother you, talk with your doctor. They can suggest ways to treat your symptoms. These treatments can vary, depending on the specific side effect you have.

If your symptoms are severe, your doctor may suggest trying an alternative to Xeloda.

Nausea and vomiting

Some people may experience nausea and vomiting while taking Xeloda. These were common in studies of the drug. In some cases, people had severe nausea and vomiting while taking Xeloda.

What might help

If you experience nausea and vomiting during your Xeloda treatment, talk with your doctor. They can suggest ways to treat your symptoms, such as taking medications for these side effects. If your symptoms are severe, your doctor may have you stop taking Xeloda and switch to a different treatment.

Allergic reaction

Like most drugs, Xeloda can cause an allergic reaction in some people. These reactions weren’t common in Xeloda’s clinical studies, though.

Symptoms can be mild to serious and can include:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)
• swelling under your skin, usually in your eyelids, lips, hands, or feet
• swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest an over-the-counter oral antihistamine, such as Benadryl (diphenhydramine), or a topical product, such as hydrocortisone cream, to manage your symptoms.

If your doctor confirms that you had a mild allergic reaction to Xeloda, they’ll decide if you should continue taking it.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms that you had a serious allergic reaction to Xeloda, they may have you switch to a different treatment.

Keeping track of side effects

During your Xeloda treatment, consider keeping notes about any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you first start taking new drugs or using a combination of treatments.

Your side effect notes can include things such as:

• what dosage of drug you were taking when you had the side effect
• how soon you had the side effect after starting that dosage
• what your symptoms were
• how they affected your daily activities
• any other medications you were taking
• any other information you feel is important

Keeping notes and sharing them with your doctor will help them learn more about how Xeloda affects you. They can then use this information to adjust your treatment plan if needed.

Get answers to some frequently asked questions about Xeloda’s side effects.

Does Xeloda cause long-term side effects?

It’s possible that treatment with Xeloda may cause long-term side effects.

Long-term side effects reported with Xeloda include:

• chest pain
• heart failure
• infertility (not being able to conceive a child)

These side effects may occur at any time during Xeloda treatment.

To learn more about the possible long-term side effects of Xeloda, talk with your doctor or pharmacist.

Will a higher dosage of Xeloda increase my risk of side effects?

It’s possible. Studies of Xeloda didn’t look at whether higher dosages affected the risk of side effects.

Other factors can raise your risk of side effects from Xeloda. These include other medical conditions you have or other medications you take.

To learn more about your specific risk of side effects during your Xeloda treatment, talk with your doctor or pharmacist.

Can Xeloda cause liver toxicity?

It’s possible that taking Xeloda can cause liver toxicity (damage). Liver failure was a very rare side effect reported in studies among people who took Xeloda with the chemotherapy drug Taxotere (docetaxel) to treat breast cancer.

High bilirubin levels can also occur with Xeloda treatment. (Bilirubin is a substance that forms when red blood cells break down.) High levels of bilirubin can be a sign of liver damage. This side effect was somewhat common in studies of Xeloda, but in most cases it was mild.

If you have questions about your risk of liver damage from Xeloda, talk with your doctor or pharmacist.

Xeloda may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before starting the treatment. The list below includes factors to consider.

Heart problems. Xeloda can cause cardiotoxicity (heart damage or problems), including a heart attack or heart failure. You may have a higher risk of these side effects if you already have heart problems. Taking Xeloda may also worsen existing heart conditions. Your doctor can help determine whether it’s safe for you to take Xeloda.

Kidney problems. Taking Xeloda can cause dehydration and, in rare cases, sudden kidney failure. If you already have kidney problems, you may have a higher risk of new or worsening kidney problems if you experience dehydration during your treatment. Your doctor can help determine whether Xeloda is right for you.

Liver problems. If you have liver problems (such as hepatitis), you may have a higher risk of side effects from Xeloda. Your doctor can help determine whether it’s safe for you to take Xeloda.

Dihydropyrimidine dehydrogenase (DPD) deficiency. If you have a DPD deficiency, a rare genetic (inherited) condition, you may have a higher risk of severe side effects from Xeloda. This includes potentially life threatening side effects, such as severely low levels of neutrophils. Due to this risk, doctors typically won’t prescribe Xeloda to people with a DPD deficiency. If you have this condition, talk with your doctor about other treatments that may be safer for you.

Allergic reaction. If you’ve had an allergic reaction to Xeloda or any of its ingredients, your doctor will likely not prescribe Xeloda. Ask them what other medications are better options for you.

Alcohol use and Xeloda

There’s no known interaction between alcohol and Xeloda. But alcohol can worsen or raise your risk of certain side effects of Xeloda, including:

• diarrhea
• dizziness
• headache
• mouth sores
• nausea and vomiting

If you drink alcohol, talk with your doctor about the amount that may be safe for you to drink while you’re taking Xeloda.

Pregnancy and breastfeeding while taking Xeloda

Xeloda is not safe to take while pregnant or breastfeeding.

If you can become pregnant, your doctor will have you take a pregnancy test before you take Xeloda to make sure you aren’t pregnant. You should use birth control during your Xeloda treatment and for at least 6 months after your last dose.

You should not breastfeed during your treatment and for at least 2 weeks after your last dose.

If you’re a male* with a partner who can become pregnant, your doctor will suggest using effective birth control during treatment with Xeloda and for at least 3 months after your last dose.

Xeloda can also cause infertility (not being able to conceive a child) in males and females.* If you’re concerned about infertility from Xeloda, talk with your doctor before starting the treatment. They may recommend a drug other than Xeloda for your condition.

* In this article, we use the terms “male” and “female” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.

Before you begin taking Xeloda, talk with your doctor. Asking questions can help you feel comfortable with your treatment plan and be aware of the possible side effects. Some example questions to help you get started include:

• How do Xeloda’s side effects compare with those of other chemotherapy drugs?
• Can my other medications raise my risk of side effects from Xeloda?
• If I have side effects of Xeloda, is there a lower dosage I can try?

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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.