Xeloda

Xeloda is the brand name for capecitabine, an oral chemotherapy drug used to treat several cancers. It is a prodrug of the anticancer agent 5-fluorouracil (5-FU) and is designed to be converted to 5-FU mainly within tumor tissue, allowing targeted cytotoxic effects while aiming to limit systemic exposure.

Mechanism of action involves conversion of capecitabine to 5-FU, which inhibits thymidylate synthase and disrupts RNA and DNA synthesis. This leads to impaired cell replication and tumor cell death. The drug is active in a range of solid tumors and is often selected for regimens that combine oral and intravenous agents.

Indications include colorectal cancer (both adjuvant and metastatic settings) and metastatic breast cancer, with use in gastric cancer within certain regimens. Commonly, Xeloda is given as part of combination regimens such as XELOX (capecitabine plus oxaliplatin) for colorectal cancer or with docetaxel for breast cancer, though exact regimens vary by country and patient.

Administration and dosing are oral and typically involve taking capecitabine twice daily for 14 days, followed by a 7-day rest, in a 21-day cycle. Dosing depends on the specific cancer, regimen, body surface area, and tolerance. Dose adjustments may be needed for renal or hepatic impairment and in cases of toxicity.

Adverse effects most commonly include hand-foot syndrome (palmar-plantar erythrodysesthesia), diarrhea, mucositis, nausea, vomiting, fatigue, rash, and liver enzyme elevations. Less common but more serious effects can include myelosuppression, dehydration, and cardiotoxic events in susceptible individuals. Monitoring and supportive care are important, and caution is advised in patients with DPD deficiency, pregnancy, or those taking certain anticoagulants, such as warfarin.