Capecitabine is a chemotherapy drug used to treat different types of cancer such as breast cancer, colorectal cancer, and cancers of the stomach, esophagus, and pancreas.

HOW IS CAPECITABINE ADMINISTERED?

Capecitabine is normally given on an outpatient basis. During treatment, you are seen by an oncologist and a nurse.

Before the day of treatment, a nurse will take a blood sample from you to see if you are fit for chemotherapy.

You will also be able to see a doctor or nurse before having chemotherapy. They will ask you how you have been feeling. If the results of your blood test are good on the day of your treatment, the pharmacist will prepare your chemotherapy.

TAKING YOUR CHEMOTHERAPY PILLS

Capecitabine is taken in tablet form. Always take the tablets exactly as you are instructed. This is important to ensure that it is working as well as possible. You will also be given other drugs to treat your dizziness.

Take the capecitabine pills twice daily. Swallow them whole with a glass of water within half an hour after a meal. Capecitabine works best if it is broken down in the stomach when the stomach is full. Take it in the morning after breakfast and then again after dinner. The doses should be spaced 10 to 12 hours apart.

Tell your doctor if you have difficulty swallowing the pills. They may suggest dissolving the capecitabine tablets in water. In this case, dissolve the tablets in a 200-ml glass of warm water, stir with a spoon until the tablets are completely dissolved, and then drink it immediately. The glass and spoon must be washed and kept separate from your other dishes and utensils.

If you vomit right after taking the pills, get in touch with your hospital. You may have to take another dose. If you forget to take a pill, do not take a double dose. Keep your normal schedule and tell your doctor or nurse.

Here are some other things you should keep in mind about the pills:

Keep them in their original packaging at room temperature. They should be stored away from heat and direct sunlight.

Keep them safe and out of the reach of children.

YOUR CHEMOTHERAPY CYCLE

Capecitabine is normally given in cycles over several months. One cycle of capecitabine often lasts for 21 days. You take the pills on days 1 to 14 of each cycle. However, this may vary depending on the type of cancer you have. It is important to take the pills as indicated by your doctor, nurse, or pharmacist.

Capecitabine can be given alone or with other chemotherapy drugs. Your doctor or nurse will tell you more about this and how many cycles you are going to have.

POSSIBLE SIDE EFFECTS OF CAPECITABINE

You may experience some of the effects mentioned here, though it is rare for a patient to have all of them. If you are taking other chemotherapy drugs simultaneously, you could have different side effects from those mentioned here. Always inform your doctor or nurse of the side effects you experience.

Your doctor can prescribe medication to help control some of the side effects. It is very important to take the medication exactly as your nurse or pharmacist has told you. Your nurse will advise you on managing the side effects. After treatment, the side effects start to get better.

RISK OF INFECTION

Capecitabine may lower your number of white blood cells. This will make you more susceptible to infection. When the number of white blood cells is low, this is called neutropenia.

Contact your hospital immediately if any of the following happens:

• your temperature goes above 38 ° C
• You suddenly feel unwell, even if your temperature is normal
• You have symptoms of infection, which may include sore throat, coughing, diarrhea, or the need to urinate frequently.

The number of white blood cells normally increases gradually, returning to normal before your next chemotherapy treatment. You will have blood tests done before your next chemotherapy. If your white blood cells are still low, your doctor may postpone the treatment.

ANEMIA (LOW RED BLOOD CELLS)

Capecitabine may lower the number of red blood cells in your blood. Red blood cells transport oxygen throughout the body. If you have a low number of red blood cells, you may be tired and short of breath. Tell your doctor or nurse if you feel like this. If you are very anemic, it's possible you will require a blood transfusion.

BRUISING AND BLEEDING

Capecitabine may lower the number of platelets you have in your blood. Platelets are cells that help the blood to clot. Tell your doctor if you have any unexplained bleeding or bruising. This includes nosebleeds, bleeding gums, blood spots, or skin eruptions (rashes). Some people may require a drip to give them more platelets.

NAUSEA

This can happen on the first few days after chemotherapy. Your doctor will prescribe you antiemetic drugs to help prevent or control your nausea. Take the medicine exactly as your nurse or pharmacist tells you. It is easier to prevent disease than it is to treat it once it has begun.

If you still have nausea or are vomiting, get in touch with the hospital as soon as possible. They can give you advice on this and change your medication.

DIARRHEA

Your doctor can prescribe medicine to control diarrhea. You may get these before you leave the hospital. It is very important to take them exactly as your nurse or pharmacist has told you. Make sure you drink at least two liters of fluids each day if you have diarrhea.

If you have more than 4-6 episodes of diarrhea a days, contact the hospital immediately. You doctor may ask you to stop taking capecitabine. When your diarrhea improves, they will tell you whether to begin taking it again. Sometimes, they may reduce the dose.

SORENESS OF THE MOUTH

You may have a sore mouth or mouth ulcers. This can make you more susceptible to infection in your mouth. Lightly brush your teeth and/or dentures in the morning and night and after meals. Use a soft-bristle toothbrush. Your nurse might ask you to rinse your mouth out regularly or use mouthwash. It is important that you follow all the instructions you are given and that you drink a lot of fluids.

Tell your nurse or doctor if you have any mouth problems. They can prescribe you drugs to prevent or treat infections of the mouth and to treat any kind of pain.

LOSS OF APPETITE

You may lose your appetite during the treatment. Try to eat in small quantities and have frequent meals. Don't worry if you don't eat much for a day or two. If your appetite doesn't get any better after a few days, tell your nurse or dietitian. They may advise you on how to get more calories and proteins in your diet. They can give you nutritional supplements or good-tasting meal-replacement drinks.

CONSTIPATION

Capecitabine can cause constipation and abdominal pain. Drinking at least two liters of fluids each day will help if this is the case. Try to eat more high-fiber foods such as fruit, vegetables, and whole-grain bread and get some light exercise.

CHANGES IN TASTE

You may get a bitter or metallic taste in your mouth or find that food tastes different. This should go away when your treatment is over. Unless you have pain or ulcers, try to use herbs and spices or strong-tasting sauces to give your food more flavor. Sucking on candy can sometimes help bitter or metallic tastes go away. Your nurse can give you further advice on this.

PAIN AND REDNESS IN THE PALMS OF THE HANDS AND SOLES OF THE FEET

This is known as palmar-plantar syndrome. It normally gets better when the treatment ends. Your doctor or nurse can give you advice and prescribe creams to improve the symptoms. It may help to keep your hands and feet cool and avoid wearing tight-fitting socks, shoes, and gloves.

TIREDNESS

Feeling very tired is a common side effect. Fatigue is often worst toward the end of treatment and for a few months after the treatment has finished. Try to pace yourself and rest as much as you need to. Help balance this with a bit of light exercise, such as short walks. If you feel drowsy, don't drive or operate heavy machinery.

MORE INFORMATION ON CAPECITABINE

BLOOD CLOT RISK

Cancer and chemotherapy increase the chances of a blood (thrombosis). A blood clot may cause symptoms such as pain, reddening or swelling in a leg, difficulty breathing, and pain in the chest. Get in touch with your doctor immediately if you have any of these symptoms. A blood clot is a serious matter, but your doctor can use drugs to treat it. Your doctor or nurse specialist can give you more information.

OTHER DRUGS

Some medicines can interact with chemotherapy or be harmful. This includes medications that can be purchased in a store or pharmacy. Folinic acid may worsen the side effects of capecitabine. Tell your doctor if you are taking any medicines, including over-the-counter drugs, complementary therapies, and herbal remedies.

FERTILITY

Capecitabine can affect your fertility. If this worries you, you can talk to your doctor before beginning treatment.

CONTRACEPTION

Your doctor will advise you not to become pregnant during the treatment. This is because the drugs can harm developing babies. It is important to use contraception during chemotherapy and for a few months after the treatment ends.

BREASTFEEDING

Women are recommended not to breastfeed during treatment and for a few months after chemotherapy has concluded.

MEDICAL AND DENTAL TREATMENT

If you have to go to the hospital for whatever reason other than cancer, always tell the doctors and nurses that you are having chemotherapy. Explain to them that you are taking chemotherapy pills that no one should stop or restart if it is not done under the advice of a cancer doctor.

Talk to your cancer doctor or nurse if you think you need dental treatment. Always let your dentist know that you are having chemotherapy.