Xeloda is a brand-name prescription medication used to treat certain forms of cancer in adults. Specifically, Xeloda is approved to treat:

  • Metastatic breast cancer. With metastatic breast cancer, breast cancer has spread to other parts of the body. For this purpose, Xeloda is approved for use:
    • with a chemotherapy drug called docetaxel (Taxotere) if certain other chemotherapies haven’t worked well enough
    • alone if certain other chemotherapies have stopped working or can no longer be used
  • Metastatic colorectal cancer. With metastatic colorectal cancer, the cancer has spread from the colon or rectum to other parts of the body. For this purpose, Xeloda is approved for use alone as a first treatment.
  • Dukes’ C colon cancer. This form of colon cancer is also called stage 3 colon cancer. It occurs when the cancer has spread through the colon wall to nearby lymph nodes. For this use, Xeloda is approved to be used alone as an adjuvant treatment* following surgery to remove the cancer.

For more information about how Xeloda is used, see the “Xeloda uses” section below.

* Adjuvant treatment is used to help prevent cancer from coming back after it has been treated in the past.

Drug details

Xeloda is a form of chemotherapy called an antimetabolite. It contains capecitabine, which is a pro-drug. A pro-drug is an inactive drug that your body changes into an active drug. When you take Xeloda, your body changes it into the active drug fluorouracil.

Xeloda comes as an oral tablet. It’s available in two strengths: 150 milligrams (mg) and 500 mg.

Effectiveness

For information about the effectiveness of Xeloda, see the “Xeloda uses” section below.

Xeloda is a brand-name drug that contains the active drug capecitabine. This active drug is also available as a generic medication. A generic drug is an exact copy of the active drug in a brand-name medication.

The generic is considered to be as safe and effective as the original drug. Generics tend to cost less than brand-name drugs.

If you’re interested in taking the generic form of Xeloda, talk with your doctor. They can tell you if it comes in forms and strengths that are suitable for your condition.

Xeloda can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Xeloda. These lists do not include all possible side effects.

For more information about the possible side effects of Xeloda, talk with your doctor or pharmacist. They can give you tips on managing any side effects that may concern or bother you.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to notify the FDA about a side effect you’ve had with Xeloda, you can do so through MedWatch.

Mild side effects

Mild side effects* of Xeloda can include:

Most of these side effects may go away within a few days to a couple of weeks. But if they become more severe or don’t go away, talk with your doctor or pharmacist.

* This is a partial list of mild side effects from Xeloda. To learn about other mild side effects, talk with your doctor or pharmacist, or view Xeloda’s prescribing information.
† For more information about this side effect, see “Side effect details” below.

Serious side effects

Serious side effects from Xeloda can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

* For more information about this side effect, see “Side effect details” below.
† Xeloda has a boxed warning for this side effect. This is the most serious warning from the FDA. It alerts doctors and patients about drug effects that may be dangerous. For more information about this side effect, see the “Xeloda interactions” section below.

Side effect details

Here’s some detail on certain side effects this drug may cause. To find out how often side effects occurred in clinical trials, see the prescribing information for Xeloda.

Hand-foot syndrome

Xeloda commonly causes a serious side effect called hand-foot syndrome. The medical term for this side effect is palmar-plantar erythrodysesthesia. It’s a form of skin toxicity (severe skin reaction) associated with some forms of chemotherapy.

Hand-foot syndrome affects the palms of your hands, the soles of your feet, or both. Symptoms may include:

  • numbness
  • tingling, prickling, or burning sensations
  • swelling
  • discomfort
  • skin redness, darkening, or discoloration
  • thick calluses or blisters
  • skin cracking or peeling
  • skin ulcers (sores)
  • pain

Hand-foot syndrome is usually mild, but it can sometimes be severe and cause trouble with daily activities. For example, you may have difficulty holding objects or walking. In some severe or long lasting cases, hand-foot syndrome can sometimes lead to the loss of your fingerprints.

Steps you can take

To help prevent and manage hand-foot syndrome, it may help to:

  • apply moisturizer to your hands and feet gently, without rubbing or massaging
  • keep your hands and feet cool
  • limit exposure of your hands and feet to hot water, for example, when bathing or doing dishes
  • avoid activities that put pressure on your hands or feet, such as jogging or playing tennis
  • avoid using tools that can press into your hands, such as knives, screwdrivers, or garden tools
  • avoid walking barefoot, even around the house

Steps your doctor may take

If you have mild symptoms of hand-foot syndrome, ask your doctor for other tips to help you feel more comfortable. They may recommend using a moisturizer containing urea or salicylic acid. They may also prescribe a corticosteroid cream such as clobetasol (Cormax, Embeline E).

If your symptoms are very painful, they may also recommend using a local anesthetic, such as lidocaine, or taking a pain reliever such as acetaminophen (Tylenol) or ibuprofen (Advil).

Call your doctor right away if you have symptoms that interfere with your daily activities. They’ll typically have you stop taking Xeloda until your symptoms improve or go away.

When you start taking Xeloda again, your doctor may prescribe a lower dose than you took before. But if your symptoms were very severe, your doctor may recommend switching to a different treatment for your cancer.

Mouth sores

Sores in the mouth or throat or on the tongue may develop during Xeloda treatment. This is a common side effect of the medication. The medical term for this side effect is mucositis.

Symptoms of mouth sores may include:

  • ulcers or other painful, red, or swollen areas inside your mouth or throat or on your tongue
  • pain when chewing or swallowing

Mouth sores are usually mild, but they can become severe and make it painful to eat or drink. Not consuming enough fluids could lead to dehydration and kidney failure.

Steps your doctor may take

If you have mouth sores while taking Xeloda, call your doctor right away, especially if you’re having trouble eating or drinking. They’ll usually have you stop taking Xeloda until your symptoms improve or go away.

Your doctor may also recommend taking a pain reliever 30 minutes before eating. In addition, they may recommend food supplements for extra nutrition or more fluids to help prevent dehydration.

When you start taking Xeloda again, your doctor may prescribe a lower dose than you took before. But if your mouth sores were very severe, your doctor may recommend switching to a different treatment for your cancer.

Tips for at-home care

If your doctor recommends managing mouth sores on your own, it may help to:

  • suck ice chips
  • eat soft foods
  • avoid foods that are dry, crunchy, spicy, salty, or acidic
  • drink through a straw
  • avoid alcohol and tobacco
  • use mouthwash as recommended by your doctor
  • reduce the amount of time you wear dentures if you have them

Diarrhea

Diarrhea may occur with Xeloda. Diarrhea is a common side effect of the medication.

Symptoms of diarrhea may include:

  • passing stools more often than usual
  • passing abnormally loose or watery stools

Diarrhea is usually mild, but it can become severe and cause you to lose more fluid than usual. This could lead to dehydration and kidney failure.

Steps you can take

If you have diarrhea while taking Xeloda, be sure to drink plenty of fluids to avoid becoming dehydrated. Try to sip fluids throughout the day, especially after a bowel movement. Sports drinks or rehydration solutions can be helpful as they contain minerals, such as sodium and potassium. These are minerals that you can lose through diarrhea.

You should also talk with your doctor or pharmacist about taking medication, such as loperamide (Imodium), to treat diarrhea.

Call your doctor right away if:

  • the number of stools you pass per day increases by four or more compared with usual
  • you have episodes of diarrhea at night
  • you can’t control your bowel movements
  • you have bloody diarrhea, severe belly pain, or a fever

If you have any of these symptoms, your doctor will usually have you stop taking Xeloda until your diarrhea improves or goes away. When you start taking Xeloda again, your doctor may prescribe a lower dose than you took before. But if your diarrhea is very severe, your doctor may recommend switching to a different treatment for your cancer.

Eye side effects

During Xeloda treatment, eye side effects may occur. These can include conjunctivitis (pink eye), eye irritation, abnormal vision, and watery eyes. However, eye side effects are not particularly common with Xeloda.

Symptoms of eye side effects may include:

If you have eye side effects while taking Xeloda, talk with your doctor or pharmacist. They may recommend eye drops that can help with these side effects.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Xeloda.

Symptoms of a mild allergic reaction can include:

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing

Call your doctor right away if you have an allergic reaction to Xeloda, as the reaction could become severe. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Here are answers to some frequently asked questions about Xeloda.

Is Xeloda a chemotherapy drug?

Yes, Xeloda is a chemotherapy drug. However, it’s different from most other chemotherapy drugs. Xeloda is taken by mouth instead of being given as an injection. It’s also slightly more targeted against cancer cells than other chemotherapy drugs.

Chemotherapy drugs kill most cells in the body that are multiplying rapidly. This includes cancer cells, but it also includes many healthy cells. As a result, chemotherapy often has several side effects.

Xeloda mainly targets cancer cells. As a result, Xeloda usually causes fewer side effects than other chemotherapy medications.

To read more about this, see the “How Xeloda works” section below.

Is Xeloda used for pancreatic cancer?

Yes, Xeloda is sometimes used to treat pancreatic cancer. However, this is an off-label use of the drug. Off-label use refers to using a drug for a purpose that hasn’t been approved by the Food and Drug Administration (FDA).

The National Comprehensive Cancer Network (NCCN) recommends Xeloda as a treatment option for pancreatic cancer in its guidelines.

If you’d like to find out more about taking Xeloda for pancreatic cancer, talk with your doctor.

Does Xeloda treat triple-negative breast cancer?

Yes, Xeloda can treat triple-negative breast cancer in certain situations. But it’s not specifically FDA-approved for this use.

Triple-negative breast cancer is the least common form of breast cancer and the hardest to treat. According to NCCN guidelines, metastatic breast cancer that’s triple negative can be treated with Xeloda. (Metastatic means the cancer has spread to other parts of your body, such as your bones or brain.)

Doctors usually treat earlier stages of triple-negative breast cancer with surgery, chemotherapy, radiation therapy, or a combination of these. According to NCCN guidelines, Xeloda is an option that can be used before or after surgery if other forms of chemotherapy don’t work well. This is an off-label use of the drug.

If you’re interested in taking Xeloda for triple-negative breast cancer, discuss this with your doctor.

What side effects can I expect during a week off from Xeloda use?

If you have any side effects with Xeloda, these are likely to improve during your week off from Xeloda use. If you have any new or worsening side effects during your week off, talk with your doctor. To read more about the dosing schedule of Xeloda, see “Xeloda dosage” below.

What are the long-term side effects of Xeloda?

Long-term side effects of Xeloda can include developing certain heart problems or kidney failure. These could last a long time or even be permanent.

Xeloda may also cause a long-term loss of fertility. After taking the drug, it may not be possible to become pregnant or make someone pregnant. To read more about this, see “Xeloda and pregnancy” below.

Most of Xeloda’s side effects improve or go away soon after you stop taking it. However, some side effects may take longer to ease, even with treatment, such as hand-foot syndrome. To read more about side effects, see the “Xeloda side effects” section above.

If you’re concerned about long-term side effects with Xeloda, talk with your doctor.

Is Xeloda used with radiation therapy?

Yes, Xeloda is sometimes used with radiation therapy. This is called chemoradiation. Taking Xeloda with radiation therapy can make the radiation more effective. But it can also increase certain side effects, such as nausea, tiredness, and hair loss.

Xeloda is commonly used in this way to treat colorectal cancer when surgery isn’t an option. However, in some cases, the drug is also used in this way after surgery for colorectal cancer.

In addition, Xeloda may be used with radiation therapy for other types of cancer. However, these are off-label uses for Xeloda. The drug is not specifically FDA-approved for treatment of cancers other than breast cancer and colorectal cancer. To learn more, see “Xeloda uses” below.

If you’d like to find out more about taking Xeloda as part of chemoradiation, talk with your doctor.

As with all medications, the cost of Xeloda can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

It’s important to note that you’ll have to get Xeloda at a specialty pharmacy. This type of pharmacy is authorized to carry specialty medications. These are drugs that may be expensive or may require help from healthcare professionals to be used safely and effectively.

Before approving coverage for Xeloda, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if the drug will be covered.

If you’re not sure if you’ll need to get prior authorization for Xeloda, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Xeloda, or if you need help understanding your insurance coverage, help is available.

Genentech, the manufacturer of Xeloda, offers cost assistance for their drug. For more information and to find out if you’re eligible for support, call 877-GENENTECH (877-436-3683) or visit the manufacturer’s website.

To learn more about saving money on prescriptions, check out this article.

Generic version

Xeloda is available in a generic form called capecitabine. A generic drug is an exact copy of the active drug in a brand-name medication. The generic is considered to be as safe and effective as the original drug. And generics tend to cost less than brand-name drugs.

If your doctor has prescribed Xeloda and you’re interested in taking capecitabine instead, talk with your doctor. They may have a preference for one version or the other. You’ll also need to check your insurance plan, as it may only cover one or the other.

The Xeloda dosage your doctor prescribes will depend on several factors. These include:

  • your body surface area (BSA)*
  • how well your kidneys work
  • other medical conditions you may have
  • if you have certain side effects with Xeloda

* Your doctor will determine your BSA based on your height in centimeters (cm) and your weight in kilograms (kg). BSA is measured in meters squared (m2). They may use a dose calculator.

Xeloda is taken in 3-week cycles. You’ll typically take it twice a day for 2 weeks and then have 1 week off treatment as a rest period. (If you have any side effects with Xeloda, these are likely to improve during your week off from Xeloda use.) You’ll repeat this 3-week cycle for as long as your doctor recommends.

If you have certain side effects during treatment, your doctor may adjust your dosage. Or they may pause your treatment or have you stop taking Xeloda.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug form and strengths

Xeloda comes as an oral tablet. It’s available in two strengths, 150 milligrams (mg) and 500 mg.

Dosage for treatment of metastatic breast cancer

The usual dosage of Xeloda for metastatic breast cancer is 1,250 mg/m2. It is taken twice a day for 2 weeks . This is followed by a 1-week rest period. Metastatic means the cancer has spread to other parts of your body, such as your bones or brain.

For example, let’s say your doctor determines that you have a BSA of 1.6 m2. In this case, your dosage would be 2,000 mg (four 500-mg tablets) taken twice a day for 2 weeks. This would be followed by a week off to complete your 3-week cycle.

Dosage for treatment of metastatic colorectal cancer

The usual dosage for metastatic colorectal cancer is 1,250 mg/m2. It is taken twice a day for 2 weeks, followed by a 1-week rest period. Metastatic means the cancer has spread to other parts of your body, such as your bones or brain.

For example, let’s say your doctor determines that you have a BSA of 1.6 m2. In this case, your dosage would be 2,000 mg (four 500-mg tablets) taken twice a day for 2 weeks. This would be followed by a week off to complete your 3-week cycle.

Dosage for adjuvant treatment of colon cancer

The usual dosage for adjuvant treatment of colon cancer is 1,250 mg/m2. It is taken twice a day for 2 weeks, followed by a 1-week rest period. Adjuvant treatment is used to prevent cancer from coming back after it has been treated in the past.

For example, let’s say your doctor determines that you have a BSA of 1.6 m2. In this case, your dosage would be 2,000 mg (four 500-mg tablets) taken twice a day for 2 weeks. This would be followed by a week off to complete your 3-week cycle.

What if I miss a dose?

If you miss a dose of Xeloda, talk with your doctor or pharmacist. They’ll recommend whether you should skip the missed dose or take it. You should not take two doses together to make up for a missed dose. And you should not take extra doses to make up for missed doses.

To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm or using a timer. You could also download a reminder app on your phone.

Will I need to use this drug long term?

Xeloda is meant to be used as a long-term treatment.

For metastatic breast or colorectal cancer, you’ll usually take Xeloda for as long as it continues to be safe and effective for you.

For adjuvant treatment of colon cancer, you’ll usually take Xeloda for 6 months (eight 3-week cycles).

The Food and Drug Administration (FDA) approves prescription drugs such as Xeloda to treat certain conditions. Xeloda may also be used off-label for other conditions. Off-label drug use means using a drug for a purpose other than what it’s been approved for by the FDA.

The following information describes FDA-approved indications (uses) of Xeloda for certain types of cancer. To learn more about cancer, view our cancer hub and breast cancer hub.

Xeloda for treatment of metastatic breast cancer

Xeloda is FDA-approved to treat metastatic breast cancer in these situations:

  • in combination with a chemotherapy drug called docetaxel (Taxotere) if chemotherapy containing an anthracycline drug* hasn’t worked
  • alone if chemotherapy with paclitaxel (Abraxane) and an anthracycline drug* has stopped working
  • alone if chemotherapy with paclitaxel has stopped working and an anthracycline drug* can no longer be used

Metastatic means the cancer has spread to other parts of your body. Breast cancer most commonly spreads to the bones, liver, lungs, and brain. The cancer may cause various symptoms depending on where it is in the body. For example, breast cancer that has spread to the brain may cause neurological issues such as seizures or headaches.

Metastatic breast cancer is also called advanced or stage 4 breast cancer.

* Anthracycline drugs include doxorubicin and epirubicin (Ellence).

Effectiveness for breast cancer

Xeloda has been found effective for treating metastatic breast cancer. It’s included as a treatment option for metastatic breast cancer in guidelines from the National Comprehensive Cancer Network (NCCN).

To find out how the drug performed in clinical studies, see Xeloda’s prescribing information.

Xeloda for treatment of metastatic colorectal cancer

Xeloda is FDA-approved for use alone as a first treatment for metastatic colorectal cancer. This form of colorectal cancer is also called advanced or stage 4 colorectal cancer. Xeloda is used for this purpose when a group of drugs called fluoropyrimidines is the preferred treatment. Xeloda is an example of a fluoropyrimidine.

Metastatic means the cancer has spread to other parts of your body, such as your bones or brain. The most common sites for colorectal cancer to spread to include the liver, lungs, and abdominal wall. It may also spread to the ovaries. Metastatic colorectal cancer may cause various symptoms depending on the part of the body affected.

Effectiveness for colorectal cancer

Xeloda has been found effective for treating metastatic colorectal cancer. NCCN guidelines include it as a treatment option for colorectal cancer.

To find out how the drug performed in clinical studies, see Xeloda’s prescribing information.

Xeloda for adjuvant treatment of colon cancer

Xeloda is FDA-approved for adjuvant treatment of Dukes’ C colon cancer (also called stage 3 colon cancer). For this purpose, Xeloda is used alone after you’ve had surgery to remove the cancer.

Xeloda is used to treat this type of cancer when a group of drugs called fluoropyrimidines is the preferred treatment. Xeloda is an example of a fluoropyrimidine.

Adjuvant treatment helps prevent cancer from coming back after it has been treated in the past. In this situation, Xeloda helps kill any cancer cells that may be left in the body after surgery.

With this form of colon cancer, the cancer has spread through the colon wall to nearby lymph nodes. Symptoms of this may include swelling, abdominal bloating, or decreased appetite.

Effectiveness for colon cancer

Xeloda has been found effective for adjuvant treatment of colon cancer. NCCN guidelines include Xeloda as a treatment option for colon cancer.

To find out how the drug performed in clinical studies, see Xeloda’s prescribing information.

Xeloda and children

Xeloda is not FDA-approved for any use in children.

Your doctor may prescribe Xeloda in combination with other drugs to treat your cancer. This is because, in some cases, taking Xeloda with other drugs can make the drug more effective than when it’s taken alone.

For example, for metastatic breast cancer, you may take Xeloda with a chemotherapy drug called docetaxel (Taxotere). Your doctor may prescribe this combination if you’ve previously had chemotherapy with an anthracycline drug*, but it hasn’t helped your cancer. In this case, you’ll receive docetaxel as an IV infusion once every 3 weeks.

Xeloda may also be used off-label with other medications to treat different forms of cancer. Off-label use refers to using a drug in a way or for a purpose that hasn’t been approved by the Food and Drug Administration (FDA). Your doctor can tell you more about this. A few examples include:

Xeloda may also be used off-label with various other medications to treat other forms of cancer.

* Anthracycline drugs include doxorubicin and epirubicin (Ellence).

Xeloda is a chemotherapy drug that’s approved to treat certain forms of breast cancer and colorectal cancer. It works by killing cancer cells. The way a drug works is called its mechanism of action.

Xeloda contains a pro-drug called capecitabine. A pro-drug is an inactive drug that your body changes into an active drug. When you take Xeloda, enzymes (proteins) in your body change capecitabine into the active chemotherapy drug fluorouracil. This mainly happens in tumor tissues because these tissues contain more of the enzymes that activate Xeloda than healthy tissues.

Fluorouracil is a form of chemotherapy called an antimetabolite. It kills cancer cells by interfering with their genetic material (DNA and RNA). This stops the cancer cells from making the proteins they need to survive. And it stops them from multiplying.

How long does it take to work?

Xeloda starts working soon after you start taking it. However, you may not notice it working. Your doctor may order certain tests, such as blood tests, to help monitor your treatment progress. They’ll let you know how your cancer is responding to Xeloda.

How long does it stay in your system?

Xeloda has a short half-life of about 45 minutes. A drug’s half-life describes how long it takes your body to remove half a dose of the drug. It typically takes about five half-lives for your body to get rid of a drug from your system. So Xeloda stays in your system for about 4 hours after you take a dose.

Xeloda isn’t known to interact with alcohol. However, drinking alcohol while you take Xeloda may increase your risk of having certain side effects. These include diarrhea, nausea, dizziness, and headache. Consuming alcohol may also be painful if you have mouth sores caused by Xeloda.

If you drink alcohol, talk with your doctor about how much is safe to drink while you take Xeloda.

Xeloda can interact with several other medications. It can also interact with certain supplements.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

Xeloda and other medications

Below is a list of medications that can interact with Xeloda. This list does not contain all drugs that may interact with Xeloda.

Before taking Xeloda, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also, tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

FDA warning: Risk of interaction with warfarin

Xeloda has a boxed warning about an interaction with warfarin (Jantoven). This is the most serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous.

Xeloda can cause a low platelet count. (Platelets are blood cells that help your blood clot.) With fewer platelets, your blood thins and does not clot as well as usual. So, your risk of bleeding can increase.

Blood thinners called coumarins help prevent blood clots by thinning your blood. An example of a coumarin is warfarin (Jantoven).

If you take Xeloda with warfarin, your risk for bleeding can increase further. This interaction can extend the time it takes your blood to clot. It can lead to serious, or in rare cases, fatal bleeding. When taking Xeloda with warfarin, this interaction can occur within days or months of starting treatment. It can also occur up to a month after you stop treatment. It’s more common in people older than age 60 years.

If you take Xeloda with warfarin, your doctor will frequently order tests to check how long it takes your blood to clot. If needed, they’ll adjust your dose of warfarin.

When to see your doctor

See your doctor right away if you have any symptoms of blood clotting problems while taking Xeloda with warfarin. These may include:

  • unusual bruising
  • unusual bleeding, such as bleeding gums or nosebleeds
  • blood in your urine or stools
  • taking longer than usual to stop bleeding if you injure yourself

If you have any questions about this boxed warning, talk with your doctor.

Other interactions

Other types of drugs that can interact with Xeloda include:

  • Allopurinol. The drug allopurinol (Lopurin, Zyloprim) is used to lower uric acid levels and treat gout. Taking Xeloda with allopurinol could make Xeloda less effective than usual. This combination is not usually recommended.
  • Leucovorin. The drug leucovorin is related to folic acid. Leucovorin is often used to increase the effectiveness of the chemotherapy drug fluorouracil. Taking Xeloda with leucovorin can increase the risk of side effects from Xeloda.
  • Phenytoin. The drug phenytoin (Dilantin) is used to treat seizures. Taking Xeloda with phenytoin could cause phenytoin to build up in your body. This could increase the risk of side effects from phenytoin.
  • CYP2C9 substrates. Drugs called CYP2C9 substrates are broken down by an enzyme (protein) in your liver called CYP2C9. Taking Xeloda with these drugs could make them build up in your body. This could increase the risk of side effects from CYP2C9 substrates. Examples of these drugs include:

Xeloda and herbs and supplements

Taking folic acid supplements with Xeloda can increase the risk of side effects from Xeloda. These include mouth sores, diarrhea, and low blood cell counts. You should not take folic acid supplements with Xeloda unless your doctor recommends them.

Be sure to check with your doctor or pharmacist before using any herbs or supplements while taking Xeloda.

Xeloda and foods

There aren’t any foods that have been specifically reported to interact with Xeloda. If you have any questions about eating certain foods with Xeloda, talk with your doctor.

Xeloda and vaccines

Xeloda can weaken your immune system. The drug can affect the way your body responds to vaccines.

If you get live vaccines while you take Xeloda, there’s a risk they could cause the infection they’re meant to protect you from. This is because live vaccines contain active but weakened forms of viruses or bacteria. You shouldn’t get live vaccines while you take Xeloda. Examples of live vaccines include:

If you get inactivated (non-live) vaccines while you take Xeloda, your immune system might not respond to them as well as usual. So these vaccines might be less effective at protecting you from infection. Examples of inactivated vaccines include:

Before you start taking Xeloda, it’s recommended that you’re up to date with any recommended vaccines. You can talk with your doctor about this.

Other drugs are available that can treat your condition. Some may be a better fit for you than others. If you’re interested in finding an alternative to Xeloda, talk with your doctor. They can tell you about other medications that may work well for you.

Note: Some of the drugs listed here are used off-label to treat these specific conditions. Off-label drug use is when a drug that’s approved by the Food and Drug Administration (FDA) is used for a purpose other than what it’s approved for.

Alternatives for treatment of metastatic breast cancer

Examples of other drugs that may be used to treat metastatic breast cancer include:

  • other chemotherapy drugs, such as:
    • carboplatin
    • cisplatin
    • cyclophosphamide
    • docetaxel (Taxotere)
    • doxorubicin
    • epirubicin (Ellence)
    • eribulin (Halaven)
    • fluorouracil
    • gemcitabine
    • ixabepilone (Ixempra kit)
    • methotrexate
    • paclitaxel (Abraxane)
    • vinorelbine
  • hormone therapy, such as:
  • targeted therapies, such as:
  • immunotherapy, such as:

Alternatives for treatment of metastatic colorectal cancer

Examples of other drugs that may be used to treat metastatic colorectal cancer include:

  • chemotherapy regimens such as:
    • CAPEOX (a combination of capecitabine and oxaliplatin)
    • FOLFOX (a combination of oxaliplatin, leucovorin, and fluorouracil)
    • FOLFIRI (a combination of leucovorin, fluorouracil, and irinotecan)
    • FOLFOXIRI (a combination of oxaliplatin, leucovorin, fluorouracil, and irinotecan)
    • FU-LV (a combination of fluorouracil and leucovorin)
    • XELIRI (a combination of capecitabine and irinotecan)
  • targeted therapy such as:
    • bevacizumab (Avastin)
    • cetuximab (Erbitux)
    • panitumumab (Vectibix)
  • immunotherapy such as:

Alternatives for adjuvant treatment of colon cancer

Examples of other drugs that may be used for adjuvant treatment of colon cancer include:

  • chemotherapy regimens such as:
    • CAPEOX (a combination of capecitabine and oxaliplatin)
    • FOLFOX (a combination of oxaliplatin, leucovorin, and fluorouracil)
    • FU-LV (a combination of fluorouracil and leucovorin)

Xeloda comes as an oral tablet that you swallow. You should take the medication according to the instructions your doctor gives you.

When to take

Xeloda is usually taken twice a day (morning and evening) for 2 weeks, followed by 1 week off treatment as a rest period. You’ll repeat this 3-week cycle for as long as your doctor recommends.

On the days you take Xeloda, try to take it at the same times each morning and evening.

To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm or using a timer. You could also download a reminder app on your phone.

Taking Xeloda with food

You should take Xeloda within 30 minutes after eating a meal.

Can Xeloda be crushed, split, or chewed?

No, you should not crush, split, or chew Xeloda. Taking Xeloda in a way other than how your doctor prescribes could be harmful. For example, particles from crushed Xeloda tablets could irritate your eyes or cause a skin rash.

You should swallow Xeloda tablets whole with a drink of water.

If you have trouble swallowing Xeloda whole, talk with your doctor. They may be able to provide you with tips to help with administration. A health professional needs to use the appropriate equipment and safety procedures for handling chemotherapy drugs.

Taking more than the recommended dosage of Xeloda can lead to serious side effects.

Do not take more Xeloda than your doctor recommends.

Overdose symptoms

Symptoms of an overdose can include:

What to do in case of overdose

If you think you’ve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use its online tool. But if your symptoms are severe, call 911 or your local emergency number, or go to the nearest emergency room right away.

Xeloda may cause fetal harm if used during pregnancy. If you can become pregnant, your doctor will likely have you take a pregnancy test before starting treatment with Xeloda. If you’re pregnant, they’ll probably recommend that you do not take Xeloda.

If you’re pregnant or plan to become pregnant, talk with your doctor about other possible ways to treat your cancer.

Xeloda and fertility

Xeloda may reduce fertility in males and females. After taking the drug, it may not be possible to become pregnant or make someone pregnant.

If you or your partner want to become pregnant, be sure to discuss this with your doctor before starting Xeloda treatment. It may be possible to freeze your eggs or sperm for future use.

Xeloda is not safe to take during pregnancy. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re taking Xeloda.

For more information about taking Xeloda during pregnancy, see the “Xeloda and pregnancy” section above.

For females taking Xeloda

If you can become pregnant, you should use effective birth control while taking Xeloda and for 6 months after your last dose.

For males taking Xeloda

If you’re a male* and have a partner who could become pregnant, you should use effective birth control while you take Xeloda. You will also need to continue to use birth control for 3 months after your last dose.

* Sex and gender exist on spectrums. Use of the terms “male” and “female” in this article refers to sex assigned at birth.

You should not breastfeed while taking Xeloda and for 2 weeks after your last dose. It’s not known if Xeloda passes into breast milk. However, if it does, it could cause serious side effects in a child who’s breastfed.

If you’re breastfeeding or plan to, talk with your doctor about other treatment options and healthy ways to feed your child.

This drug comes with several precautions.

FDA warning: Risk of interaction with warfarin

This drug has a boxed warning. This is the most serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous.

Xeloda has the risk of increasing the effect of coumarin-type blood thinners such as warfarin (Jantoven). This interaction can increase the time it takes your blood to clot. It can lead to serious, or in rare cases, fatal bleeding. When taking Xeloda with warfarin, this interaction can occur within days or months of starting treatment. It can also occur up to a month after you stop treatment. It’s more common in people older than age 60 years.

If you take Xeloda with warfarin, you should have frequent tests to check the time it takes your blood to clot. If needed, your doctor will adjust your dose of warfarin.

To read more about this interaction, see the section above called “Xeloda interactions.”

Other precautions

Before taking Xeloda, talk with your doctor about your health history. Xeloda may not be right for you if you have certain medical conditions or other factors affecting your health. These include the ones mentioned below.

Note: For more information about the potential negative effects of Xeloda, see the “Xeloda side effects” section above.

Allergic reaction. If you’ve ever had an allergic reaction to Xeloda or any of its ingredients, your doctor will likely not prescribe Xeloda.

Your doctor will also likely not prescribe Xeloda if you’ve ever had an allergic reaction to a related chemotherapy drug called fluorouracil (Efudex). This is because Xeloda is a pro-drug. A pro-drug is an inactive drug that your body changes into an active drug. When you take Xeloda, your body changes it into the active drug fluorouracil.

Ask your doctor what other medications are better options for you.

Heart disease. Xeloda can sometimes cause heart problems, such as changes to your heartbeat, as well as angina, heart attack, and heart failure. If you already have heart disease, you may be more likely than usual to have these side effects with Xeloda. Talk with your doctor about whether Xeloda is right for you.

Liver problems. If you have liver problems, you may have an increased risk of side effects with Xeloda. Talk with your doctor about whether Xeloda is right for you. They may want to monitor you more closely than usual.

Kidney problems. Xeloda can sometimes cause dehydration that can lead to kidney failure. If you already have kidney problems, you may have an increased risk of this side effect. Xeloda may also build up in your body and increase your risk of other side effects. For this reason, your doctor may prescribe a Xeloda dosage that’s lower than usual. But if you have severe kidney problems, your doctor will likely not prescribe Xeloda.

DPD deficiency. Dihydropyrimidine dehydrogenase (DPD) deficiency is a rare inherited condition in which you lack an enzyme called DPD. If you have DPD deficiency, you may have an increased risk of serious, life threatening side effects with Xeloda. Your doctor will likely not prescribe Xeloda if you have DPD deficiency. Ask your doctor what other medications are better options for you.

Pregnancy. Xeloda may cause fetal harm if used during pregnancy. For more information, see the “Xeloda and pregnancy” section above.

Breastfeeding. You should not breastfeed while taking Xeloda and for 2 weeks after your last dose. For more information, see the “Xeloda and breastfeeding” section above.

When you get Xeloda from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee that the medication is effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk with your pharmacist about whether you might still be able to use it.

Storage

How long a medication remains good to use can depend on many factors, including how and where you store the medication.

You should store Xeloda tablets at room temperature, which is about 77°F (25°C). You can temporarily store the drug at temperatures between 59°F and 86°F (15°C to 30°C), such as when traveling. Avoid storing this medication in areas where it could get damp or wet, such as bathrooms.

Disposal

If you no longer need to take Xeloda and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

This article provides several useful tips on medication disposal. You can also ask your pharmacist for information about how to dispose of your medication.

Disclaimer: Medical News Today 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.

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