Xeloda (capecitabine) is a prescription brand-name medication. The Food and Drug Administration (FDA) has approved it to treat specific types of cancers in certain adults. These include:

Here are some fast facts about Xeloda:

  • Active ingredient: capecitabine, which is a type of chemotherapy
  • Drug class: nucleoside metabolic blocker
  • Drug form: oral tablet
  • Drug strengths: 150 milligrams (mg) and 500 mg

Your doctor may prescribe Xeloda for 6 months. Or they may prescribe the drug longer than that. This depends on your cancer type and how your body responds to the drug.

As with other drugs, Xeloda can cause side effects. Read on to learn about potential common, mild, and serious side effects. For a general overview of Xeloda, including details about its uses, see this article.

Xeloda can cause certain side effects, some of which are more common than others. These side effects may be temporary, lasting a few days to weeks. But if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

These are just a few of the more common side effects reported by people who took Xeloda in clinical trials:

* For more information about this side effect, see “Side effect specifics” below.

Mild side effects can occur with Xeloda use. This list doesn’t include all possible mild side effects of the drug. For more information, you can refer to Xeloda’s prescribing information.

Mild side effects that have been reported with Xeloda include:

These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you develop a side effect while taking Xeloda and want to tell the FDA about it, visit MedWatch.

* For more information about this side effect, see “Side effect specifics” below.

Xeloda may cause serious side effects. The list below may not include all possible serious side effects of the drug. For more information, you can refer to Xeloda’s prescribing information.

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.

Serious side effects that have been reported and their symptoms include:

* Xeloda has a boxed warning for the risk of this drug interaction. A boxed warning is a serious warning from the Food and Drug Administration (FDA). For details, see the “Precautions for Xeloda” section below.
* For more information about this side effect, see “Side effect specifics” below.

Xeloda may cause several side effects. Here are some frequently asked questions about the drug’s side effects and their answers.

What side effects of Xeloda should I expect during my week off treatment?

Typically, you won’t experience any new side effects during your week off Xeloda treatment. In fact, any side effects that you experience from Xeloda should improve during your week off.

Xeloda is taken in cycles. Each cycle lasts 3 weeks. In the first 2 weeks, you’ll take Xeloda twice per day. Then, in the last week, you won’t take Xeloda at all.

If you experience side effects with Xeloda treatment, they should ease during this week off. However, if you notice any new or worsening side effects, be sure to tell your doctor. They can help determine what may be causing these side effects.

How long before Xeloda side effects typically start?

The timing and severity of Xeloda’s side effects can vary from person to person.

For example, diarrhea is the most common side effect of Xeloda. Some people may develop this side effect after taking Xeloda for just 1 day or longer than that. It’s possible to also develop diarrhea after taking the drug for over a year. Among the people who had diarrhea in clinical trials, half started experiencing it about 34 days after beginning Xeloda treatment.

Another side effect of Xeloda is hand-foot syndrome. (To learn more, see the “Side effect specifics” section below.) In clinical trials, people taking Xeloda developed hand-foot syndrome about 79 days after starting treatment, on average.

If you have questions about when side effects could start during Xeloda treatment, talk with your doctor. They’ll recommend ways to manage them.

Learn more about some of the side effects that Xeloda may cause. To find out how often side effects occurred in clinical trials, see the prescribing information for Xeloda.

Hand-foot syndrome

It’s possible to experience hand-foot syndrome from Xeloda treatment. Hand-foot syndrome is a skin condition that can become severe. And it may occur as a side effect of taking certain drugs, such as chemotherapy. Hand-foot syndrome was a common side effect of Xeloda.

Symptoms can include the following in your hands and feet:

  • numbness or tingling
  • pain
  • blistering or ulcers (sores)
  • swelling or discoloration

The above symptoms can be mild or severe. In severe cases, it’s also possible for hand-foot syndrome to affect your fingerprints.

What you can do

It’s important to tell your doctor if you experience any of the above symptoms. They can treat the condition right away.

If you have mild symptoms, your doctor may monitor your condition to be sure that it doesn’t worsen. They may also recommend an over-the-counter drug, such as acetaminophen (Tylenol) or ibuprofen (Advil), to help relieve pain

If you have severe symptoms, your doctor may recommend pausing Xeloda treatment until your symptoms ease. In some cases, they may recommend a lower dosage of Xeloda. (To learn more about Xeloda’s dosage, see this article.)

Hair loss

You may experience hair loss from taking Xeloda. Hair loss was reported in clinical trials of the drug. However, it was not a common side effect.

What you can do

If you notice hair loss during your Xeloda treatment, especially if it’s severe or bothersome to you, tell your doctor. In some cases, they may recommend ways to manage your hair loss.

Eye problems

It’s possible to develop problems that affect your eyes while you’re taking Xeloda. Examples include eye irritation, swelling, or infection, such as conjunctivitis (pink eye).

Eye problems were not commonly reported in people taking Xeloda. And in most cases, they were mild. However, it’s still important to be aware of symptoms of eye side effects before you start Xeloda treatment.

Symptoms can include:

What you can do

Tell your doctor if you notice any eye problems during your Xeloda treatment. They can help determine if Xeloda is the cause of these side effects. Your doctor or pharmacist can also recommend the best way to treat these side effects. In some cases, they may recommend medications, such as eyedrops, to help prevent these eye problems from occurring.

Severe skin reactions

It’s rare, but possible for Xeloda to cause severe skin reactions. Some of these may be serious and even life threatening. Examples of these conditions include Stevens-Johnson syndrome and toxic epidermal necrolysis. It isn’t clear whether these reactions occurred in clinical trials of the drug. However, rare types of skin reactions have been reported after the drug became available for use. Due to this risk, you should be aware of the possible symptoms of skin reactions.

Symptoms can include:

What you can do

If you develop symptoms of a severe skin reaction, see a doctor right away. They can help get treatment for your skin reaction as soon as possible.

If you have a severe skin reaction, your doctor will likely recommend you stop taking Xeloda. They may prescribe a different medication to treat your cancer.

It’s also possible for Xeloda to cause another skin condition called hand-foot syndrome. This is a skin problem that can occur in people taking certain medications. Your doctor can help determine what skin condition you’re experiencing. (For more information on hand-foot syndrome, see “Hand-foot syndrome” above.)

Neuropathy

It’s possible for Xeloda to cause neuropathy (nerve damage). Neuropathy was not a common side effect reported in clinical trials of Xeloda. Specifically, Xeloda may cause peripheral neuropathy. This is a type of neuropathy that affects your hands and feet.

Symptoms of peripheral neuropathy can include the following in your hands or feet:

  • numbness
  • tingling
  • weakness
  • pain

It’s also possible for Xeloda to cause another condition called polyneuropathy. With polyneuropathy many nerves are affected.

What you can do

If you notice symptoms of neuropathy during your Xeloda treatment, tell your doctor. They may recommend medications to decrease your neuropathy symptoms. In some cases, they may recommend a different treatment option for your cancer.

Allergic reaction

As with most drugs, Xeloda can cause an allergic reaction in some people. This side effect was rare in the drug’s clinical trials.

Symptoms can be mild or serious and can include:

  • skin rash
  • itching
  • flushing
  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What you can do

Be sure to tell your doctor about any medications that you’re allergic to. If you’ve had an allergic reaction to a chemotherapy drug called fluorouracil, you may also have an allergic reaction to Xeloda.

For mild symptoms of an allergic reaction, call your doctor right away. They may recommend ways to ease your symptoms and determine whether you should keep taking Xeloda. But if your symptoms are serious and you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Tell your doctor about any medications or medical conditions that you have before you start treatment with Xeloda. They can help you determine if Xeloda may be safe for you.

Boxed warning: Risk of interaction with warfarin

Xeloda has a boxed warning for the risk of interaction if it’s taken with certain blood thinners, including warfarin (Jantoven). This is a serious warning from the Food and Drug Administration (FDA).

If you take Xeloda along with certain blood thinners, you may have an increased risk of bleeding. In some cases, this bleeding may be serious or even life threatening. Bleeding may occur within a few days of starting Xeloda treatment. However, in some people, it can occur even 1 month after stopping Xeloda treatment. If you’re over 60 years old, your risk of bleeding may be higher.

Before you start Xeloda treatment, it’s important to tell your doctor about any medications you’re taking. They can help you determine if it’s safe for you to take Xeloda with these drugs.

In some cases, if you’re taking certain blood thinner drugs, your doctor may monitor your blood more often. If needed, they can adjust the dosage of your blood thinner to avoid an increased risk of bleeding.

Other precautions

Be sure to talk with your doctor about your health history before you take Xeloda. This drug may not be the right treatment for you if you have certain medical conditions or other factors that affect your health. The conditions and factors to consider include:

Kidney problems. It’s possible for Xeloda to cause dehydration due to severe digestive side effects, such as diarrhea or vomiting. This may lead to kidney problems. If you already have kidney problems, taking Xeloda may worsen your condition. Due to this risk, your doctor may prescribe a lower dosage* of Xeloda. If you have severe kidney problems, your doctor may recommend a different treatment option for you.

Allergic reaction. If you’ve had an allergic reaction† to Xeloda or any of its ingredients, your doctor will likely not prescribe the drug. Also, your doctor will likely not prescribe Xeloda if you’ve had an allergic reaction to a chemotherapy drug called fluorouracil. (When you take Xeloda, your body converts it into fluorouracil.) Ask your doctor what other medications may be better options for you.

Heart conditions. It’s possible for Xeloda to cause heart problems, such as irregular heartbeat or heart attack. If you already have heart disease, you may have an increased risk of developing these heart problems from taking Xeloda. Xeloda may also worsen your existing condition. Your doctor can help determine if it’s safe for you to take Xeloda.

Liver problems. Tell your doctor if you have any liver problems before starting treatment with Xeloda. Liver problems may increase your risk of side effects from taking Xeloda. If you have liver problems, your doctor can determine if it’s safe for you to take the drug.

Dihydropyrimidine dehydrogenase deficiency. Tell your doctor if you have a condition called dihydropyrimidine dehydrogenase (DPD) deficiency. People with this condition have lower levels of DPD (a type of enzyme) than usual. If you have this condition, you may have an increased risk of side effects from taking Xeloda. In most cases, your doctor will not prescribe you Xeloda if you have DPD deficiency. Talk with your doctor about the best treatment options for you.

* To learn more about Xeloda’s dosage, see this article.
† For additional information about this precaution, see the “Side effect specifics” above.

Alcohol use with Xeloda

There are no known interactions between Xeloda and alcohol.

However, drinking alcohol during your Xeloda treatment may worsen any side effects you may develop from the drug.

For example, both Xeloda and alcohol can cause similar symptoms, including:

  • nausea
  • vomiting
  • weakness
  • dizziness
  • headache

So, drinking alcohol while you’re taking Xeloda can further increase your risk of these side effects. In addition, alcohol may make mouth sores more painful. (Mouth sores are a possible side effect of Xeloda.) So, if you have mouth sores, your doctor may recommend avoiding alcohol.

If you’d like to drink alcohol during your treatment with Xeloda, talk with your doctor.

Pregnancy and breastfeeding while taking Xeloda

Xeloda is not safe to take during pregnancy or while you’re breastfeeding.

This medication can cause harm to a developing fetus. There haven’t been any studies done in humans taking Xeloda during pregnancy. However, in animal studies, Xeloda caused pregnancy loss. But keep in mind that animal studies do not always indicate what may happen in humans.

Due to this risk, your doctor will have you take a pregnancy test before starting Xeloda treatment. Females* who can become pregnant should also use birth control while taking Xeloda. And they should use it for at least 6 months after stopping treatment.

Males* who have female partners taking Xeloda should use birth control during treatment and for at least 3 months after their last dose.

It’s not known if Xeloda passes into breastmilk or what effects the drug may have on a breastfed child. Due to the possible risks, your doctor will not recommend breastfeeding during your Xeloda treatment. And they won’t recommend it for at least 2 weeks after your last dose.

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

You may experience side effects from your treatment with Xeloda. In most cases, side effects may be mild. However, it’s possible to develop severe side effects from this drug.

If you’d like to learn more about Xeloda, talk with your doctor or pharmacist. They can help answer any questions you have about side effects from taking the drug.

Besides talking with your doctor, you can do some research on your own. These articles might help:

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.