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Epirubicin, carboplatin and capecitabine (ECarboX)

Find out what the drug combination chemotherapy ECarboX is, how you have it and other important information.

ECarboX is a combination of chemotherapy drugs. It’s made up of:

  • epirubicin (Pharmorubicin)
  • carboplatin (Paraplatin)
  • capecitabine (Xeloda)

You may have it to treat:

  • oesophageal cancer
  • stomach cancer

How you have ECarboX chemotherapy

You have ECarboX chemotherapy as cycles of treatment each lasting 3 weeks. Depending on your needs, you can have up to 8 cycles, taking around 6 months in total.

You have:

  • capecitabine as a tablet - taken twice a day, morning and night, and swallowed whole with plenty of water within 30 minutes of eating
  • epirubicin as an injection into your bloodstream (intravenously) once each cycle
  • carboplatin as a drip into your bloodstream over 30 minutes once each cycle

You have epirubicin and carboplatin into your bloodstream through a thin, short tube (a cannula). The nurse or doctor puts it into a vein in your arm each time you have treatment.

Or you can have them through a central line, a PICC line or a portacath. These are long, plastic tubes that give the drugs through a large vein in your chest. The tube stays in place throughout the course of treatment.

Taking your tablets or capsules

You must take tablets and capsules according to the instructions your doctor or pharmacist gives you.

Whether you have a full or empty stomach can affect how much of a drug gets into your bloodstream.

You should take the right dose, not more or less.

Never stop taking a cancer drug without talking to your specialist first.

When you have treatment

You have each cycle of treatment in the following way.

Day 1
  • epirubicin as an injection into your vein
  • carboplatin as a drip for 30 minutes into the bloodstream
  • capecitabine tablet in the morning and evening
Day 2 to 21
  • capecitabine tablet in the morning and evening

Then you start your cycle again.

Tests during treatment

You have blood tests before and during your treatment to check your levels of blood cells. They also check how well your liver and kidneys are working.

Side effects

Important information

Other medicines, foods and drink

Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.

Pregnancy and contraception

This drug may harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment with this drug and for at least 3 months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.

Breastfeeding

Don’t breastfeed during this treatment because the drugs may come through in your breast milk.

Fertility

You may not be able to become pregnant or father a child after treatment with this drug. Talk to your doctor before starting treatment if you think you may want to have a baby in the future. Men may be able to store sperm before starting treatment. Women may be able to store eggs or ovarian tissue but this is rare.

Immunisations

Don’t have immunisations with live vaccines while you’re having treatment and for at least 6 months afterwards.

In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and Zostavax (shingles vaccine).

You can:

  • have other vaccines, but they might not give you as much protection as usual
  • have the flu vaccine
  • be in contact with other people who've had live vaccines as injections

Avoid contact with people who’ve had live vaccines taken by mouth (oral vaccines). This includes the rotavirus vaccine given to babies. The virus is in the baby’s urine for up to 2 weeks and can make you ill. So, you mustn't change their nappies for 2 weeks after their vaccination.

You also need to avoid anyone who has had oral polio or typhoid vaccination recently.

DPD deficiency

Around 5 out of 100 people (5%) have low levels of an enzyme called DPD in their bodies. A lack of DPD can mean you’re more likely to have severe side effects from capecitabine. It doesn’t cause symptoms so you won’t know if you have a deficiency. Contact your doctor if your side effects are severe.

More information about this treatment

For further information about this treatment go to the electronic Medicines Compendium (eMC) website.

You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.

Last reviewed: 
11 Oct 2016
  • Combination chemotherapy with carboplatin, capecitabine and epirubicin (ECarboX) as second- or third-line treatment in patients with relapsed ovarian cancer: a phase I/II trial
    C Rothermundt and others
    British Journal of Cancer. 2006 Jan 16; 94(1): 74–78

  • Electronic medicines compendium, SPC and PILs
    Accessed January 2016

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