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Epirubicin, cisplatin and capecitabine (ECX)

Find out how you have ECX chemotherapy, when you’ll have it and other important information about having this chemotherapy.

ECX is a combination of chemotherapy drugs made up of:

  • epirubicin (also called Pharmorubicin)
  • cisplatin
  • capecitabine (also called Xeloda)

It is a treatment for stomach and oesophageal (foodpipe) cancer.

How you have ECX chemotherapy

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

  • capecitabine as a tablet – you take it twice a day, morning and night, and swallow it whole with plenty of water
  • epirubicin as an injection into your bloodstream (intravenously) once each cycle
  • cisplatin as a drip into your bloodstream over 1 hour, once each cycle

You have cisplatin and epirubicin 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.

You can also have them through long lines: a central line, a PICC line or a portacath.

These are long, plastic tubes that give the drugs into 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
  • fluids to hydrate you for 1 hour into the bloodstream
  • cisplatin as a drip for 1 hour into the bloodstream
  • more fluids to hydrate you for 2 hours
  • take capecitabine tablets morning and evening
Days 2 to 21
  • take capecitabine tablets morning and evening

Then you start the 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 treatment might harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment and for a few months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.

Breast feeding

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


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.


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.

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: 
23 Aug 2016
  • Electronic medicines compendium
    Accessed July 2016

  • Immunisation against infectious disease: Chapter 6: General contraindications to vaccination
    Public Health England
    First published: March 2013 and regularly updated on the Gov.UK website

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