Decorative image

Irinotecan and capecitabine (XELIRI)

Find out what XELIRI is, how you have it and other important information about taking this drug combination.

What is it

XELIRI is the name of a combination of chemotherapy drugs used to treat advanced bowel cancer (colorectal cancer). 

It is made up of the following drugs: 

  • irinotecan (also called Campto)
  • capecitabine (also called Xeloda)

How it works

XELIRI works by interfering with the DNA in cancer cells.

DNA is the genetic code that is in the heart of all animals and plants cells. It controls everything the cells do. Cancer cells need to make and repair DNA in order to grow and multiply. 

Irinotecan blocks an enzyme, called topoisomerase I. Cells needs this enzyme to divide and grow into 2 new cells. If this enzyme is blocked, then the cell's DNA gets tangled up and the cancer cells can't divide. 

Capecitabine stops cells making and repairing DNA. 

How you have it

Irinotecan is a clear yellow fluid. You have it as a drip into your bloodstream (intravenously). 

Capecitabine is a peach coloured tablets. You take them twice a day, morning and evening.

Your doctor will tell you which dose of capecitabine you need to take. You might have 2 different strengths of tablets to make up the correct dose. Take the tablets up to 30 minutes after a meal, with plenty of water.

Into your bloodstream

You have the treatment through a drip into your arm. A nurse puts a small tube (a cannula) into one of your veins and connects the drip to it.

You might need a central line. This is a long plastic tube that gives the drugs into a large vein, either in your chest or through a vein in your arm. It stays in while you’re having treatment, which may be for a few months.

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 it

You have irinotecan and capecitabine chemotherapy as cycles of treatment. Each cycle lasts 2 or 3 weeks. 

You usually have it for as long as it controls your cancer. 

2 week cycle

Day 1
  • You have irinotecan as a 30 minute drip into your bloodstream
  • You take capecitabine tablets twice a day
Day 2 to 10
  • You take capecitabine tablets twice a day
Day 11 to 15
  • You have no treatment

You then start your next treatment cycle. 

3 week cycle

Day 1
  • You have irinotecan as a 30 minute drip into your bloodstream
  • You take capecitabine tablets twice a day
Day 2 to 14
  • You take capecitabine tablets twice a day
Day 15 to 21
  • You have no treatment

You then start your next treatment cycle. 

Tests during treatment

You have blood tests before starting treatment and during your treatment. They check your levels of blood cells and other substances in the blood. 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 6 months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.

Breastfeeding

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

Treatment for other conditions

Always tell other doctors, nurses or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.

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.

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.

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.

Information and help

Dangoor sponsorship

About Cancer generously supported by Dangoor Education since 2010.