XELIRI (Irinotecan and capecitabine) | Cancer Research UK
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XELIRI (Irinotecan and capecitabine)

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This page tells you about the chemotherapy drug combination Xeliri (irinotecan and capecitabine) and its possible side effects. There is information about


Xeliri chemotherapy

Xeliri is the name of a combination of chemotherapy drugs used to treat advanced bowel cancer (colorectal cancer). This treatment is made up of the drugs

  • Irinotecan (also called Campto)
  • Capecitabine (also called Xeloda)

How Xeliri works

Irinotecan and capecitabine work by interfering with DNA in the cancer cells. DNA is the genetic code that is in the heart of all animal and plant 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. 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 Xeliri

Irinotecan is a clear yellow fluid. You have it into your bloodstream (intravenously). You can have it through a thin, short tube (a cannula) put into a vein in your arm each time you have treatment. Or you may have it through a central line, a portacath, or a PICC line. These are long, plastic tubes that give the drugs directly into a large vein in your chest. You have the tube put in before or during your course of treatment and it stays in place as long as you need it.

You can read our information about having chemotherapy into a vein.

Capecitabine is peach coloured tablets. You take them twice a day. Your doctor will tell you which dose you need to take. Swallow them whole, with plenty of water, within 30 minutes of finishing a meal. It is very important that you take tablets according to the instructions your doctor or pharmacist gives you. For example, 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. And never stop taking a cancer drug without talking to your specialist first.

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

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

2 week cycle

  • On the first day you have a 30 minute drip (infusion) of irinotecan and begin taking capecitabine tablets twice a day
  • You continue to take the capecitabine tablets for 9 days
  • Then you have 5 days with no treatment
  • You then start your next treatment cycle

3 week cycle

  • On the first day you have a 30 minute drip (infusion) of irinotecan and begin taking capecitabine tablets twice a day
  • You continue to take the capecitabine tablets for 2 weeks
  • Then you have a week with no treatment
  • You then start your next treatment cycle

Tests during treatment

You have blood tests before starting treatment and regularly during your treatment. The tests check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.


About side effects

We've listed the side effects associated with Xeliri. You can use the links to find out more about each side effect. Where there is no link, please go to our information about cancer drug side effects or use the search box at the top of the page.

You may have a few side effects. They may be mild or more severe. A side effect may get better or worse through your course of treatment. Or more side effects may develop as the course goes on. This depends on

  • How many times you've had the drug before
  • Your general health
  • The amount of the drug you have (the dose)

The side effects may be different if you are having Xeliri with other medicines.

Tell your doctor or nurse straight away if any of the side effects get severe.


Common side effects

More than 10 in every 100 people have one or more of the side effects listed below.

  • An increased risk of getting an infection from a drop in white blood cells – it is harder to fight infections and you can become very ill. You may have headaches, aching muscles, a cough, a sore throat, pain passing urine, or you may feel cold and shivery. If you have a severe infection this can be life threatening. Contact your treatment centre straight away if you have any of these effects or if your temperature goes above 38°C
  • Tiredness and breathlessness due to a drop in red blood cells (anaemia) – you may need a blood transfusion
  • Bruising more easily due to a drop in platelets – you may have nosebleeds, or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs (known as petechiae)
  • Increased sweating – you will have a drug called atropine before the irinotecan to help reduce this
  • Increased saliva production – atropine helps to reduce this
  • Watery eyes
  • Abdominal cramps
  • Diarrhoea – this can occasionally be severe on the day you have treatment and for a day or so afterwards. Atropine helps to reduce this. You will also have anti diarrhoea medicine to take at home if you need it. Make sure you follow any special advice you have been given about how to cope with diarrhoea. Contact your doctor or nurse straight away if you are worried or if the diarrhoea goes on for more than 48 hours.
  • Tiredness and weakness (fatigue)
  • Feeling or being sick is usually well controlled with anti sickness medicines. Tell your doctor or nurse if it is not controlled
  • Loss of appetite
  • A sore mouth
  • Complete hair loss affects most people but some people just have hair thinning
  • Some people develop soreness, redness and peeling on the palms of the hands and soles of the feet (hand-foot syndrome). This may cause tingling, numbness, pain and dryness

Occasional side effects

Between 1 and 10 in every 100 people have one or more of these.

  • Muscle cramps
  • Liver changes that are very mild and  unlikely to cause symptoms
  • Skin rashes, which may be itchy
  • Higher levels of bilirubin in your blood
  • Constipation may occur but is usually well controlled with laxatives – tell your doctor or nurse if you are constipated for more than 3 days
  • Headaches and dizziness
  • Eye infections
  • Women may stop having periods (amenorrhoea) – this may be temporary

Rare side effects

Fewer than 1 in 100 people have these.

  • Swollen ankles
  • Temporary chest pain

Important points to remember

Talk to your doctor, pharmacist or nurse about all your side effects so they can help you manage them. They can give you advice or reassure you. Your nurse will give you a contact number to ring if you have any questions or problems. If in doubt, call them.

Other medicines

Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and over the counter remedies. Some drugs can react together.

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 and for at least 6 months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.


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


Immunisations and chemotherapy

You should not have immunisations with live vaccines while you are having chemotherapy or for at least 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG, yellow fever and Zostavax (shingles vaccine).

You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your chemotherapy. It is safe to have the flu vaccine.

It is safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with vaccines you take by mouth (oral vaccines), but not many people in the UK have these now. So there is usually no problem in being with any baby or child who has recently had any vaccination in the UK. You might need to make sure that you aren't in contact with anyone who has had oral polio, cholera or typhoid vaccination recently, particularly if you live abroad.


Related information

On this website you can read about 

Advanced bowel cancer (colorectal cancer)

Irinotecan (also called Campto)

Capecitabine (also called Xeloda)

Taking medicines safely


More information about Xeliri drugs

This page does not list all the very rare side effects of this treatment that are very unlikely to affect you. For further information about these drugs look at the Electronic Medicines Compendium website at www.medicines.org.uk.

If you have a side effect not mentioned here that you think may be due to this treatment you can report it to the Medicines Health and Regulatory Authority (MHRA) at yellowcard.mhra.gov.uk.

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Updated: 1 September 2015