Capecitabine (Xeloda)
What capecitabine is, how you have it and other important information about taking capecitabine for bile duct cancer.
Capecitabine is a chemotherapy drug used for many different types of cancer. You might have it on its own or with other chemotherapy drugs.
Capecitabine is a type of chemotherapy called an anti metabolite. It stops cells making and repairing DNA. Cancer cells need to make and repair DNA so they can grow and multiply.
How you have capecitabine
Capecitabine is a tablet you take twice a day, morning and evening.
You might have two different strengths of tablets to make up the correct dose.
Take the tablets up to 30 minutes after a meal, with plenty of water.
Tell your doctor or pharmacist if you have difficulty swallowing. You can dissolve the tablets in 200mls warm water. This takes about 15 minutes.
Stir the liquid gently with a spoon from time to time, but don’t crush the tablets. Then drink the liquid immediately.
Rinse the cup with some more water and drink it. This makes sure you have the whole dose. Wash the cup and spoon well afterwards. Keep them away from your other cups and cutlery, so that no one else uses them.
Taking your tablets or capsules
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.
Talk to your healthcare team before you stop taking or miss a dose of a cancer drug.
When you have capecitabine
You might have capecitabine as a course of several cycles of treatment. Each cycle is often over 3 weeks, but this depends on the type of cancer you have.
For example, you may take capecitabine every day for 2 weeks. Then have a week with no treatment. You then start the next cycle. Or you may take capecitabine every day for a few months.
Your doctor will tell you:
- what dose of capecitabine you need to take
- when to take it
- how long to take it for
Tests
You have blood tests before 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
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 get someone pregnant while you're having treatment and for a few months afterwards.
Talk to your doctor or nurse about effective contraception before starting treatment. Let them know straight away if you or your partner become pregnant while having treatment.
Breastfeeding
Don’t breastfeed during this treatment because the drug may come through into your breast milk.
Blood clots
You are more at risk of developing a blood clot during treatment. Drink plenty of fluids and keep moving to help prevent clots.
Treatment for other conditions
If you are having tests or treatment for anything else, always mention your cancer treatment. For example, if you are visiting your dentist.
DPD deficiency
Between 2 and 8 out of 100 people (2 to 8%) have low levels of an enzyme called dihydropyrimidine dehydrogenase (DPD) in their bodies. A lack of DPD can mean you’re more likely to have severe side effects from capecitabine or fluorouracil. It might take you a bit longer to recover from the chemotherapy. These side effects can rarely be life threatening.
Before starting treatment with capecitabine or fluorouracil you have a blood test to check levels of DPD. So you may start treatment with a lower amount (dose) of the drug or have a different treatment. Your doctor or nurse will talk to you about this.
Immunisations
Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having. Ask your doctor or pharmacist how long you should avoid live vaccinations.
In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and one of the shingles vaccines called Zostavax.
You can have:
- other vaccines, but they might not give you as much protection as usual
- the flu vaccine (as an injection)
- the coronavirus (COVID-19) vaccine - talk to your doctor or pharmacist about the best time to have it in relation to your cancer treatment
Members of your household who are aged 5 years or over are also able to have the COVID-19 vaccine. This is to help lower your risk of getting COVID-19 while having cancer treatment and until your 
recovers from treatment.
Contact with others who have had immunisations - You can be in contact with other people who have had live vaccines as injections. Avoid close contact with people who have recently had live vaccines taken by mouth (oral vaccines) such as the oral typhoid vaccine. Sometimes people who have had the live shingles vaccine can get a shingles type rash. If this happens they should keep the area covered.
If your immune system is severely weakened, you should avoid contact with children who have had the flu vaccine as a nasal spray as this is a live vaccine. This is for 2 weeks following their vaccination.
Babies have the live rotavirus vaccine. The virus is in the baby’s poo for about 2 weeks and could make you ill if your immunity is low. Get someone else to change their nappies during this time if you can. If this isn't possible, wash your hands well after changing their nappy.
More information about this treatment
We haven't listed all the very rare side effects of this treatment. For further information see the electronic Medicines Compendium (eMC) website.
You can report any side effect you have that isn’t listed here to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.
