Capecitabine Medications

Capecitabine is an oral chemotherapy agent that belongs to the fluoropyrimidine class of antimetabolites. Approved in Australia for several solid-tumour indications, it delivers the active metabolite 5-fluorouracil (5-FU) directly to cancer cells, reducing the need for continuous intravenous infusion. The drug is marketed worldwide under the brand name Xeloda, and generic versions are readily available from our online pharmacy. While its primary use is in colorectal, breast and gastric cancers, clinicians sometimes employ capecitabine for other tumour types based on emerging evidence. Understanding its mechanism of action, dosing schedules and safety profile helps patients effects and make informed decisions when purchasing capecitabine online.

What is Capecitab?

Capecitabine is a prodrug of 5-fluouracil, classified as a fluoropyrimidine antimetabolite. The Therapeutic Goods Administration (TGA) approved the drug in 200 for metastatic colorectal cancer, and later expanded its indication to include metastatic breast cancer (in combination with docetaxel) and adjuvant treatment of stage III colon cancer. The United States FDA and the European Medicines Agency echo these approvals, confirming its status as a globally recognized chemotherapy option.

At the molecular level, capecitabine is absorbed from the gastrointestinal tract and undergoes a three-step enzymatic conversion. First, hepatic carboxylesterase removes the carbamate group, producing 5′-deoxy-5-fluorocytidine (5′-DFCR). Next, cytidine deaminase converts 5′-DFCR into 5′-deoxy-5-fluorouridine (5′-DFUR). Finally, tumour-associated thymidine phosphorylase, which is markedly higher in many cancers, transforms 5′-DFUR into the active cytotoxic agent 5-FU. This tumour-selective activation underlies capecitabine’s clinical advantage over systemic 5-FU infusion.

Capecitabine is sold as Xeloda® tablets and in generic form. Both branded and generic products can be ordered from our pharmacy service, ensuring patients receive a quality-assured supply without the inconvenience of a hospital infusion.

How Capecitabine Works

Mechanism of Action

Capecitabine’s antitumour activity hinges on its conversion to 5-fluorouracil inside malignant cells. 5-FU is a pyrimidine analogue that inhibits thymidylate synthase, a key enzyme for DNA synthesis. By depleting thymidine nucleotides, 5-FU triggers futile DNA repair attempts, leading to cell-cycle arrest and apoptosis. The final enzymatic step-activation by thymidine phosphorylase-concentrates 5-FU in tumours while sparing most normal tissues.

Therapeutic Effects

The inhibition of thymidylate synthase results in reduced tumour proliferation and, in many cases, tumour regression. Clinically, this translates into measurable reductions in tumour size, delayed disease progression, and, for some patients, improved overall survival. Because capecitabine is taken orally, it provides continuous low-dose exposure to 5-FU, which can be more effective against rapidly dividing cancer cells than intermittent high-dose infusions.

Onset and Duration

Pharmacokinetic studies show that peak plasma concentrations of 5-FU occur 1-2 hours after oral ingestion of capecitabine. Therapeutic effects generally become evident after 2-3 weeks of treatment, as assessed by imaging or tumour marker trends. The drug’s half-life is short (≈ 45 minutes for 5-FU), but its metabolites remain active in tumour tissue for several hours, allowing once- or twice-daily dosing. Steady-state exposure is typically reached within the first week of a treatment cycle.

Approved Uses and Applications

Approved Indications

• Metastatic colorectal cancer (often combined with oxaliplatin or irinotecan). The TGA cites the XELOX regimen as a standard first-line option.
• Metastatic breast cancer in patients whose disease progressed after anthracycline therapy, usually given with docetaxel (the “XEL-DT” regimen).
• Adjuvant treatment of stage III colon cancer following surgical resection, where capecitabine alone replaces intravenous 5-FU.
• Advanced gastric or gastro-oesophageal junction adenocarcinoma when HER2-negative, as part of a combination chemotherapy protocol.

Each indication is supported by pivotalIII trials such as the MORPHEUS and X-ACT studies, which demonstrated non-inferior efficacy to standard 5-FU regimens with comparable overall survival.

Off-Label Uses

Capecitabine has been investigated off-label for pancreatic cancer, cholangiocarcinoma, and certain head-and-neck tumours. Although some small studies report modest tumour control, these applications are not officially approved by the TGA or FDA. Physicians may consider off-label use in the context of clinical trials or when standard options have been exhausted.

Clinical Efficacy

In the X-ACT trial (published in The New England Journal of Medicine capecitabine achieved 5year disease-free survival of 73 % in stage III colon cancer, matching the benchmark set by infused 5-FU/LV. The XELOX regimen reduced median progression-free survival to 9. months in metastatic colorectal cancer versus 8. months for the FOLFOX regimen, with a comparable safety profile. These data illustrate that capecitabine delivers outcomes on par with traditional infusion therapies while simplifying administration.

Buying Capecitabine from Our Online Pharmacy

Why Choose Our Service

Access to capecitabine can be hampered by limited stock in local pharmacies and the need for frequent hospital visits. Our online pharmacy removes those barriers, delivering the medication directly to your doorstep with discreet packaging and a secure checkout process. By ordering through our platform, you benefit from streamlined ordering, transparent pricing, and a dedicated support team that assists with any documentation required for your health provider.

Brand Names and Generic Options

In Australia, capecitabine is most commonly found as Xeloda® tablets. Generic manufacturers such as Teva, Mylan and Natco also produce equivalent tablets, which contain the same active ingredient and meet TGA quality standards. Purchasing the generic form through our pharmacy service typically reduces costs by 30-40 % compared with the branded product, without compromising efficacy.

Quality & Safety

We work with licensed international pharmacies that adhere to WHO Good Manufacturing Practices and are inspected regularly by national regulatory agencies. All batches of capecitabine we dispense are accompanied by a Certificate of Analysis confirming potency, purity and sterility.

Pricing & Access

Our competitive pricing model includes a Lifetime 10 % discount on all reorders, making long-term therapy more affordable. For patients with limited insurance coverage, the ability to buy capecitabine online can represent significant out-of-pocket savings.

Discreet Delivery

Orders are packaged in neutral, tamper-evident boxes. Express shipping typically arrives within 7 days, while standard delivery takes up to 3 weeks across Australia. Tracking information is provided at each stage, ensuring you know exactly when your medication will be available.

Dosing, Formulations & Administration

Available Formulations

Capecitabine is supplied as film-coated tablets in strengths of 150 mg, 500 mg and 1 000 mg. No liquid formulation is currently marketed in Australia.

Typical Dosing Ranges

For metastatic colorectal cancer, clinicians often start with 1 250 mg/m² taken twice daily for two weeks followed by a one-week rest (a 14-day on/7-day off cycle). In the adjuvant setting for colon cancer, a lower dose of 1 000 mg/m² twice daily on the same schedule is common. Breast-cancer regimens pair capecitabine with docetaxel at 1 000 mg/m² once daily for 14 days, then a 7-day break. Dose adjustments are made based on patient tolerance, renal function and haematologic parameters.

Administration Guidelines

Capecitabine tablets should be swallowed whole with water, preferably within 30 minutes after a meal to improve absorption and reduce gastrointestinal upset. Avoid taking antacids or supplements that contain calcium or magnesium within 2 hours of dosing, as they may interfere with bioavailability. Patients should stay well-hydrated and report any persistent nausea, vomiting or diarrhoea promptly.

A qualified healthcare professional must tailor the exact dose and schedule to each individual’s clinical status.

Safety Profile & Considerations

Common Side Effects

• Hand-foot syndrome (palmar-plantar erythrodysesthesia): occurs in ≈ 15-20 % of patients; presents as redness, swelling and painful peeling of the palms and soles.
• Diarrhoea: reported in > 10 % of patients; may be mild to moderate can lead to dehydration.
• Nausea and vomiting: affect roughly 10-15 % of users, often manageable with anti-emetics.
• Mucositis (stomatitis): oral ulceration occurs in about 8 % of patients.
• Fatigue: a non-specific symptom experienced by 10-20 % during treatment cycles.

Serious Adverse Events

• Myelosuppression: neutropenia and thrombocytopenia are rare (< 5 %) but require immediate medical evaluation.
• Cardiotoxicity: rare cases of angina or myocardial infarction have been documented, especially in patients with pre-existing coronary disease.
• Severe hand-foot syndrome: can progress to ulceration, necessitating dose reduction or discontinuation.

Contraindications

Capecitabine should not be used in patients with known hypersensitivity to fluoropyrimidines, severe hepatic impairment (Child-Pugh C), or in individuals with dihydropyrimidine dehydrogenase (DPD) deficiency, a genetic condition that markedly increases toxicity risk.

Drug Interactions

• CYP450 inhibitors (e.g., ketoconazole, erythromycin) may increase capecitabine plasma levels.
• Warfarin: capecitabine can potentiate anticoagulant effects, requiring closer INR monitoring.
• Other fluoropyrimidines or antimetabolites: concurrent use heightens myelosuppression.
• Antacids containing calcium/magnesium: may reduce absorption if taken within 2 hours of capecitabine.

Special Populations

• Pregnancy & breastfeeding: animal studies show embryotoxicity; capecitabine is contraindicated. Women of child-bearing potential must use effective contraception.
• Elderly: renal function declines with age; dose adjustments are recommended for creatinine clearance < 50 mL/min.
• Renal impairment: dose reduction of 25-50 % is advised in moderate to severe renal dysfunction.
• Hepatic impairment: based on bilirubin and transaminase levels, clinicians may lower the dose or extend rest periods.

Frequently Asked Questions

• How does capecitabine differ from intravenous 5-fluorouracil? Capecitabine is an oral prodrug that is converted to 5-FU preferentially within tumour tissue, offering a more convenient dosing schedule and potentially fewer systemic peaks compared with continuous infusion.

• What is the typical time frame for capecitabine to start working? Clinical response is usually assessed after 2-3 weeks of therapy, though some patients notice tumour shrinkage on imaging as early as the first treatment cycle.

• Can I take capecitabine with food? Yes, the tablets should be taken within 30 minutes after a meal to enhance absorption and minimise gastrointestinal upset.

• What should I do if I develop hand-foot syndrome? Reduce the dose or pause treatment, keep the affected skin moisturised, avoid friction or heat, and contact your oncology team promptly.

• Is it safe to combine capecitabine with over-the-counter vitamins? Most vitamins are tolerated, but calcium- or magnesium-containing antacids can lower capecitabine absorption; separate them by at least 2 hours.

• How long does capecitabine stay in my system after the last dose? The active metabolite 5-FU has a short half-life about 45 minutes, but metabolites may persist for up to 24 hours; complete clearance generally occurs within a few days.

• Are there any foods I should avoid while on capecitabine? There are no strict dietary restrictions, but limiting alcohol can reduce liver strain, and staying hydrated helps manage diarrhoea.

• What are the most concerning side effects that require emergency care? Severe neutropenia (fever, chills), uncontrolled diarrhoea leading to dehydration, sudden chest pain, or extensive hand-foot ulceration should prompt immediate medical attention.

• Can capecitabine be used after other chemotherapy has failed? Off-label studies suggest activity in certain refractory tumours, but such use must be guided by an oncologist familiar with the evidence base.

• What information should I provide my doctor when discussing capecitabine?

  • Complete list of current medications, including supplements and over-the-counter drugs.
  • History of liver or kidney disease, and any known DPD deficiency.
  • Recent lab results (CBC, renal and hepatic panels).
  • Specific treatment goals and concerns about side-effects.

Disclaimer

The information provided about capecitabine is for general knowledge only. It does not replace professional medical consultation or the official prescribing information for medications containing this ingredient. All treatment decisions, including dosing, formulation selection, and monitoring, should be made under the supervision of a qualified healthcare provider who can assess individual medical history, current medications, and specific health needs. We assume all readers are responsible adults capable of making informed decisions about their health. Our online pharmacy offers access to medications containing capecitabine for individuals who may have limited availability through traditional pharmacies, prescription-based insurance schemes, or who are seeking affordable generic alternatives. Always consult your doctor before starting, changing, or discontinuing any medication containing capecitabine.

External Resources about Capecitabine

• Capecitabine Sandoz - NPS MedicineWise
• Capecitabine - Memorial Sloan Kettering Cancer Center
• Capecitabine | Macmillan Cancer Support
• Patient information - Breast cancer metastatic - Capecitabine | eviQ
• Capecitabine - Chemocare