Buy Capecitabine
Capecitabine
Capecitabine Properties
About Capecitabine
Generic Capecitabine is an oral chemotherapy agent used in the treatment of several solid tumours, including colorectal, gastric, breast and head-and-neck cancers. It belongs to the antimetabolite class and works as a pro-drug that is converted inside the body to 5-fluorouracil (5-FU), the active cytotoxic compound. In Australia the drug is listed on the Therapeutic Goods Administration (TGA) register and is available by prescription only. While its primary role is to slow tumour growth, clinicians also sometimes employ it in combination with other agents to enhance response rates. Off-label investigations have explored its use in pancreatic and pancreatic-neuroendocrine tumours, although such applications remain experimental in the Australian setting.
What is Generic Capecitabine?
Generic Capecitabine is a chemotherapeutic pro-drug marketed in tablet form, typically 500 mg per pill. It falls under the antimetabolite category of anticancer medicines and received TGA approval for use in adult patients with metastatic colorectal cancer in 2004, later expanding to gastric, breast (adjuvant) and head-and-neck indications. The product is chemically identical to the branded formulation Xeloda® (Roche), meaning it delivers the same amount of active ingredient and meets the same bio-equivalence standards required by Australian law. As a generic, it offers a more affordable option without compromising efficacy, allowing patients to access essential therapy through the public or private health system.
How Capecitabine Works
Capecitabine is designed to exploit the metabolic differences between cancerous and normal cells. After oral ingestion, the tablet is absorbed through the gastrointestinal tract and undergoes a three-step enzymatic conversion. First, hepatic carboxylesterase removes the protective ester group, producing 5′-deoxy-5-fluorocytidine (5′-dFCR). Second, cytidine deaminase, abundant in the liver and tumour tissue, converts 5′-dFCR to 5′-deoxy-5-fluorouridine (5′-dFUR). The final step depends on thymidine phosphorylase, an enzyme markedly over-expressed in many tumours compared with healthy tissue. Thymidine phosphorylase transforms 5′-dFUR into the active chemotherapeutic 5-fluorouracil (5-FU).
Once formed, 5-FU inhibits thymidylate synthase, an enzyme essential for DNA synthesis, and incorporates into RNA, disrupting transcription and protein synthesis. The selective activation within tumour cells results in higher intracellular concentrations of 5-FU where it is needed most, while sparing most normal tissues. Pharmacokinetic studies show peak plasma levels of 5-FU occurring 1-2 hours after the last capecitabine dose, with a terminal half-life of roughly 45-60 minutes for the active metabolite. Oral administration provides a convenient route compared with intravenous 5-FU, yet the drug retains comparable antitumour activity.
Why Capecitabine is Used for Cancer Treatment Conditions
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Metastatic Colorectal Cancer Why effective: Tumour cells in the colon often over-express thymidine phosphorylase, enabling efficient conversion of capecitabine to 5-FU directly within the tumour micro-environment. Clinical trials (e.g., the BICC-C trial) demonstrated non-inferior overall survival compared with continuous infusion 5-FU, establishing capecitabine as a first-line oral option.
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Gastric Cancer (Advanced) Why effective: Studies such as the REAL-2 trial showed that adding capecitabine to oxaliplatin improved response rates and progression-free survival relative to cisplatin/5-FU regimens, supporting its role as a preferred fluoropyrimidine in gastric protocols.
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Breast Cancer (Adjuvant, HER2-negative) Why effective: When combined with docetaxel, capecitabine reduced disease recurrence in high-risk patients (CREATE-X trial). Its oral route improves adherence during the prolonged adjuvant phase, and the toxicity profile differs enough to allow sequential use after anthracycline-based therapy.
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Head-and-Neck Squamous Cell Carcinoma Why effective: Capecitabine replaces infusional 5-FU in concurrent chemoradiotherapy regimens, delivering comparable locoregional control while simplifying outpatient management.
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Combination Regimens (e.g., CAPOX, XELOX) Why effective: Pairing capecitabine with oxaliplatin leverages synergistic DNA damage-oxaliplatin induces platinum-DNA crosslinks, while 5-FU impairs repair-resulting in higher objective response rates in colorectal and gastric cancers.
Across these indications, capecitabine’s oral administration, comparable efficacy to intravenous fluoropyrimidines, and manageable safety profile place it as a cornerstone of modern chemotherapy protocols.
Off-Label and Investigational Uses of Capecitabine
Limited peer-reviewed data have examined capecitabine in pancreatic adenocarcinoma and in combination with immune checkpoint inhibitors for refractory melanoma. Small Phase II studies report modest tumour-control rates, but the evidence remains insufficient for routine clinical adoption in Australia. Off-label use should only be considered under the supervision of a qualified healthcare provider.
Is Capecitabine Right for You?
Capecitabine is most appropriate for adults with confirmed solid tumours that express thymidine phosphorylase or for whom an oral fluoropyrimidine is clinically justified. Patients with good gastrointestinal absorption and who can adhere to a strict dosing schedule benefit most. Caution is advised in individuals with severe hepatic impairment, as the first metabolic step occurs in the liver, and in those with known dihydropyrimidine dehydrogenase (DPD) deficiency, because accumulation of 5-FU can lead to life-threatening toxicity. Pregnancy and breastfeeding are contraindicated; the drug crosses the placenta and is excreted in milk. Elderly patients may require dose adjustments due to reduced renal clearance. As noted in the medication information, concurrent use of strong CYP3A4 inducers such as rifampicin may lower plasma concentrations, potentially compromising efficacy.
Taking Capecitabine Effectively
Capecitabine is typically prescribed as 500 mg tablets taken twice daily for 14 consecutive days followed by a 7-day rest period (the “2-weeks-on, 1-week-off” cycle). The tablets should be swallowed whole with water, preferably within 30 minutes after a meal to lessen gastrointestinal irritation. Food does not markedly affect absorption, but a high-fat meal can delay peak concentrations by up to 30 minutes-this timing is not clinically significant but consistency aids tolerability. If a dose is missed, take it as soon as remembered unless the next scheduled dose is less than 12 hours away; in that case, skip the missed dose and resume the regular schedule. For travel, keep tablets in their original container, protected from moisture, and ensure a supply for at least two cycles in case of customs delays. Patients using other oral agents should stagger administration times by at least two hours to avoid potential absorption interactions.
Understanding Side Effects and How to Manage Them
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Hand-Foot Syndrome (Palmar-Plantar Erythrodysesthesia) The exact mechanism relates to 5-FU accumulation in the capillary beds of the palms and soles, causing inflammation. Preventive measures include using moisturisers, avoiding tight shoes, and limiting heat exposure. At the first sign of redness or tenderness, dose reduction or temporary interruption often mitigates progression.
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Diarrhoea 5-FU disrupts rapidly dividing intestinal epithelium, leading to increased motility and fluid loss. Patients should maintain adequate hydration, follow a low-fiber, low-fat diet, and use loperamide at the onset of loose stools. Persistent diarrhoea beyond 48 hours warrants medical review.
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Mucositis Oral mucosal inflammation stems from cytotoxic effects on the buccal lining. Gentle oral hygiene, alcohol-free mouthwashes, and topical benzydamine can provide relief. Severe ulceration may require dose adjustment.
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Myelosuppression Bone-marrow suppression results from 5-FU interfering with DNA synthesis in hematopoietic progenitors. Routine blood counts before each cycle allow early detection; growth-factor support (e.g., filgrastim) may be prescribed for neutropenia.
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Cardiotoxicity (Rare) Occasionally, capecitabine induces coronary vasospasm, presenting as chest pain or ECG changes. Prompt evaluation is essential; therapy is discontinued if cardiac events are confirmed.
Patients should contact their oncology team immediately for signs of severe neutropenia (fever, sore throat), uncontrolled vomiting, or sudden visual disturbances, as these may indicate serious complications.
Buying Capecitabine from Our Online Pharmacy
Obtaining capecitabine through a reputable source can alleviate the logistical and financial hurdles many Australian patients face. Our online pharmacy collaborates with licensed international distributors that meet TGA-recognized quality standards, ensuring each shipment contains authentic, pharmaco-peered medication.
Why Choose Our Service?
- Convenient access - Order from the comfort of home and receive a discreet package within the standard delivery window.
- Cost transparency - Competitive pricing on generic capecitabine often saves up to 40 % compared with retail pharmacy rates.
Quality & Safety
We partner with pharmacies that operate under stringent regulatory frameworks and adhere to WHO Good Manufacturing Practices. Every batch undergoes independent verification to confirm potency and purity before dispatch.
Pricing & Access
The 500 mg tablets are offered at a per-tablet price that reflects bulk purchasing power, with an additional lifetime 10 % discount on all reorders. For patients preferring brand-name Xeloda®, we list the alternative so they can compare costs directly.
Discreet Delivery
Standard shipping arrives in 3 weeks; express options deliver within ≈ 7 days. Each parcel is sealed in unmarked packaging, protecting privacy while complying with Australian customs regulations.
Frequently Asked Questions
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How long does it take for capecitabine to start working? Therapeutic concentrations of 5-FU appear within 1-2 hours after each dose, but measurable tumour response typically emerges after two to three treatment cycles, coinciding with radiologic reassessment.
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Can I drink alcohol while taking capecitabine? Moderate alcohol intake does not significantly alter capecitabine metabolism, but excessive consumption may exacerbate gastrointestinal toxicity and should be avoided.
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Is dose reduction safe if I experience hand-foot syndrome? Yes. Clinical guidelines recommend a stepwise reduction of 25 % for grade 2 symptoms and a 50 % reduction for grade 3, pending oncologist approval.
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What should I do if I vomit shortly after taking a dose? If vomiting occurs within 30 minutes, contact your treatment centre; a repeat dose is not automatically advised because it may increase toxicity risk.
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Are there dietary restrictions with capecitabine? No specific foods are prohibited, but a balanced diet low in fat and refined sugars helps minimise diarrhoea and supports overall treatment tolerance.
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How does capecitabine compare with intravenous 5-FU? Efficacy is comparable in most settings, while the oral route offers greater convenience and reduced need for infusion centre visits. Toxicity profiles are similar, though capecitabine may cause more hand-foot syndrome.
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Can capecitabine be used after surgery for colorectal cancer? In the adjuvant setting, capecitabine (often combined with oxaliplatin) is a standard postoperative regimen to eradicate microscopic disease and lower recurrence risk.
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Is there a risk of developing resistance to capecitabine? Tumours can up-regulate thymidine phosphorylase inhibitors or develop alterations in DNA repair pathways, which may diminish response over time. Switching to alternative fluoropyrimidines or adding targeted agents is a common strategy.
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What monitoring is required during treatment? Baseline and pre-cycle complete blood counts, liver function tests, and renal function assessments are essential. Imaging studies are repeated every 8-12 weeks to evaluate tumour response.
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Can capecitabine be taken with other oral anticancer drugs? Concurrent oral agents are sometimes combined (e.g., with irinotecan in the CAPIRI regimen), but timing and dose scheduling must be coordinated by the oncology team to avoid overlapping toxicities.
Glossary
- Pro-drug
- An inactive compound that is metabolised in the body to produce an active pharmacological agent.
- Thymidine phosphorylase
- An enzyme highly expressed in many tumour cells that catalyses the final step converting capecitabine’s intermediate into 5-fluorouracil.
- Hand-Foot Syndrome
- A dose-limiting toxicity characterised by redness, swelling, and pain on the palms and soles, caused by drug accumulation in capillary networks.
- Dihydropyrimidine dehydrogenase (DPD) deficiency
- A genetic condition reducing breakdown of fluoropyrimidines, leading to increased systemic exposure and severe toxicity.
- CAPOX (or XELOX)
- A chemotherapy regimen that pairs capecitabine with oxaliplatin, commonly used in colorectal and gastric cancers.
Disclaimer
The information provided about capecitabine is for general knowledge only and does not replace professional medical consultation. All treatment decisions, including those regarding off-label use, should be made under the supervision of a qualified healthcare provider. We assume readers are responsible adults capable of making informed decisions about their health. Our online pharmacy offers access to 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.
