Xeloda (Capecitabine 500mg) Contraindications – Absolute and Relative

Absolute and relative contraindications for Xeloda (capecitabine 500mg)

When prescribing medication, it is essential to consider the contraindications to ensure the safety and effectiveness of treatment. Xeloda (capecitabine 500mg), manufactured by Roche, is a widely used chemotherapy drug for the treatment of various cancers. However, it is vital to be aware of the absolute and relative contraindications associated with Xeloda before initiating therapy.

Absolute contraindications for Xeloda:

1. Known hypersensitivity to capecitabine or any of its components: It is crucial to identify patients who may have experienced allergic reactions to capecitabine or any of its ingredients. This information can be obtained from the patient’s medical history or through allergy tests. Administration of Xeloda to individuals with hypersensitivity can lead to severe allergic reactions and should be strictly avoided.
2. Poor kidney function (creatinine clearance less than 30 mL/min): Patients with impaired kidney function may experience difficulty in eliminating capecitabine from their bodies, leading to increased drug levels and potential toxicity. In such cases, alternative treatment options should be considered to avoid adverse effects.
3. Pregnancy or breastfeeding: Xeloda has been shown to cause harm to the developing fetus and can be excreted in breast milk, posing a risk to the nursing infant. Therefore, it is contraindicated in pregnant women and breastfeeding mothers.
4. Dihydropyrimidine dehydrogenase (DPD) deficiency: DPD is an enzyme responsible for the breakdown of capecitabine into its active form. Patients with DPD deficiency are unable to metabolize capecitabine properly, leading to increased levels of the drug and an increased risk of severe side effects. Testing for DPD deficiency should be performed before initiating treatment with Xeloda.

Relative contraindications for Xeloda:

In certain circumstances, the use of Xeloda may be considered with caution in patients with relative contraindications. It is important to carefully assess the potential benefits versus the risks when deciding to prescribe Xeloda in these situations:

• Poor liver function: Xeloda is primarily metabolized in the liver, and individuals with severe liver impairment may have difficulty processing the drug. Close monitoring of liver function is necessary in these patients, and dose adjustments may be required.
• History of coronary artery disease: Xeloda has been associated with an increased risk of cardiovascular events, including myocardial infarction (heart attack) and angina. Patients with a history of coronary artery disease should be closely monitored, and the risks and benefits of treatment should be carefully evaluated.
• Age above 80 years: Older adults may be more susceptible to the side effects of Xeloda. Close monitoring and dose adjustments may be necessary to minimize the risk of adverse reactions.
• Severe bone marrow dysfunction: Xeloda can cause bone marrow suppression, resulting in a decreased production of blood cells. Patients with severe bone marrow dysfunction, such as those with aplastic anemia, should use Xeloda with caution due to the increased risk of complications.

It is crucial to consult with healthcare professionals, such as oncologists or pharmacists, to assess the individual patient’s suitability for Xeloda treatment based on their medical history, laboratory test results, and overall health status.

Please note that the information provided here is for illustrative purposes only and should not be used as a substitute for professional medical advice. Always consult a healthcare provider for guidance regarding the appropriate use and contraindications of Xeloda or any other medication.

Use of Xeloda capecitabine 500mg in cancer treatment

Xeloda capecitabine 500mg, manufactured by Roche, is a widely used medication in the treatment of various types of cancer, including breast, colorectal, and stomach cancer. It belongs to a class of drugs known as antimetabolites, which work by inhibiting the growth of cancer cells.

Why is Xeloda capecitabine 500mg used?

Xeloda capecitabine 500mg is commonly prescribed to patients with advanced or metastatic cancer who have not responded to or cannot tolerate other types of chemotherapy. It may also be used as part of combination therapy with other anticancer drugs.

How does Xeloda capecitabine 500mg work?

Xeloda capecitabine 500mg is converted into an active form in the body, which inhibits the production of DNA and RNA, necessary for the growth and replication of cancer cells. By disrupting these processes, Xeloda capecitabine 500mg effectively slows down or stops the growth of cancer cells, thereby preventing the spread of the disease.

What are the side effects of Xeloda capecitabine 500mg?

Like any medication, Xeloda capecitabine 500mg may cause side effects. The most common side effects include:

• Weakness
• Nausea
• Vomiting
• Diarrhea
• Loss of appetite
• Hand-foot syndrome (redness, swelling, and pain in the hands and feet)

It is important for patients to report any side effects to their healthcare provider, as they can provide guidance and support to manage these side effects.

Who should not use Xeloda capecitabine 500mg?

Xeloda capecitabine 500mg is contraindicated in certain individuals due to the potential risk of severe side effects. The following are absolute contraindications:

• Pregnant or breastfeeding women
• Patients with known hypersensitivity to the drug or its components
• Patients with a deficiency in the enzyme dihydropyrimidine dehydrogenase (DPD)

Additionally, Xeloda capecitabine 500mg should be used with caution in individuals with the following conditions (relative contraindications):

• Impaired liver function
• Impaired kidney function
• Bone marrow suppression
• Patients with severe diarrhea or vomiting

It is always important for patients to inform their healthcare provider about any pre-existing medical conditions or medications they are taking before starting treatment with Xeloda capecitabine 500mg.

Xeloda capecitabine 500mg has been extensively studied and shown to be effective in numerous clinical trials. For example, a study published in the New England Journal of Medicine showed that Xeloda capecitabine 500mg, when combined with other chemotherapeutic agents, significantly improved overall survival in patients with advanced colorectal cancer compared to standard chemotherapy alone.

Conclusion

Xeloda capecitabine 500mg is a valuable tool in the treatment of various types of cancer. Its mechanism of action, coupled with its proven efficacy in clinical trials, makes it an important option for patients who have not responded to other treatments or cannot tolerate traditional chemotherapy.

Use of Xeloda capecitabine 500mg in Geriatric Patients

In the treatment of geriatric patients, Xeloda capecitabine 500mg has shown to be effective and well-tolerated. Geriatric patients, typically aged 65 years and older, may have different characteristics and needs compared to younger patients, which should be taken into consideration when prescribing and administering this medication.

Efficacy in Geriatric Patients

Multiple studies have demonstrated the efficacy of Xeloda in geriatric patients. One study published in the Journal of Clinical Oncology investigated the use of Xeloda as monotherapy in patients with metastatic colorectal cancer. The study included a subgroup analysis of patients aged 70 years or older, and it showed comparable progression-free survival and overall survival rates between the geriatric subgroup and the overall study population.
Another study published in the Annals of Oncology evaluated the use of Xeloda in combination with docetaxel in patients with metastatic breast cancer. Again, the study included a subgroup analysis of patients aged 65 years or older, and it showed similar efficacy outcomes between the geriatric subgroup and the overall study population.

Safety Profile in Geriatric Patients

Xeloda capecitabine 500mg has also demonstrated a favorable safety profile in geriatric patients. While older patients may be more susceptible to certain side effects, such as myelosuppression and hand-foot syndrome, studies have shown that the overall incidence and severity of adverse events were comparable between geriatric and younger patients.
According to a review published in the journal Drugs & Aging, dose adjustments may be necessary in geriatric patients due to age-related changes in drug metabolism and clearance. However, these dose adjustments can help minimize the risk of toxicity and improve treatment outcomes.

Considerations for Prescribing Xeloda in Geriatric Patients

When prescribing Xeloda capecitabine 500mg to geriatric patients, healthcare providers should consider individual patient characteristics and comorbidities. Close monitoring of hematological and renal functions is recommended, as well as assessing the patient’s performance status and ability to tolerate treatment.
Additionally, it is important to consider potential drug interactions with other medications commonly used in geriatric patients. Certain drugs, such as warfarin and phenytoin, can interact with Xeloda and increase the risk of adverse events. Therefore, dose adjustments or alternative treatment options may be necessary.
In conclusion, Xeloda capecitabine 500mg has been shown to be effective and well-tolerated in geriatric patients. However, healthcare providers should consider individual patient characteristics, closely monitor for potential side effects, and assess for potential drug interactions when prescribing this medication to geriatric patients.

Absolute and Relative Contraindications of Xeloda (Capecitabine 500mg)

Absolute Contraindications

Absolute contraindications of Xeloda (capecitabine 500mg) are conditions or situations where the use of this medication is completely prohibited due to potential harm or severe adverse effects. It is crucial to avoid the use of Xeloda in patients with the following conditions:

• Known hypersensitivity: Xeloda should not be administered to individuals who have a known hypersensitivity or allergy to capecitabine or any of its components. Severe allergic reactions may occur, and immediate medical attention is required.
• Severe renal impairment: Due to the risk of increased toxicity, Xeloda is contraindicated in patients with severe renal impairment (creatinine clearance less than 30 mL/min). Close monitoring of renal function is necessary in patients with mild to moderate renal impairment.
• Pregnancy and breastfeeding: Xeloda can cause significant harm to the fetus during pregnancy and may be excreted in breast milk, potentially causing harm to the nursing infant. It should not be used during pregnancy and breastfeeding unless the potential benefits outweigh the risks.

Relative Contraindications

Relative contraindications of Xeloda (capecitabine 500mg) are situations where caution should be exercised and the potential benefits and risks should be carefully evaluated before initiating treatment. The following conditions are relative contraindications for Xeloda:

• Severe hepatic impairment: Xeloda should be used with caution in patients with severe hepatic impairment, as the metabolism and elimination of the drug may be compromised. Liver function tests should be monitored regularly, and dosage adjustments may be necessary.
• Diarrhea: Xeloda can cause diarrhea as a side effect. Patients with a history of severe or persistent diarrhea should be closely monitored, and the medication may need to be temporarily or permanently discontinued.
• Thymidine phosphorylase deficiency: Individuals with a deficiency of the enzyme thymidine phosphorylase may be at increased risk of severe adverse effects with Xeloda. Genetic testing or evaluation of the thymidine phosphorylase enzyme level may be considered before initiating treatment.

It is essential to consult a healthcare professional or oncologist before starting Xeloda (capecitabine 500mg) to determine if there are any contraindications specific to the individual patient’s medical history and condition.

Absolute and Relative Contraindications for Xeloda (Capecitabine 500mg)

Xeloda (generic name: capecitabine) is a chemotherapy medication used to treat different types of cancer, including breast, colorectal, and gastric cancer. However, it’s important to note that there are certain circumstances in which the use of Xeloda is contraindicated. These contraindications can be grouped into absolute and relative contraindications.

Absolute Contraindications

• Pregnancy: Xeloda is known to cause harm to a developing fetus, and therefore it should not be used during pregnancy. It is important to use effective contraception methods while taking Xeloda and for at least 6 months after treatment.
• Severe renal impairment: Xeloda is primarily eliminated from the body through the kidneys, and individuals with severe renal impairment may experience increased toxicity. Therefore, Xeloda is contraindicated in patients with severe renal impairment.
• Known hypersensitivity to capecitabine or any of its components: If a patient has previously had an allergic reaction to Xeloda or any component of the medication, its use should be avoided.
• Dihydropyrimidine dehydrogenase (DPD) deficiency: DPD is an enzyme that is responsible for breaking down and inactivating capecitabine. People with a deficiency of this enzyme are at a higher risk of severe toxicity from Xeloda and should not take the medication.

Relative Contraindications

Relative contraindications are circumstances in which the use of Xeloda may still be considered, but with caution and close monitoring. These include:

• Moderate renal impairment: Individuals with moderate renal impairment may still be able to use Xeloda but at a reduced dosage. Close monitoring of kidney function and dose adjustments may be necessary.
• Known liver disease or impairment: Xeloda is primarily metabolized in the liver, and individuals with liver disease or impairment may experience increased toxicity. Close monitoring of liver function is necessary.
• Severe hematologic toxicities from previous treatments: If a patient has experienced severe hematologic toxicities (such as low white blood cell count) from previous chemotherapy treatments, the use of Xeloda should be approached with caution and close monitoring of blood counts.
• Concomitant use of certain medications: Xeloda may interact with certain medications, including warfarin (increased risk of bleeding) and phenytoin (decreased effectiveness of capecitabine). Close monitoring and possible dose adjustments may be required if using Xeloda concomitantly with these medications.

It is important to note that the above list of contraindications is not exhaustive and that individual patient factors and medical history should always be taken into consideration when prescribing Xeloda. If you are considering using Xeloda, please consult with your healthcare provider for personalized advice and guidance.

6. Adverse reactions and side effects

Xeloda (capecitabine) is generally a well-tolerated medication, but like any other chemotherapy drug, it can cause side effects. Some of the common side effects include:

• Nausea and vomiting
• Diarrhea
• Abdominal pain
• Loss of appetite
• Fatigue
• Mouth sores

These side effects are usually mild to moderate and can be managed with supportive care measures, such as anti-nausea medications or adjustments to the dose of Xeloda.

In addition to the common side effects, Xeloda may also cause some more serious adverse reactions. These include:

• Hand-foot syndrome: a condition characterized by redness, swelling, and pain on the palms of the hands and soles of the feet
• Cardiotoxicity: Xeloda can affect the heart, leading to symptoms such as chest pain, shortness of breath, and irregular heart rhythm
• Hepatotoxicity: Xeloda may cause liver dysfunction, which can manifest as jaundice, abdominal pain, and elevated liver enzymes
• Myelosuppression: a decrease in the production of blood cells, which can increase the risk of infection, bleeding, and anemia

If any of these serious side effects occur, it is important to seek medical attention immediately. Your healthcare provider will assess the risks and benefits of continuing Xeloda and may adjust the treatment accordingly.

To minimize the risk of side effects, it is essential to follow your healthcare provider’s instructions and report any symptoms or concerns. They will monitor your treatment closely and may recommend dose adjustments or supportive care measures to help manage side effects.

It is important to note that not all patients will experience these side effects, and the severity can vary from person to person. If you have specific questions or concerns about the potential side effects of Xeloda, it is best to consult with your healthcare provider.

7. Recommended Dosage and Administration

When prescribing Xeloda (capecitabine) 500mg, it is essential to follow the recommended dosage and administration guidelines to ensure safe and effective treatment.

Dosage

The recommended dosage of Xeloda may vary depending on the specific type of cancer being treated. The most common recommended dosage is:

• Metastatic colorectal cancer: The recommended starting dose is 1,250 mg/m² administered orally twice daily (morning and evening) for 2 weeks, followed by a 1-week rest period.
• Adjuvant colon cancer: The recommended starting dose is 1,250 mg/m² administered orally twice daily (morning and evening) for 2 weeks, followed by a 1-week rest period. Treatment cycles should be repeated every 3 weeks for a total of 8 cycles.
• Metastatic breast cancer: The recommended starting dose is 2,500 mg/m² administered orally in divided doses (morning and evening) for 2 weeks, followed by a 1-week rest period.

It is important to note that the dosage may be adjusted based on individual patient characteristics, such as body surface area, tolerability, and response to treatment. Therefore, it is crucial to consult with a healthcare professional for personalized dosage recommendations.

Administration

Xeloda tablets should be taken with water within 30 minutes after a meal. The tablets should not be crushed or chewed and should be swallowed whole. It is important to adhere to the prescribed dosing schedule and not to skip or double doses unless instructed by a healthcare professional.

During treatment with Xeloda, regular monitoring of blood counts and liver function is recommended to assess the patient’s response to therapy and detect any potential adverse effects.

Additionally, it is crucial for patients to understand the importance of complying with the prescribed treatment regimen and to promptly report any concerning symptoms or side effects to their healthcare provider.

For more detailed information on dosage and administration, please refer to the prescribing information provided by Roche, the manufacturer of Xeloda.

Category: Xeloda

Tags: Xeloda, Capecitabine