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This document provides essential safety information regarding the use of capecitabine. Understanding the potential risks and necessary precautions can help ensure safe and effective treatment. Please review the following points and discuss any concerns with your healthcare provider:

• Risk of Bleeding with Blood Thinners: Patients using capecitabine alongside anticoagulants like warfarin may face an increased risk of serious, potentially life-threatening bleeding. This risk may continue for up to one month after discontinuation of capecitabine. Regular blood tests (INR/PT) are necessary to monitor your condition. Notify your healthcare provider immediately if you notice signs of unusual bleeding or bruising, such as bloody or tarry stools.

• Severe Diarrhea: Capecitabine may cause severe diarrhea, leading to dehydration. Monitor your bowel movements closely, especially within the first month of treatment. Contact your healthcare provider if you experience more than four episodes of diarrhea per day, nocturnal diarrhea, or bloody stools accompanied by severe stomach pain and fever. Your doctor may recommend pausing the medication until symptoms improve.

• Heart Complications: Some individuals may experience heart problems, including chest pain and abnormal heart rhythms, while taking capecitabine. This risk is heightened for those with pre-existing heart conditions. Inform your oncologist about your heart health history for appropriate monitoring.

• Dehydration and Kidney Issues: Capecitabine can lead to dehydration, potentially resulting in severe kidney failure. Symptoms like vomiting, diarrhea, and appetite loss are common and can contribute to dehydration. Keep your healthcare team informed about any side effects to adjust treatment as needed. This precaution is crucial for individuals with a history of kidney problems or those on medications affecting kidney function.

• Skin Reactions: Hand-and-foot syndrome is a frequent skin reaction to capecitabine, often presenting as tingling, numbness, or redness in hands and feet. If the reaction becomes painful or develops blisters, contact your healthcare provider immediately. Treatment adjustments may be necessary.

• Low Blood Cell Counts: This risk is increased when capecitabine is taken with other chemotherapy agents, leading to reduced blood cell levels.

• Pregnancy Risk: Capecitabine may harm an unborn baby. Females capable of becoming pregnant should use effective contraception during treatment and for six months afterward. Males with partners who can become pregnant should use contraception, such as condoms, during treatment and for three months after the last dose.

• Serious Toxicity in DPD Deficiency: Individuals with the rare genetic condition dihydropyrimidine dehydrogenase (DPD) deficiency may experience severe toxicity when taking capecitabine. Testing for this condition before starting treatment is recommended to adjust dosage accordingly.

• Contraindications: Do not use capecitabine if you have a known hypersensitivity to fluorouracil, as it may pose significant health risks.

Always consult with your healthcare provider for personalized medical advice and report any adverse effects or concerns promptly.

When taking this medication, some individuals may experience common side effects such as nausea, diarrhea, fatigue, stomach pain, vomiting, and hand-foot syndrome, which can present as pain, swelling, redness, or numbness of the hands and feet. These symptoms are generally mild, but if they persist or become bothersome, it's advisable to consult a healthcare provider. Eating smaller meals and staying hydrated can help manage nausea and diarrhea. Temporary hair loss and changes in taste or nails may also occur, but these effects typically resolve after treatment ends.

In some cases, more serious side effects may occur, requiring immediate medical attention. These include severe nausea and vomiting, mouth sores, easy bruising or bleeding, unusual tiredness, swelling of the ankles or feet, vision changes, and symptoms of kidney problems such as a change in urine output or dark urine. Hand-foot syndrome should be managed by avoiding excessive heat or pressure on the hands and feet.

Additionally, this medication can weaken your immune system, increasing the risk of serious infections. Promptly report any signs of infection, such as persistent sore throat, fever, or chills, to your healthcare provider. Severe skin reactions, such as blisters or peeling skin, and heart-related symptoms like chest pain or irregular heartbeat, are rare but require urgent care. Lastly, although a severe allergic reaction is uncommon, seek immediate help if you experience symptoms like rash, swelling, or difficulty breathing. Always communicate any side effects you experience to your healthcare provider for appropriate management.

When taking Capecitabine (Xeloda), it's essential to inform your doctor and pharmacist of all the medications and supplements you are currently using, including prescription, over-the-counter, herbal, and dietary products. Capecitabine can have interactions with various other medications.

It is advised not to use Capecitabine alongside products containing fluorouracil due to their similarity. Additionally, avoid using Capecitabine with live vaccines such as those for measles, mumps, rubella, and varicella, as well as the Zoster and Rotavirus vaccines. Your doctor might choose to avoid or adjust your treatment if these are involved.

Some medications, like Allopurinol, Acenocoumarol, Warfarin, and certain other vaccines and drugs, are generally not recommended to be used with Capecitabine unless necessary. In such cases, your doctor may adjust your dosage or the frequency of use.

Lastly, combining Capecitabine with medications such as Fosphenytoin, Phenytoin, and Leucovorin might increase the risk of side effects. However, your doctor might consider this combination if it provides the best treatment outcome, with possible adjustments to how often you use these medications. Always consult with your healthcare provider for personalized advice.