Capecitabine (Capeloda)

Taking Capecitabine as instructed is essential to maximise its effectiveness. Please follow these key points:

• Your dose is based on several factors, including your height, weight, overall health, and diagnosis.
• You should take Capecitabine for 14 consecutive days, twice daily. After completing this, you will have one week off the medication before starting a new cycle.
• You should only take Capecitabine twice daily on the days of your radiation therapy. This means no medication is taken on weekends or public holidays unless you are scheduled for radiation on those days.
• Take Capecitabine twice daily with water, within 30 minutes after a meal, at the same times each day, and at least 10–12 hours apart.
• Swallow Capecitabine tablets whole. Do not crush, cut, or dissolve them. If swallowing is difficult, consult your doctor for alternative options.
• If you miss a dose, do not take an extra dose or double up. Simply take your next dose at the usual time. Record missed doses and inform your doctor during your next appointment.

• Warfarin (a blood-thinning medication): Capecitabine interacts with warfarin. Inform your doctor if you are taking it; an alternative blood thinner may be prescribed.
• Other medications: Capecitabine also interacts with phenytoin, allopurinol, and certain other drugs. Inform your doctor about any medications you are taking.
• Herbal remedies: Some herbal medications, including St. John’s Wort, may affect chemotherapy.

• Store Capecitabine at room temperature (below 25°C) in a dry place, away from light.
• Keep it out of reach of children and pets.
• Whenever possible, administer Capecitabine to yourself.
• If someone else needs to handle the tablets, they should wear gloves.
• Use a separate daily pill box or reminder for Capecitabine. Do not mix it with other medications. If using a pill box, wash it with soap and water before refilling and wash your hands thoroughly after handling the medication.
• Do not dispose of unused Capecitabine in household trash or flush it down the sink/toilet. Return it to your practice for safe disposal.
• If travelling, store Capecitabine in a sealed plastic bag.

Decreased White Blood Cells (WBCs) and Risk of Infection

Blood tests will monitor your WBCs, haemoglobin, platelet count, and kidney function before each cycle.

Precautions to reduce infection risk:

• Wash your hands frequently, especially before eating or after using the bathroom.
• Avoid crowded places and people with fevers, flu, or infections.
• Maintain good personal hygiene.

Contact your doctor if you experience:

• Fever over 38°C.
• Chills, sore throat, or burning during urination.

Decreased Haemoglobin (Anaemia)

You may feel tired or fatigued more easily.

Tips:

• Aim for 7–8 hours of sleep each night.
• Balance activity with rest.
• Stay as active as possible but rest when needed.

Contact your doctor immediately if you experience:

• Shortness of breath.
• Dizziness or palpitations.

Decreased Platelet Count and Risk of Bleeding

Take extra precautions to avoid bruises, cuts, or injuries.

Tips:

• Use a soft toothbrush and maintain oral hygiene.
• Shave with an electric razor.
• Avoid picking your nose and blow gently.

Seek medical attention if you notice:

• Prolonged bleeding (e.g., from a nosebleed or cut).
• Blood in your urine, stool, or when coughing.

Nausea or Vomiting

• Eat slowly and in small portions.
• Drink 8–10 glasses of water daily (unless otherwise advised).
• Avoid spicy, greasy, or strongly flavoured foods.

Fatigue

• Stay as active as possible but rest when needed.
• Plan activities for when you feel most energetic.

Diarrhoea

• Stay hydrated and eat bland, low-fibre foods like bananas, rice, and potatoes.
• Avoid raw vegetables, high-fibre foods, and lactose-containing products.
• Over-the-counter medications like loperamide or Smecta may help. Contact your doctor if symptoms persist.

Mouth Irritation or Sores

• Rinse your mouth frequently and practise good oral hygiene.
• Use salt and bicarbonate rinses and apply lip balm for moisture.
• Avoid acidic or spicy foods.

Hand-Foot Syndrome (HFS)
This skin reaction may cause redness, dryness, or tenderness on the hands and feet.

Tips to prevent HFS:

• Use moisturiser regularly (we will provide a recommended cream).
• Avoid hot showers, tight shoes, and vigorous activities.
• Cool your hands and feet using wet towels (avoid direct ice contact).

Contact your doctor if symptoms worsen.

Cardiotoxicity
Seek immediate medical attention if you experience chest pain or tightness.

• Women should not become pregnant, and men should not father a child during treatment and for at least six months after the last dose.
• Do not breastfeed while on Capecitabine or for two weeks after completing treatment.