# Capecitabine

Source: https://nuclide.cc/drugs/capecitabine/  
Nuclide record `capecitabine` (Agent). Data CC BY-NC 4.0, attribute "Data from Nuclide (nuclide.cc)"; commercial use needs a licence.

## TL;DR

Capecitabine (Xeloda) is a tablet form of the chemotherapy fluorouracil. It is a backbone of treatment for bowel cancer and a standard option in advanced breast cancer.

## Summary

Capecitabine was approved by the FDA in 1998 for anthracycline- and taxane-resistant metastatic breast cancer and later for adjuvant stage III colon cancer (X-ACT: disease-free survival at least equivalent to bolus fluorouracil and leucovorin), metastatic colorectal cancer, perioperative chemoradiotherapy for rectal cancer and, with docetaxel, for anthracycline-pretreated breast cancer. The EU authorised Xeloda in 2001; it is also approved there for gastric cancer. It is the oral partner in CAPOX and CAPTEM and in the CREATE-X post-neoadjuvant breast regimen. Hand-foot syndrome, diarrhoea and cardiotoxicity are the key toxicities, and DPD deficiency (DPYD variants) causes severe or fatal toxicity, so genotype-guided dosing is increasingly used. Warfarin interaction carries a boxed warning.

## Fields

- Kind: Agent
- Status: approved
- Last checked: 2026-09-10
- Tags: nci-list; generic
- Brand: Xeloda
- Modality: Oral fluoropyrimidine prodrug (antimetabolite)
- Mechanism: Converted in three steps, the last by thymidine phosphorylase enriched in tumours, to fluorouracil; FdUMP blocks thymidylate synthase and FUTP is incorporated into RNA.
- Approvals: US 1998: Metastatic breast cancer after anthracycline and taxane; later adjuvant and metastatic colorectal cancer, rectal chemoradiotherapy; EU 2001: Colorectal, gastric and breast cancer

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Capecitabine
- US label (DailyMed): https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=capecitabine
- NCI drug page: https://www.cancer.gov/about-cancer/treatment/drugs/capecitabine
- EPAR: https://www.ema.europa.eu/en/medicines/human/EPAR/xeloda

## Connected records

- indications: [HER2-positive breast cancer](https://nuclide.cc/indications/breast-her2-positive/)
- trials: [A Phase I/II, Dose Finding and Optimization Study of [177Lu]Lu-NeoB in Combination With Capecitabine in Patients With GRPR+, ER+, HER2- Metastatic Breast Cancer After Progression on Previous Endocrine Therapy in Combination With a CDK4/6 Inhibitor.](https://nuclide.cc/trials/nct06247995/), [Lutetium 177Lu-Edotreotide Versus Best Standard of Care in Well-differentiated Aggressive Grade-2 and Grade-3 GastroEnteroPancreatic NeuroEndocrine Tumors (GEP-NETs) - COMPOSE](https://nuclide.cc/trials/nct04919226/)
- pairings: [PRRT (177Lu-DOTATATE) with capecitabine and temozolomide (CAPTEM)](https://nuclide.cc/pairings/prrt-plus-captem/)

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