biology

Capecitabine

Capecitabine is a biology topic covered in the lgStudy science library. This page brings together a partial reference excerpt, illustrations, worked examples, real-world applications and a short study plan, so you can understand Capecitabine rather than just read about it. In short: Capecitabine, sold under the brand name Xeloda among others, is an anticancer medication used to treat breast cancer, gastric cancer and colorectal cancer. For breast cancer it is often used together with docetaxel.

Key takeaways

Capecitabine belongs to biology; place it in that map before memorising details.
Learn the definition first, then one example that makes the definition concrete.
Connect Capecitabine to a quantity you can measure, compute or draw — that is where exam questions come from.
Reproduce the core statement of Capecitabine from memory before moving on to harder problems.

Reference excerpt

Capecitabine, sold under the brand name Xeloda among others, is an anticancer medication used to treat breast cancer, gastric cancer and colorectal cancer. For breast cancer it is often used together with docetaxel. It is taken by mouth. Common side effects include abdominal pain, vomiting, diarrhea, weakness, and rashes. Other severe side effects include blood clotting problems, allergic reactions, heart problems such as cardiomyopathy, and low blood cell counts. Use during pregnancy may result in harm to the fetus. Capecitabine, inside the body, is converted to 5-fluorouracil (5-FU) through which it acts. It belongs to the class of medications known as fluoropyrimidines, which also includes 5-FU and tegafur. Capecitabine was patented in 1992 and approved for medical use in 1998. It is on the World Health Organization's List of Essential Medicines.

Medical uses Capecitabine is indicated for

adjuvant treatment of people with Stage III colon cancer as a single agent or as a component of a combination chemotherapy regimen; perioperative treatment of adults with locally advanced rectal cancer as a component of chemoradiotherapy; treatment of people with unresectable or metastatic colorectal cancer as a single agent or as a component of a combination chemotherapy regimen; treatment of people with advanced or metastatic breast cancer as a single agent if an anthracycline- or taxane-containing chemotherapy is not indicated; treatment of people with advanced or metastatic breast cancer in combination with docetaxel after disease progression on prior anthracycline-containing chemotherapy; treatment of adults with unresectable or metastatic gastric, esophageal, or gastroesophageal junction cancer as a component of a combination chemotherapy regimen; treatment of adults with HER2-overexpressing metastatic gastric or gastroesophageal junction adenocarcinoma who have not received prior treatment for metastatic disease as a component of a combination regimen; adjuvant treatment of adults with pancreatic adenocarcinoma as a component of a combination chemotherapy regimen.

Adverse effects Adverse effects by frequency:

Very common (>10% frequency)

Notes on adverse effects:

Contraindications Contraindications include:

History of hypersensitivity to fluorouracil, capecitabine or any of its excipients DPD deficiency (see Pharmacogenetics) Pregnancy and lactation Severe leucopenia, neutropenia, or thrombocytopenia Severe hepatic impairment or severe renal impairment Treatment with sorivudine or its chemically related analogues, such as brivudine In 2020, the EU and UK license was updated to state that capecitabine was contra-indicated in patients that "have a known complete absence of dihydropyrimidine dehydrogenase (DPD) activity". In US, as of 2024, there is no specific contraindication on the package inserts however, there is a cautionary warning: "Patients with certain homozygous or compound heterozygous variants in the DPYD gene are at increased risk for acute early-onset toxicity and serious, including fatal, adverse reactions due to XELODA (e.g., mucositis, diarrhea, neutropenia, and neurotoxicity). XELODA is not recommended for use in patients known to have certain homozygous or compound heterozygous DPYD variants that result in complete absence of DPD activity. Withhold or permanently discontinue based on clinical assessment. No XELODA dose has been proven safe in patients with complete absence of DPD activity. " Within the UK, DPYD testing to check for this contraindication is now routine practice, this is not the case in the US.

Drug interactions Drugs it is known to interact with include:

Sorivudine or its analogues, such as, brivudine. CYP2C9 substrates, including, warfarin and other coumarin-derivatives anticoagulants Phenytoin, as it increases the plasma concentrations of phenytoin. Calcium folinate may enhance the therapeutic effects of capecitabine by means of synergising with its metabolite, 5-FU. It may also induce more severe diarrhoea by means of this synergy.

Pharmacogenetics The dihydropyrimidine dehydrogenase (DPD) enzyme is responsible for the detoxifying metabolism of fluoropyrimidines, a class of drugs that includes capecitabine, 5-fluorouracil and tegafur. Genetic variations within the DPD gene (DPYD) can lead to reduced or absent DPD activity, and individuals who are heterozygous or homozygous for these variations may have partial or complete DPD deficiency; an estimated 0.2% of individuals have complete DPD deficiency. Those with partial or complete DPD deficiency have a significantly increased risk of severe or even fatal drug toxicities when treated with fluoropyrimidines; examples of toxicities include myelosuppression, neurotoxicity and hand-foot syndrome.

Mechanism of action Click on genes, proteins and metabolites below to link to respective articles.

Capecitabine is metabolised to 5-FU which in turn is a thymidylate synthase inhibitor, hence inhibiting the synthesis of thymidine monophosphate (ThMP), the active form of thymidine which is required for the de novo synthesis of DNA.

Drug synthesis

Overdose Uridine Triacetate is a potential antidote for cases of suspected overdose.

Society and culture

Brand names

One of the brand names is Xeloda, marketed by Genentech. Others include Xitabin, Capcibin, Kapetral and Pecaset by Eurolab.

References

Further reading Dean L (2016). "Capecitabine Therapy and DPYD Genotype". In Pratt VM, McLeod HL, Rubinstein WS, et al. (eds.). Medical Genetics Summaries. National Center for Biotechnology Information (NCBI). PMID 28520372. Bookshelf ID: NBK385155.

Illustrations

Worked examples

Example 1 — a first encounter with Capecitabine

Start with the simplest possible case. Write down what Capecitabine claims or describes in one sentence, then invent the smallest concrete situation in which that sentence is true. In biology, the smallest case is usually a single object, a single equation or a single measurement. Check that every symbol or term in your sentence has a meaning in that case.

Example 2 — changing one variable

Take the situation from Example 1 and change exactly one quantity: double it, halve it, or set it to zero. Predict what should happen to Capecitabine before you calculate. Comparing your prediction with the result is the fastest way to find out whether you understand the idea or only the words.

Example 3 — an exam-style question

Typical questions about Capecitabine ask you to (a) state it precisely, (b) apply it to given data, and (c) explain a limitation. Practise writing all three answers in under five minutes; the third part is what separates a full-mark answer from an average one.

Applications of Capecitabine

In research: Capecitabine appears in biology research whenever the underlying quantities have to be modelled precisely. Papers usually cite it as a starting assumption and then explore where it breaks down.
In technology and industry: Engineering practice reuses Capecitabine in design rules, simulations and safety margins. Knowing the idea lets you read a specification sheet and understand why the numbers look the way they do.
In the classroom: Capecitabine is common in secondary-school and first-year university syllabi. It links to neighbouring topics Carbamates, Drugs developed by Genentech, Drugs developed by Hoffmann-La Roche, so understanding it makes those chapters shorter.
In everyday life: Look for Capecitabine outside the textbook — in sport, cooking, traffic, electronics or the sky above you. An example you found yourself is remembered far longer than one you were given.

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How to study Capecitabine in 20 minutes

Read the reference excerpt below once, without taking notes.
Close the page and write down what Capecitabine means in your own words.
Compare your version with the excerpt and mark what you missed.
Work through the three examples above with pen and paper.
Explain Capecitabine out loud to somebody else — or to Teacher Smith in the lgStudy chat.

Frequently asked questions

What is Capecitabine in simple terms?

Why does Capecitabine matter?

Because it connects several biology ideas at once: it gives you a definition you can apply, a quantity you can calculate, and a way to check whether a result is plausible.

How should I study Capecitabine?

Read the excerpt, restate it from memory, then work through the examples and applications listed on this page. The five-step study plan above takes about twenty minutes.

What does this page cover?

It gives you a compact reference excerpt plus original lgStudy explanations, examples, applications and study material on Capecitabine.