Xeloda

By Anton J. Bilchik, MD
Medically Reviewed by Lakesha Farmer, PharmD, MBA
Last Update: January 15, 2025

What is Xeloda?

Xeloda Xeloda (capecitabine) is an oral chemotherapy medication used to treat certain types of cancer, including breast cancer, colon cancer, and colorectal cancer. It works by interfering with the growth of cancer cells, slowing their spread and reducing tumor size. This drug is often prescribed for advanced or metastatic cancers and can be used alone or in combination with other treatments. Its convenience as a pill makes it an alternative to traditional intravenous chemotherapy, allowing patients to undergo treatment from the comfort of their homes.

Approved by the FDA, this 5-FU prodrug is activated in the body and converted into 5-fluorouracil (5-FU), a powerful anti-cancer agent. Clinical studies have shown that this chemotherapy agent can significantly improve survival rates and quality of life for patients, with fewer hospital visits compared to IV chemotherapy. It is important to follow your doctor’s instructions carefully while taking capecitabine to manage side effects and achieve the best treatment outcomes.

FAQ

Is Xeloda considered chemo?

Yes, Xeloda is considered chemotherapy. It is an oral chemotherapy drug used to treat cancers such as breast cancer, colon cancer, and colorectal cancer. Unlike traditional intravenous chemotherapy, this anti-cancer drug is taken as a pill, making it a more convenient option for many patients. Once ingested, the body converts Xeloda into 5-fluorouracil (5-FU), a potent anti-cancer agent that targets and slows the growth of cancer cells.

This drug is widely recognized for its effectiveness and is often used alone or in combination with other treatments. It has been shown in studies to improve survival rates and quality of life for cancer patients. While it is less invasive than IV chemotherapy, it is still a powerful treatment with potential side effects, so regular monitoring and guidance from your healthcare provider are essential.

Is it used to treat breast cancer?

Yes, Xeloda is an effective treatment for breast cancer, particularly in advanced or metastatic stages. It is commonly prescribed for HER2-negative breast cancer and for patients whose cancer has not responded to other therapies such as anthracyclines or taxanes. The medication works by targeting and slowing the growth of cancer cells, offering a convenient oral chemotherapy option that can be taken at home.

Studies highlight its effectiveness in improving outcomes. For instance, research published in The New England Journal of Medicine showed that adding this fluoropyrimidine-based drug to the treatment plan for early-stage triple-negative breast cancer reduced the risk of recurrence by 30%. In cases of metastatic breast cancer, this medication has demonstrated tumor shrinkage in up to 36% of patients. Regular monitoring and guidance from a healthcare provider are essential to manage side effects and optimize the benefits of this treatment.

What does Xeloda do to your body?

It works by targeting rapidly dividing cancer cells in the body. Once taken, it is converted by the liver into 5-fluorouracil (5-FU), a chemotherapy agent that disrupts the production of DNA in cancer cells, slowing their growth and preventing them from spreading. This mechanism makes it effective in treating cancers such as breast cancer, colon cancer, and colorectal cancer.

While it specifically targets cancer cells, capecitabine can also affect healthy cells that divide quickly, such as those in the digestive tract, bone marrow, and hair follicles. This may lead to side effects like diarrhea, nausea, fatigue, and low blood cell counts. Proper monitoring and adjustments by your healthcare provider help maximize benefits and manage potential side effects effectively.

What is the success rate of this medication?

The success rate of Xeloda varies depending on the type and stage of cancer being treated. For colon cancer, studies show that capecitabine, when used as an adjuvant therapy, has a 3-year disease-free survival rate of approximately 64-71%. This data, published in The New England Journal of Medicine, highlights its effectiveness in reducing the risk of cancer recurrence after surgery.

In metastatic breast cancer, this drug has shown tumor response rates of up to 36%, according to clinical trials. When combined with other treatments, such as lapatinib, the medication improves progression-free survival rates in patients with advanced disease. The drug’s oral convenience and proven efficacy make it a valuable option for many cancer patients, though success varies by individual factors. Regular follow-ups with a healthcare provider ensure optimal outcomes.

How long do you stay on Xeloda?

The duration of capecitabine treatment depends on the type and stage of cancer being treated, as well as the patient’s individual response and tolerance to the medication. Typically, Xeloda is taken in cycles lasting 14 days on the drug, followed by a 7-day break to allow the body to recover. This three-week cycle is repeated as prescribed by your doctor, often for several months or until the treatment achieves its goals.

For adjuvant therapy in colon cancer, patients may be on this medication for around six months, depending on how well the cancer responds. In cases of metastatic breast or colorectal cancer, treatment may continue longer, sometimes for years, if the medication is effectively controlling the disease and side effects are manageable. An interesting aspect of Xeloda is its oral administration, which allows patients to take it at home, offering more flexibility compared to intravenous chemotherapy. Always follow your doctor’s recommendations and attend regular check-ups to monitor your progress and adjust the treatment plan as needed.

Are there any interactions?

Yes, capecitabine can interact with other medications, increasing the risk of side effects or reducing its effectiveness. It’s important to inform your healthcare provider about all drugs, supplements, or herbal remedies you are taking to avoid harmful interactions.

Common drug interactions with Xeloda include:

Warfarin and other blood thinners: Increases the risk of bleeding. Studies show that up to 15% of patients on capecitabine with anticoagulants may experience serious bleeding complications.
Phenytoin: Xeloda can raise phenytoin levels, increasing the risk of toxicity and side effects like confusion or lethargy.
Folic acid supplements: May amplify the effects of the fluoropyrimidine-based drug, leading to enhanced toxicity.
Leucovorin: While sometimes intentionally combined with fluoropyrimidines, this can intensify side effects such as diarrhea and low blood cell counts.
Live vaccines (e.g., MMR or yellow fever): Can increase the risk of severe infections due to capecitabine’s immune-suppressing effects.

Avoiding these combinations and monitoring closely with your healthcare provider can help manage potential risks. Always consult your doctor before starting or stopping any medication while on targeted cancer therapy.

What is the life expectancy of someone on Xeloda?

The life expectancy of someone on Xeloda depends on the type and stage of cancer, as well as individual health factors. For stage III colon cancer, studies published in The New England Journal of Medicine have shown that this oral chemotherapy drug, when used as adjuvant therapy, provides a 5-year overall survival rate of approximately 70%. This demonstrates its effectiveness in reducing the risk of cancer recurrence after surgery.

In patients with metastatic breast or colorectal cancer, this 5-FU prodrug has been shown to extend progression-free survival. For example, clinical trials indicate that this chemotherapy agent can extend progression-free survival by 6 to 9 months, particularly when combined with other treatments like oxaliplatin or bevacizumab. While it may not cure advanced cancers, the medication improves quality of life and offers valuable additional time, depending on how well the disease responds to treatment. Regular monitoring by a healthcare provider is essential to optimize outcomes and manage side effects.

Do you lose your hair on Xeloda?

Hair loss is not a common side effect of capecitabine, unlike many traditional chemotherapy drugs. Clinical studies and patient data show that only 1-3% of patients experience mild hair thinning or loss while taking Xeloda. This occurs because this oral drug targets rapidly dividing cancer cells, with less impact on hair follicle cells compared to intravenous chemotherapies like taxanes, which are more commonly associated with significant hair loss.

For the small percentage of patients who do experience hair thinning, it is usually temporary and resolves after completing treatment. Capecitabine’s lower risk of hair loss makes it a more favorable option for many patients, particularly for those managing cancers such as breast cancer, colon cancer, or colorectal cancer. If you notice any unusual hair loss, consult your healthcare provider, as other factors like stress or additional medications may also contribute. Regular monitoring and communication with your medical team can ensure optimal treatment outcomes and address any concerns effectively.

What foods to avoid while taking this drug?

While taking Xeloda, it’s important to avoid certain foods that may interfere with the medication’s effectiveness or increase side effects. Proper dietary choices can help manage symptoms and improve treatment outcomes.

Foods to avoid while on capecitabine medication:

Grapefruit and grapefruit juice: Can interfere with how the liver processes the chemotherapy agent, potentially increasing side effects.
High-folate foods: Foods like spinach, broccoli, and fortified cereals should be consumed in moderation, as folate can enhance the drug’s toxicity.
Raw or undercooked foods: To reduce the risk of infection due to a weakened immune system, avoid sushi, raw eggs, and undercooked meats.
Alcohol: Increases the risk of liver toxicity, which is a known side effect of the fluoropyrimidine-based drug.
Spicy or acidic foods: These can worsen gastrointestinal symptoms like diarrhea or nausea, which are common with targeted cancer therapy.

Maintaining a balanced diet rich in mild, easily digestible foods can help manage side effects.

Is it worth taking Xeloda?

This capecitabine medication is considered a highly effective treatment option for certain cancers, particularly breast cancer, colon cancer, and colorectal cancer, due to its proven ability to slow disease progression and reduce tumor size. Its oral formulation offers the convenience of at-home treatment, which many patients prefer over intravenous chemotherapy. This convenience can significantly improve the quality of life by reducing frequent hospital visits.

Clinical trials have demonstrated that Xeloda is particularly beneficial when used alone or alongside other therapies, such as oxaliplatin or bevacizumab, enhancing treatment outcomes. For instance, studies highlight its ability to shrink tumors or manage cancer progression in over 30% of patients with metastatic disease. While it may not be suitable for everyone due to potential side effects like nausea or diarrhea, regular monitoring and adjustments by a healthcare provider ensure its risks are well-managed. Ultimately, this 5-FU prodrug is considered a valuable option for many cancer patients seeking an effective and flexible treatment.

Does Xeloda shrink tumors?

Yes, this drug is effective in shrinking tumors, particularly in cancers like breast cancer, colon cancer, and colorectal cancer. Once ingested, capecitabine is converted in the body into 5-fluorouracil (5-FU), a chemotherapy agent that targets rapidly dividing cancer cells, disrupting their DNA production and ultimately shrinking tumors.

Clinical studies have demonstrated the drug’s effectiveness in tumor reduction. For example, in patients with metastatic breast cancer, Xeloda has shown tumor response rates of up to 36% when used as a standalone treatment. When combined with other therapies like oxaliplatin for colorectal cancer, this agent has been shown to improve tumor control significantly, extending progression-free survival. These results, backed by research published in The New England Journal of Medicine, confirm the drug’s ability to manage cancer growth effectively. Regular monitoring by a healthcare provider ensures optimal dosing and helps manage potential side effects for the best treatment outcomes.

Who should not take Xeloda?

Xeloda is a powerful chemotherapy drug, but it may not be suitable for everyone. Certain conditions, medications, or health factors can make this drug unsafe. Always consult your doctor to determine if capecitabine medication is right for you.

People who should not take these pills include:

Those with severe kidney disease: Capecitabine is processed by the kidneys, and impaired kidney function can lead to dangerous drug accumulation.
Individuals with known DPD enzyme deficiency: A deficiency in dihydropyrimidine dehydrogenase (DPD), an enzyme required to break down the medication, can cause severe toxicity.
Pregnant or breastfeeding women: This agent can harm a developing fetus or pass into breast milk, making it unsafe during pregnancy or breastfeeding.
Patients allergic to capecitabine or fluorouracil (5-FU): An allergy to these ingredients can result in severe allergic reactions.
People taking warfarin or phenytoin: This anti-cancer drug interacts with these medications, increasing the risk of bleeding or toxicity.

Proper screening and medical advice are essential before starting targeted cancer therapy. Inform your healthcare provider about your complete medical history and any medications you are taking to avoid complications.

How bad are side effects?

The side effects of Xeloda (capecitabine) can vary from mild to severe, depending on the individual and dosage. While many patients tolerate these pills well, some experience side effects that require management or adjustment in treatment. According to clinical studies, more than 50% of patients report mild to moderate side effects, while severe reactions occur in about 10-15% of users.

Common side effects include:

Nausea and vomiting: Affects up to 35% of patients, typically manageable with anti-nausea medications.
Diarrhea: Experienced by up to 50% of users, ranging from mild to severe.
Hand-foot syndrome: Causes redness, swelling, and peeling of the skin, occurring in up to 45% of patients.
Fatigue: Reported by 20-40% of patients, often mild but sometimes limiting daily activities.
Low blood cell counts: Occurs in 10-15% of users, increasing the risk of infections or bleeding.

Severe side effects like liver enzyme elevation, heart problems, or severe diarrhea are less common but require immediate medical attention. Regular monitoring by a healthcare provider and dose adjustments can help minimize risks, ensuring safe and effective treatment. Always report any new or worsening symptoms to your doctor promptly.

When should I stop taking capecitabine?

You should stop taking this medication if directed by your healthcare provider due to specific reasons, such as severe side effects, lack of effectiveness, or completion of your prescribed treatment cycle. Common reasons for stopping the medication include unmanageable side effects like severe diarrhea, hand-foot syndrome, or dangerously low blood cell counts. For instance, clinical guidelines recommend discontinuation if Grade 3 or 4 toxicities, such as persistent diarrhea or liver enzyme elevations, occur.

If you notice symptoms like extreme fatigue, chest pain, severe nausea, or signs of an allergic reaction (rash, swelling, difficulty breathing), you should stop the medication immediately and contact your doctor. Never stop taking this drug on your own without consulting your healthcare provider, as doing so could affect the effectiveness of your cancer treatment. Regular monitoring and follow-ups ensure that your treatment is adjusted appropriately for the best outcomes.

What is the price of Xeloda (capecitabine)?

As of 2025, the price of Xeloda (capecitabine) varies depending on dosage, quantity, and pharmacy location. A typical supply of 60 tablets of 150 mg costs around $850 to $900, while 120 tablets of 500 mg may range between $5,500 and $6,000. Generic versions are significantly cheaper, with prices for 60 tablets of 150 mg starting at approximately $175 and 20 tablets of 500 mg costing around $260.

To save money, patients can compare prices at different pharmacies, use online discount programs, or discuss with their doctor about switching to the generic version, which is equally effective. Regular communication with your healthcare provider and pharmacist ensures you get the best value while maintaining effective treatment.

How long does capecitabine stay in your system?

This drug is processed quickly by the body, with a short elimination half-life of approximately 0.75 hours (45 minutes). This means that half of the drug is removed from the bloodstream within that time. Typically, it takes about 3-5 half-lives for a drug to be nearly eliminated from the system. Based on this, capecitabine (Xeloda) is generally cleared from the body within 4 hours after the last dose.

However, its active form, 5-fluorouracil (5-FU), may remain active in the tissues for longer, depending on factors like liver and kidney function. In patients with impaired kidney function, the clearance rate of capecitabine can decrease, prolonging its presence in the body. Clinical studies have shown that dose adjustments are necessary for those with reduced kidney function, as up to 85% of the drug is excreted through urine.

Although the drug itself leaves the system quickly, its effects on rapidly dividing cancer cells can last much longer, contributing to its effectiveness as a chemotherapy agent. Always follow your doctor’s instructions and discuss any concerns about the anti-cancer drug’s duration and effects on your body.

About the Author

dr Anton Bilchik Dr. Anton J. Bilchik, MD, is a highly respected Professor of Surgery and Chief of Medicine at the John Wayne Cancer Institute, where he has been at the forefront of cancer treatment and research since 2012. Known for his expertise in minimally invasive surgery and surgical oncology, he has authored over 200 research publications and has continuously secured National Institutes of Health (NIH) grants since 2001. He also serves as Medical Director of the California Oncology Research Institute and a Professor at UCLA’s David Geffen School of Medicine. Dr. Bilchik’s career includes pivotal roles such as Director of Gastrointestinal Surgical Oncology at the John Wayne Cancer Institute. A graduate of the University of the Witwatersrand, he completed advanced training at Yale University and UCLA, specializing in surgical oncology and gastrointestinal research. His groundbreaking contributions, blending cutting-edge science with compassionate care, have earned him numerous accolades, including the Anti-Defamation League’s Humanitarian Award in 2012.

Disclaimer: This content is provided for informational purposes only and should not be used as a replacement for professional medical advice, diagnosis, or treatment. Always consult a licensed healthcare provider before altering your medications or health plan. If you have questions or concerns about your health, seek immediate advice from a qualified medical professional.