Kapetral (Capecitabine)

Capecitabine is used in the management of solid tumours that are responsive to fluoropyrimidine therapy, particularly in adult oncology patients.

• Colorectal cancer: improves disease control and overall survival when used as adjuvant or metastatic therapy.
• Breast cancer: employed in combination regimens for metastatic disease, extending progression‑free intervals.
• Gastric cancer: utilized in advanced disease settings to enhance response rates and palliation.

• Capecitabine is a pro‑drug that is enzymatically converted to 5‑fluorouracil (5‑FU) preferentially within tumour tissue. The resulting 5‑FU inhibits thymidylate synthase and becomes incorporated into RNA and DNA, disrupting nucleic‑acid synthesis and leading to tumour cell death.

Capecitabine may cause a range of adverse reactions, varying from mild to severe.

Common Side Effects

• Diarrhea: frequent loose stools that may lead to dehydration.
• Nausea and vomiting: gastrointestinal upset common during treatment.
• Hand‑foot syndrome: redness, swelling, or pain on palms and soles.
• Fatigue: persistent tiredness affecting daily activities.
• Alopecia: hair thinning or loss.

Serious or Rare Side Effects

• Neutropenia: marked reduction in white blood cells increasing infection risk.
• Thrombocytopenia: low platelet count that can cause bleeding.
• Severe cardiac toxicity: rare cases of chest pain or arrhythmia.
• Stevens‑Johnson syndrome: severe skin reaction with blistering.
• Allergic reactions: anaphylaxis or severe hypersensitivity.

When prescribing Kapetral, clinicians should consider several safety and monitoring factors.

• Renal impairment: adjust therapy and monitor renal function.
• Hepatic dysfunction: use with caution and assess liver enzymes.
• Pregnancy: contraindicated; classified as category D.
• Diarrhea: monitor closely and treat promptly to prevent dehydration.
• Hand‑foot syndrome: assess regularly and modify dose if severe.
• Store at ambient temperature: keep in original pack, protect from moisture.

Capecitabine can interact with other medicines, affecting its efficacy or safety.

Major Interactions (Avoid)

• Strong CYP3A4 inducers (e.g., rifampin): may markedly reduce capecitabine exposure.
• Anticoagulants (e.g., warfarin): increased risk of bleeding.
• Concurrent radiation therapy: may amplify mucosal toxicity.

Moderate Interactions (Monitor Closely)

• Antiemetics such as ondansetron: may alter capecitabine metabolism.
• Other fluoropyrimidines (e.g., 5‑FU): additive bone‑marrow suppression.
• Proton pump inhibitors: potential effect on drug absorption.