Xeloda (capecitabine)
Genentech / Roche; generics available · Fluoropyrimidine / Oral 5-FU Prodrug
What is Xeloda? Xeloda (capecitabine) is an oral fluoropyrimidine prodrug that is converted to 5-FU within tumor tissue. It is approved for colorectal cancer (adjuvant and metastatic) and metastatic breast cancer, offering the convenience of oral administration vs IV 5-FU.
About Xeloda
| Brand Name | Xeloda |
| Generic / INN | capecitabine |
| Drug Class | Fluoropyrimidine / Oral 5-FU Prodrug |
| Manufacturer | Genentech / Roche; generics available |
| Administration | Oral tablet |
| FDA Approval | 1998 |
FDA-Approved Uses for Xeloda
Indications are based on FDA approval. Your healthcare provider determines appropriate use based on your specific diagnosis, stage, biomarker status, and overall clinical picture.
- Colorectal cancer — adjuvant after surgery for Dukes' C (stage III)
- Metastatic colorectal cancer — as first-line treatment
- Metastatic breast cancer — after anthracycline and taxane failure; with docetaxel after anthracycline failure
How Does Xeloda Work?
Capecitabine is an oral prodrug that undergoes a 3-step enzymatic conversion to 5-fluorouracil (5-FU) — preferentially in tumor tissue (where thymidine phosphorylase expression is higher). 5-FU inhibits thymidylate synthase (TS), blocking DNA synthesis, and incorporates into RNA, disrupting RNA processing in cancer cells.
Dosage & Administration
1250 mg/m² orally twice daily (2500 mg/m²/day total) for 14 days followed by 7 days off (21-day cycle). Take within 30 minutes after a meal with water. Dose reductions (1000 or 750 mg/m²) for toxicity.
Dosing is individualized by the prescribing clinician. Never adjust your dose without consulting your healthcare provider. This information is educational only and does not replace the official prescribing information.
Warnings, Precautions & Side Effects
General Warning
Hand-foot syndrome (HFS/palmar-plantar erythrodysesthesia) — common and dose-limiting; dose reduce at grade 2+. Diarrhea — can be severe; manage aggressively. Cardiotoxicity — contraindicated in patients with severe renal impairment (CrCl <30 mL/min). Warfarin interaction (dramatically increases INR). Embryo-fetal toxicity.
- Hand-foot syndrome — dose-limiting
- Diarrhea — grade 3-4 possible
- Cardiotoxicity
- Warfarin interaction (INR monitoring essential)
- Renal impairment contraindication (CrCl <30)
- Embryo-fetal toxicity
Common Side Effects
- Hand-foot syndrome (HFS)
- Diarrhea
- Nausea
- Vomiting
- Fatigue
- Mucositis
- Anorexia
- Abdominal pain
This is not a complete list. Always report new or worsening symptoms to your healthcare provider promptly.
Storage & Handling
Store at room temperature 25°C (77°F). Keep in original container. Protect from moisture.
BiologicHealthPlus provides temperature-monitored cold-chain specialty delivery for medications requiring refrigeration. Never use a medication if its storage conditions have been compromised.
Insurance Coverage, Prior Authorization & Patient Assistance
🛡️ Commercial Insurance
Xeloda is covered by most major commercial insurance plans when medically necessary and prior authorized. Coverage tier and cost-sharing vary by plan.
✅ Prior Authorization
Prior authorization is required by virtually all insurance plans for Xeloda. BiologicHealthPlus handles the complete prior authorization process at no cost to patients or providers.
🏥 Medicare Coverage
Medicare Part D covers this oral specialty medication. Medicaid coverage varies by state.
🆓 Patient Assistance
Manufacturer patient assistance programs may be available for eligible uninsured or underinsured patients. Contact BiologicHealthPlus for a confidential eligibility review.
Prior Authorization Patient Assistance Insurance & Savings Medication Costs
Frequently Asked Questions — Xeloda
Xeloda (capecitabine) is an oral chemotherapy that is converted to 5-FU inside the body, preferentially in tumor tissue. It offers oral convenience vs IV 5-FU infusions and is used for colorectal cancer and metastatic breast cancer.
Hand-foot syndrome (palmar-plantar erythrodysesthesia) causes redness, swelling, pain, and peeling of the palms and soles. It is the most common dose-limiting side effect of capecitabine.
Yes. Generic capecitabine tablets (150 mg and 500 mg) are widely available from multiple manufacturers.
Yes — capecitabine significantly increases warfarin (Coumadin) levels, raising bleeding risk. Patients on warfarin must have INR monitored closely and warfarin dose adjusted.
Related Medications & Conditions
Related Medications
5-FU (fluorouracil IV) · Oxaliplatin · Irinotecan · Bevacizumab (Avastin) · Pemetrexed
Related Conditions
Colorectal cancer · Metastatic breast cancer · Gastric cancer