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.
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.
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