Side effects of Capecitabine, or Xeloda

[ronswife]

Hello All,

My husband is having a very rough time with the many side effects he is getting from his oral chemo Capecitabine. I think it's also called Xeloda? Anyway, he has a big reduction in his appetite, feels worn out most of the time, has bouts of severe itching, and a few other effects. What can be done about this at home? He has told his onc about this. Thank SO much for any help you can give me!!

[ktwmn]

Is he on anything in addition to xeloda? Is he still taking avastin? I was recently switched to xeloda (from 5FU) due to port migration resulting in removal and found xeloda to have less effects than 5FU. I understand that everybody is different, though.

[WriterGirl1969]

Hello All,

My husband is having a very rough time with the many side effects he is getting from his oral chemo Capecitabine. I think it's also called Xeloda? Anyway, he has a big reduction in his appetite, feels worn out most of the time, has bouts of severe itching, and a few other effects. What can be done about this at home? He has told his onc about this. Thank SO much for any help you can give me!!

Hi Ron's wife. So sorry to hear he's having such a rough go of it. Telling the Onc is definitely the best thing to do, since they will often adjust dosage for this reason. I was worried when they did that for me, but as they explained it, they start at a very high dose (determined max by BMI), and then slowly reduce it down to where you get maximum benefit with minimal side effects. Of course, it's also possible this particular type won't work well and they'll switch to another. Is he also getting the Oxa?

For me, on the days I was a little off digestion-wise, I ate / drank whatever felt soothing. Sometimes I would do a milkshake, or others I would take a sip of ginger ale. Not the best remedy, but when it gets down to it you do what you can to feel good and get through chemo. Also, is he on anything for nausea? I was on Omeprazole already, but it kept me pretty good throughout in terms of being able to eat okay.

For the fatigue, I mostly tried to keep cool (heat made it worse) and sleep when my body needed it.

The itching I can definitely identify with! I noticed it more toward the end, but I always had itchy skin. I think it has to do with the drying effect of the chemo. Encourage him to drink lots of water. I couldn't stand plain water (made me more nauseas), but I did the flavored sparkling water or just flavored water just fine. It also kept my mouth moisturized, which helped make me not so nauseas.

Hope this helps.
Hugs and Prayers to both you and hubby!
--Tracy

[rp1954]

There are several nutritional manuevers that people have used to tamp down xeloda side effects including IV vitamin C, glutamine, PSK with other nutrients and foods. Not with conventional oncologists of course, but integrative MDs or NDs, hopefully with some cooperation from your oncologist.

An adequate support and nutritional program can make all the difference whether someone can stay on chemo or not. I say this after we were almost derailed by chemo side effects early on, years ago.

[WriterGirl1969]

Great info, rp.
And one thing I forgot to note in my original reply - you may want to have hubby be careful how many foods with Folic Acid he's eating. As I understand it, this is already included in Xeloda, and getting a lot more of it can increase side effects. Look for labels that say "enriched flour" or "enriched wheat flour" and for percentages of Folic Acid. Cereals and Carb products are primary holders of it. I found a bread with a low % by comparison to other breads, and tried to stay away from cereal. Also, no multi-vitamins during treatment. Some vitamins are okay, but others (already included in the multi-vits) are not. Check with your oncologist to see what's okay.

[WriterGirl1969]

Here's an excellent quote from weissoccermom from another thread...

With respect to the GI upset with Xeloda, here are a few things you should be aware of.

1. Make sure you are not taking any folic acid supplementation....that will irritate your GI tract when taking Xeloda. This also means being off of all multivitamins as well.
2. Make sure you take your Xeloda within 30 minutes after eating....NOT on an empty stomach and NOT during the meal.
3. Watch your folic acid intake with the foods you eat. You should be aware that wheat in the USA/Canada are fortified with folic acid so foods such as: bread, crackers, pasta, pretzels, cereal etc. are fortified with folic acid. Many of these tend to be the foods we reach for when our stomachs are upset.
4. Finally, ask your doctor for a script for something like Nexium (Rx strength or two OTC/day) or get OTC Prilosec. Since 5FU/Xeloda can cause GI upset and/or heartburn, many people will take something like Nexium.

Try to gut it out (no pun intended) to get all the cycles in, particularly since the dosage has been reduced. If you haven't tried any of the above, give them a try and see if it makes any difference with your GI problems.

[Carolinabluetec]

Only problems that I had with Capecitabine were fairly servere Hand-Foot syndrome and stomach issues. Switched to Prilosec from Xantac (took care of stomach issues) and Oncologist was fairly aggressive with dose reduction for foot issues. I still have some foot and hand issues almost 2 years out from end of chemo. No other problems and if I am still NED in a few months Onc is going to cut me loose.

[ronswife]

Is he on anything in addition to xeloda? Is he still taking avastin? I was recently switched to xeloda (from 5FU) due to port migration resulting in removal and found xeloda to have less effects than 5FU. I understand that everybody is different, though.

Yes, he is still getting Avastin by infustion every 3 weeks. Praying that can be adjusted depending on 10/18 CT results!

[ronswife]

I want to thank everyone for their wise and kind posts! I have copied a lot of info you wrote and will use it to help Ron.

God Bless you all!