JJH wrote:Welcome to the Forum, and thanks for preparing a signature in advance.
You have 2 questions, but I'll start with the first one. To answer the first one, we need to know both your mother's weight and her height. This is needed in order to calculate Body Surface Area which in turn is needed to calculate the correct daily dose in mg. So, would you be able to provide both her height and weight? Also, could you specify how many Xeloda pills of which size she took in the morning, and how many Xeloda pills of which size she took at night?
Thank you.
sdino wrote:As JJH said, I believe one driving factor is the weight of the person. My Wife started out with 3500 mg/day. But was reduced to 3000 mg/day due to hand/foot syndrome. She stayed on Xeloda+Avastin from Aug 2018 to Feb 2019 with slight progression. Near Feb 2019, we could tell progression was getting slightly worse.
Hopepray wrote:... I am worried after reading many posts here on Xeloda dosing as most seem to have a 3000mg per day. I know it's weight dependant and she's around 68kgs or 150lbs...
Hopepray wrote:...My mom is 150lbs and 5.3 ft as I noted in my previous reply which I am not sure has been approved yet.
Hopepray wrote:...She is around 150lbs and 5 feet 3 inches.
JJH wrote:Hopepray wrote:... I am worried after reading many posts here on Xeloda dosing as most seem to have a 3000mg per day. I know it's weight dependant and she's around 68kgs or 150lbs...Hopepray wrote:...My mom is 150lbs and 5.3 ft as I noted in my previous reply which I am not sure has been approved yet.Hopepray wrote:...She is around 150lbs and 5 feet 3 inches.
Thank you for the update. I will assume that your mom is 5 feet 3 inches and not 5.3 feet. (5.3 feet is more like 5 feet 4 inches.)
With this information we can calculate the correct dose for your mom.
First, let me say that the standard Xeloda dose for use with neo-adjuvant radiation is usually 825 mg/m2. (This is different from the standard dose used in Capeox (Xeloda + oxaliplatin), and it is different from the standard dose that sdino's wife had under her regimen of Xeloda +Avastin. In these matters you have to pay very close attention to the particular regimen that Xeloda is being used in.) Your mom was on the regimen "Neoadjuvant Capecitabine / Radiation Therapy"
Here is a table showing the standard
There is one thing in this table that is very, very important. It is the acronym bid, which in Latin means "twice a day". So, this standard dose of 825 mg/m2 needs to be taken twice a day (i.e., morning and evening)
With your mom's height and weight we can use a BSA calculator to get her Body Surface Area. Then in the second part of the calculator we can calculate how many milligrams of Xeloda your mom should have taken in the morning and how many in the evening.
By using a height of 63 inches and a weight of 150 pounds, the calculator will show her Body Surface Area. (Note: In the on-line form you have to first click on the down-arrows to change the height units from centimeters to inches, and the weight units from kilograms to pounds before you click on "Calculate Body Surface Area". Also, you have to enter 825 in the Drug dosage/M2 box so that the calculator wil do the conversion.)
Once you have done all this and clicked on the "Calculate" button you will see the Results:
BSA = 1.71
Dose = 1410.75 bid
In other words, the correct morning dose is 1410.75 and the correct evening dose is 1410.75, for a total daily dose of 2821.50 mg.
To approximate 1410.75 with the available pill sizes of 500 mg and 150 mg, the pharmacist might prescribe 2 large pills and 3 small pills every morning and every evening. Or he might decide to do the approximation in a different way.There is no way to come up with exactly 1410.75mg with only 500 mg and 150 mg pills.
BSACalculator
https://globalrph.com/medcalcs/body-surface-area-bsa/
So, if these calculations are correct, then your mom received only about half of the Xeloda that she should have received. If this is true, I don't know why. Maybe the doctor or pharmacist wrote the prescription as "1,500 mg. bid" but didn't explain what bid meant.
You need to have a professional look into this soon, before they start the CAPEOX cycles, because if they did the calculations wrong for the 5 weeks of chemo/radiation they might make the same kind of mistake in the CAPEOX dosing.
Let us know what you find out.
Thank you.
Hopepray wrote:Thanks JJH, the cap pills given were 500mg and the doc told us 3 in the morning and 2 in the night. Sorry for not being clear before and yes this was given as a radio sensitising agent we were told:
So would you think that in a neo-adjuvant setting, as a radio sensitizing agent, Xeloda dose of 1500 mg for a full day that was given to my mom fall close to the standard 825mg/m2 twice daily. Which is 1650mg for a full day.
Hopepray wrote:By Dose = 1410.75 bid did you mean this for a proper chemotherapy regimen like if we were to start with the CapeOX cycles?
JJH wrote:Hopepray wrote:Thanks JJH, the cap pills given were 500mg and the doc told us 3 in the morning and 2 in the night. Sorry for not being clear before and yes this was given as a radio sensitising agent we were told:
So would you think that in a neo-adjuvant setting, as a radio sensitizing agent, Xeloda dose of 1500 mg for a full day that was given to my mom fall close to the standard 825mg/m2 twice daily. Which is 1650mg for a full day.
If your mom took 3 in the morning and 2 at night, then the full-day Xeloda dose she was receiving was 5 x 500mg =2,500 mg, not 1,500mg. Why do you say 1 500 mg? Where did that come from? The required full-day dose for her is 2,821.5 mg, so 2,500 mg is a little short of that.
Sorry she was taking 2 in the morning and 1 in the night-confirmed in the prescription. I did a big typo in last reply. The total is right in a day was 1500mg. As a dose for radio sensitizing agent isn't that enough dose, I know the last table you put says 825mg/m2 bid. Which makes it 1650mg in the whole day?Hopepray wrote:By Dose = 1410.75 bid did you mean this for a proper chemotherapy regimen like if we were to start with the CapeOX cycles?
No, not at all. The CapeOX regimen has a completely different dosing schedule. For your mom, it would be 1,710 mg in the morning and 1,710 mg at night for a total daily dose of 3,420 mg. This is more than she was taking during radiation because CapeOX is a full therapeutic regimen.
Hopepray wrote:Sorry she was taking 2 in the morning and 1 in the night-confirmed in the prescription. I did a big typo in last reply. The total is right in a day was 1500mg. As a dose for radio sensitizing agent isn't that enough dose, I know the last table you put says 825mg/m2 bid. Which makes it 1650mg in the whole day?
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