Capecitabine (Xeloda) - Uses, Side Effects, and More

What are the most common side effects of capecitabine?

The most common side effects of capecitabine are listed below. These side effects may vary depending on the condition that is being treated. Tell your healthcare provider if you have any of these side effects that bother you.

• Diarrhea (see below)
• Hand-foot syndrome (see below)
• Nausea and vomiting
• Stomach pain
• Tiredness
• Blood disorders (see below)
• High bilirubin levels (see below)
• Mouth sores or mouth inflammation
• Hair loss
• Fluid retention
• Skin rash

There may be other side effects of capecitabine that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of capecitabine?

While less common, the most serious side effects of capecitabine are described below, along with what to do if they happen.

Severe Allergic Reactions. Capecitabine may cause allergic reactions, which can be serious. Stop taking capecitabine and get help right away if you have any of the following symptoms of a serious allergic reaction.

• Breathing problems or wheezing
• Racing heart
• Fever or general ill feeling
• Swollen lymph nodes
• Swelling of the face, lips, mouth, tongue, or throat
• Trouble swallowing or throat tightness
• Itching, skin rash, or pale red bumps on the skin called hives
• Nausea or vomiting
• Dizziness, feeling lightheaded, or fainting
• Stomach cramps
• Joint pain

Heart Problems. Capecitabine can cause heart problems, including heart attack, chest pain, abnormal heart rhythm, heart failure, and sudden death. The risk for these problems is higher in people who have heart disease. Stop taking capecitabine and get emergency help if you have any of the following symptoms of a heart problem.

• Chest pain
• Shortness of breath
• Dizziness or lightheadedness

Diarrhea. Diarrhea is common with capecitabine, and it can sometimes be severe. If you are given medicine to prevent or treat diarrhea, take it exactly as your healthcare provider tells you. Stop taking capecitabine and call your healthcare provider right away if you have severe diarrhea, you have bowel movements at night, or if the number of bowel movements you have per day goes up by four or more from what you usually have. Also call your healthcare provider right away if you have severe stomach pain or bloody diarrhea. 

Dehydration. Capecitabine may cause dehydration. You may be at higher risk of dehydration if you have a loss of appetite, nausea and vomiting, or diarrhea. Dehydration may lead to low blood pressure, especially when you stand up (orthostatic hypotension), or kidney damage. Stop taking capecitabine and call your healthcare provider right away if you have any of the following symptoms.

• Vomiting two or more times in one day
• Loss of appetite from nausea
• Diarrhea
• Dizziness or lightheadedness
• Weakness or unusual tiredness
• Confusion
• Unsteadiness
• Peeing less than normal
• Swelling in your legs, ankles, and feet
• Loss of appetite or nausea
• Difficulty catching your breath or chest pain or pressure
• Seizures
• Extreme thirst

Kidney Damage. Kidney damage can happen when taking capecitabine. You may have a higher risk of kidney damage if you already have kidney problems or you take other medicines that can cause kidney problems. Call your healthcare provider right away if you have any of the following symptoms of kidney damage.

• Reduced need to pee
• Swelling in your feet, ankles, or legs
• Weakness or unusual tiredness
• Difficulty catching your breath or chest pain/pressure
• Confusion
• Nausea
• Seizures

Severe Skin and Mouth Reactions. Capecitabine can cause severe skin reactions, called Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), that can lead to death if not treated. Capecitabine can also cause mouth or tongue sores. If you develop a rash, stop taking capecitabine and call your healthcare provider right away. Get emergency help if you have any of the following symptoms of SJS or TEN.

• Painful red or purple skin that looks burned and peels off
• Flat red rash or blisters on your skin, mouth, nose, and genitals
• Red, painful, watery eyes
• Ulcers, swelling, or redness in your mouth or on your tongue

Hand-Foot Syndrome. Capecitabine can cause "hand-foot" syndrome, also called palmar-plantar erythrodysesthesia syndrome. Hand-foot syndrome can cause you to have numbness, tingling, or changes in feeling in the palms of your hands and soles of your feet. It may also cause redness, swelling, or pain in your hands and feet. Stop taking capecitabine and call your healthcare provider right away if you have any of these symptoms and cannot do your usual activities.

Blood Disorders. Capecitabine can cause low levels of white blood cells, platelets, and red blood cells (anemia), and these problems can sometimes be severe. Keep all appointments with your healthcare provider for bloodwork. If your white blood cell levels are very low, you may develop an infection. Call your healthcare provider right away if you have signs or symptoms of an infection or any of the following symptoms.

• Fever
• Shortness of breath
• Pale or yellowish skin
• Easy bruising or bleeding
• Frequent infection
• Unusual weakness or tiredness
• Dizziness, lightheadedness, or feeling like you are about to pass out
• Headache
• Fast or abnormal heartbeat
• Stomach pain

High Bilirubin Levels and Liver Problems. Capecitabine may cause problems with your liver or an increase of bilirubin levels in your blood, which can sometimes be severe. Keep all appointments with your healthcare provider to check your bloodwork while you are taking capecitabine. Call your healthcare provider right away if your skin or the whites of your eyes turn yellowish in color (also called jaundice).