Capecitabine
Capecitabine
CLINICAL USE
Antineoplastic agent (antimetabolite):
Colorectal, colon and breast cancer DOSE IN NORMAL RENAL FUNCTION
1.25 g/m2 twice daily for 14 days, repeated after 7 days PHARMACOKINETICS
Molecular weight                           :359.4 %Protein binding                           :54 %Excreted unchanged in urine     : 3 Volume of distribution (L/kg)       :No datahalf-life – normal/ESRD (hrs)      :0.85/Increased DOSE IN RENAL IMPAIRMENT
GFR (mL/MIN)
30–50 75% of dose (950 mg/m2 twice daily) use with care10–30 Avoid <10           : Avoid DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES
CAPD                :Unknown dialysability. Dose as in GFR <10 mL/min HD                     :Unlikely to be dialysed. Dose as in GFR <10 mL/minHDF/high flux   :Unknown dialysability. Dose as in GFR <10 mL/minCAV/VVHD      :Unknown dialysability. Dose as in GFR=10–30 mL/min IMPORTANT DRUG INTERACTIONS
Potentially hazardous interactions with other drugsAllopurinol: avoid concomitant use Anticoagulants: possibly enhances effect of coumarinsAnti-epileptics: reported toxicity with phenytoin, due to increased phenytoin levelsAntipsychotics: avoid concomitant use with clozapine – increased risk of agranulocytosis ADMINISTRATION
Reconstition
– Route
Oral Rate of Administration
–Comments
Give after food OTHER INFORMATION
Capecitabine is a prodrug that is metabolised to fluorouracilContraindicated in severe renal impairment due to increased incidence of grade 3 or 4 adverse reactions in patients with GFR of 30–50 mL/minExtensive absorption (~70%) after food intake. First metabolised in the liver and then in the tumour. Up to 96% dose is recovered in the urine. Terminal T½ = 0.85 hours
See how to identify renal failure stages according to GFR calculation
See how to diagnose irreversible renal disease
Home