Capecad 500mg (Capecitabine)

Description  of  Capecad 500mg (Capecitabine 500mg)

Capecad 500mg (Capecitabine 500mg) is known as fluoropyrimidine carbamat who having the anti-cancer activity. The drug supplied as oblong and film coated tablet for oral administration. Capecad 500mg (Capecitabine 500mg) is a systemic prodrug of 5’-deoxy-5-fluorouridine (5’-DFUR) which is changed to 5 fluoro uracil, the main ingredient which is used as Capecitabine. Capecad 500mg (Capecitabine 500mg) is also have anti-metabolite activity and the activity of Capecad 500mg (Capecitabine 500mg) tablet will inhibits the growth of tumor cells and slows their spread in the body. Capecad 500mg (Capecitabine 500mg) is prescription drugs sold under the proper guidance of medical oncologist and pharmacist.

INDICATIONS of  Capecad 500mg (Capecitabine 500mg)

colorectal cancer

Adjuvant treatment in duke’s colon cancer first line therapy in colon-rectal cancer metastasis

breast cancer

In metastatic breast cancer: used in combination with docetaxel after failure of anthracycline containing chemotherapy

MECHANISM OF ACTION  of  Capecad 500mg (Capecitabine 500mg)

Enzymes changes capecitabine to 5-fluorouracil (5-FU) in vivo. Both normal and cancer cells metabolize 5-FU to 5-fluoro-2’-deoxyuridine monophosphate (FdUMP) and 5-fluorouridine triphosphate (FUTP). These metabolites leads to cell damage by two different mechanisms. First, FdUMP and the folate cofactor, N5-10-methylenetetrahydrofolate, link to thymidylate synthase (TS) and form a complex of covalently bound ternary. This bounding prohibits the thymidylate from 2’-deoxyuridylate formation. Thymidylate is the required precursor of thymidine triphosphate, which is specifically used for the synthesis of DNA, so that a inadequacy of this mixture can prevent cell division. Second, during the synthesis of RNA the nuclear transcriptional enzymes can mistakenly fused FUTP in place of uridine triphosphate (UTP). This metabolic error can prevent RNA processing and synthesis of protein.

Absorption of  Capecad 500mg (Capecitabine 500mg)

The time to peak plasma level at about 1.5 hours Food reduced both the rate and duration of absorption of Capecad 500mg (Capecitabine 500mg) with mean Cmax and AUC0-∞ reduced by 60% and 35% respectively

Distribution of  Capecad 500mg (Capecitabine 500mg)

The human plasma protein bound to Capecad 500mg (Capecitabine 500mg) is occurs in less than 60%

Metabolism of  Capecad 500mg (Capecitabine 500mg)

Capecad 500mg (Capecitabine 500mg) is largely metabolized to 5-FU enzymatically. In liver, 60 kDa carboxylesterase hydrolyses to 5’-deoxy-5-fluorocytidine. An enzyme which converts 5’-DFCR to 5’-DFUR known as Cytidine deaminase. another an enzyme which involved in the conversion of 5’-DFUR to 5-FU active drug is Thymidine phosphorylase

Excretion of  Capecad 500mg (Capecitabine 500mg)

The route of elimination of Capecad 500mg (Capecitabine 500mg) is occurred through urine 95.5% The mean terminal half life period of Capecad 500mg (Capecitabine 500mg) is 0.75 hour

 SIDE EFFECTS  of  Capecad 500mg (Capecitabine 500mg)

Most common side effects :
Diarrhea, nausea, anemia, Lymphopenia, head and foot syndrome, edema, fatigue, fever, headache, pain, paresthesia, alopecia, dermatitis, abdominal pain, anorexia, loss of appetite, constipation, dyspepsia, stomatitis, vomiting, neutropenia, thrombocytopenia, dyspnea, bilirubin decreased, eye irritation
Common side effects :
Dermatitis , rash, dizziness, headache, Chest pain, weakness, dehydration, dry mouth, dyspepsia, Pruritus, taste disturbance, back pain Post marketing reports: Toxic leukoencephalopathy

PRECAUTIONS  of  Capecad 500mg (Capecitabine 500mg)

Cardio toxicity: while taking Capecad 500mg (Capecitabine 500mg), cardio toxicity occurs like; myocardial infarction, angina, dyshythmias, cardiac arrest sudden death, Cardiomyopathy Diarrhea: patients with severe diarrhea should be monitored Dihydropyrimidine dehydrogenase deficiency Dehydration and renal failure Embryo fetal toxicity Mucocutaneous and dermatologic toxicity Hyperbilirubinaemia Hematological problems Care should be taken while using in geriatric patients Hepatic insufficiency Coagulopathy: concomitant with warfarin, anti-coagulant response should be monitored

DRUG INTERACTION of  Capecad 500mg (Capecitabine 500mg)

Capecad 500mg (Capecitabine 500mg) interaction with warfarin and phenprocoumon, bleeding occurs. These events occurred within several days and even a month also Interaction of phenytoin with Capecad 500mg (Capecitabine 500mg), toxicity related to elevation of phenytoin levels Concomitant use of Leucovorin: the toxicity and concentration of 5-FU increased by Leucovorin. In elderly patients, phenytoin and Leucovorin is administered weekly which may cause; diarrhea, dehydration, enterocolitis which may causes death. other than warfarin, there is no drug interaction occurs while concomitant with CYP2C9 substrates While combination of Capecad 500mg (Capecitabine 500mg) with CYP2C9 substrates Care should be taken

CONTRAINDICATION of  Capecad 500mg (Capecitabine 500mg)

Renal impairment patients. Patients with hypersensitivity to Capecad 500mg (Capecitabine 500mg) or other components.

PREGNANCY  of Capecad 500mg (Capecitabine 500mg)

Pregnancy category: D Capecad 500mg (Capecitabine 500mg) may cause harm to the fetus. Generally Capecad 500mg (Capecitabine 500mg) should not be recommended in pregnancy or women who are become pregnant

LACTATION  of Capecad 500mg (Capecitabine 500mg)  

Excretion into breast milk taking account on this, discussion should done on whether to discontinue the breast feeding or the drug. Use of drug is contraindicated during breastfeeding. It is unclear the effect of using the drug on new born babies.

DOSAGE of  Capecad 500mg (Capecitabine 500mg)

Monotherapy:
First line therapy of patients with advanced colorectal cancer:
The usual dose of Capecad 500mg (Capecitabine 500mg) is 1250mg/m2 should be taken orally as twice daily (morning and evening dose 2500mg/m2); therapy continue for 2 weeks followed by 1 week rest period given as 3 weeks cycle
Adjuvant therapy for Duke’s colon cancer:
The usual dose of Capecad 500mg (Capecitabine 500mg) is 1250mg/m2 orally as twice daily (morning and evening dose 2500mg/m2); for 2 weeks followed by 1 week given as 3 weeks for total 8 cycles (24 weeks)
Breast cancer:
Monotherapy: Recommended dose: 1250mg/m2 should be taken as orally for twice daily In combination with docetaxel; 1250mg/m2 of Capecad 500mg (Capecitabine 500mg) with 75mg/m2 of docetaxel for 3 weeks After a meal the drug Capecad 500mg (Capecitabine 500mg) should be given within 30 minutes
In pediatric:
The safety and efficacy of the Capecad 500mg (Capecitabine 500mg) tablets in pediatric patients has not been established

STORAGE  of  Capecad 500mg (Capecitabine 500mg)

Capecad 500mg (Capecitabine 500mg) should be stored at 20℃ to 25℃ (68℉ to 77℉)

MISSED DOSE of  Capecad 500mg (Capecitabine 500mg)

If missed a dose the have it as soon possible or Missed dose should be swapped and continue the regular dosing schedule for avoiding adverse conditions. If missed dose occurs, it should not be resume and continue the next schedule.