Capegard - 100mg


Description


Capegard 150mg is a chemotherapy drug. It is used to treat many types of cancer including breast, colon, rectal, stomach, esophageal and pancreatic cancers.
Capegard 150mg is given as tablets.
Capegard 150mg is a prescription drugs which is used under the guidance of medical oncologist


Indication

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


Capecitabine belongs to type of chemotherapy Known as anti-metabolite. The body converts capecitabine into a general chemotherapy drug called fluorouracil. It blocks cells making and repairing DNA. Cancer cells require to make and repair DNA, so they can develop and replicate.






Dosage and administration


Duke Stage C Colon Cancer dosage as follows :
Adjuvant therapy :
The recommended dose is 1,250 mg/m2 orally twice a day for 2 weeks, followed by 1-week rest period, given as 3 week cycles for a total of 8 cycles (24 weeks).
Colorectal Cancer dosage as follows :
Metastatic disease :
The recommended dose is 1250 mg/m2 twice a day for 2 weeks every 21 days.
Breast Cancer dosage as follows :
Metastatic, resistant to paclitaxel, anthracyclines
Monotherapy: The recommended dose is 1250 mg/m2 twice a day for 2 weeks every 3 weeks
Concomitant use of therapy with Docetaxel: 1250 m2 orally twice a day for 2 weeks every 3 weeks plus Docetaxel 75 mg/m2 1 hour intravenous infusion every 3 weeks.
Administration :
Take the table swallowing with water within 30 minutes after a meal
In pediatric:
The safety and efficacy of the Capegard 150mg tablets in pediatric patients has not been established

ADME


Absorption:
Time to peak plasma level at about 1.5 hours
Food reduced both the rate and duration of absorption of Capegard 150mg with mean Cmax and AUC0-∞ reduced by 60% and 35% respectively
Distribution:
The human plasma protein bound to Capegard 150mg is occurs in less than 60%
Bio-activation and metabolism:
Capegard 150mg is largely metabolized to 5-FU enzymatically. In liver, 60 kDa carboxylesterase hydrolyses to 5’-deoxy-5-fluorocytidine.
Excretion:
The route of elimination of Capegard 150mg is occurred through urine 95.5%
The mean terminal half-life period of Capegard 150mg is 0.75 hour

Precautions


Coagulopathy: concomitant with warfarin, anti-coagulant response should be monitored
Diarrhea: patients with severe diarrhea should be monitored
Cardio toxicity: while taking Capegard 150mg, cardio toxicity occurs like; myocardial infarction, angina, dyshythmias, cardiac arrest sudden death, Cardiomyopathy
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

Drug Interaction


Anticoagulant: Capegard 150mg concomitant with warfarin and phenprocoumon, bleeding occurs. These events occurred within several days and even a month also
Phenytoin: combination of phenytoin and Capegard 150mg, toxicity related to elevation of phenytoin levels
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.
CYP2C9 substrate: other than warfarin, there is no drug interaction occurs while concomitant with CYP2C9 substrates
Care should be taken while combination of Capegard 150mg with CYP2C9 substrates
Drug-food interaction:
In case of administering Capegard 150mg with food, it leads to reduce the rate and duration of absorption of Capegard 150mg.
Capegard 150mg tablets should be administered within 30 minutes after food

Side Effects


10%:
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
Post marketing reports:
Toxic leukoencephalopathy

Pregnancy & Lactation


Pregnancy category: D
Capegard 150mg may cause harm to the fetus
Generally,Capegard 150mg should not be recommended in pregnancy or women who are become pregnant
Breast feeding is not recommended



Missed Dose


The patient missed to take a single dose of Capegard 150mg, should consult with medical oncologist and follow the suggestions Do not self-medicate. Or missed dose should be swapped and continue the regular dosing schedule Do not double the dose


Storage


Capegard 150mg should be stored at 20oC to 25oC (68oF to 77oF)


Contraindication


Capegard 150mg is contraindicated to renal impairment patients
Capegard 150mg is contraindicated in patients with hypersensitivity to Capegard 150mg or other components


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