L01BC06 - Capecitabine |
Not porphyrinogenic |
NP |
Rationale
Non-CYP metabolized. However, side effects such as nausea and vomiting may be potentially porphyrinogenic through reduction in caloric intake.
Chemical description
Capecitabine is non-cytotoxic fluoropyrimidine carbamate, a prodrug to 5-fluorouracil.
Therapeutic characteristics
Capecitabine is used after surgery in colorectal cancer and in ventricular cancer and advanced breast cancer as a component in combination therapy. Administered orally. In ventricular cancer given together with platinium based drugs, in breast cancer together with docetaxel. Common adverse reactions of capecitadine that can be confused with an acute porphyric attack are nausea, vomiting, diarrhoea, abdominal pain, and obstipation, ataxia and peripheral neuropathy less common. Side effects such as nausea and vomiting may be potentially porphyrinogenic through reduction in caloric intake.
Metabolism and pharmacokinetics
Capecitabine is metabolized in the liver by carboxylesterase, cytidine deaminase and tymidine phosphorylase to 5-fluorouracil. May downregulate CYP 2C9 within days or months giving rise to impaired metabolism of coumarin drugs and bleeding. Results the manufacturers in-vitro studies indicate that capecitabine and its metabolites do not inhibit the metabolism of substrates of the major cytochrome P-450 isoenzymes.
IPNet drug reports
No.
References
- Drug reference publications
- McEvoy GK, editor. Capecitabine. The AHFS Drug Information 2008. Bethesda, MD: American Society of Health-System Pharmacists; 2009. Electronic version (04.12.09). #3346
- Sweetman SC, editor. Martindale: The complete drug reference. Capecitabine. Pharmaceutical Press 2009. #3348
- Summary of Product Characteristics
- Norwegian medicines agency. Summary of Product Characteristics (SPC). Xeloda. #3347
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