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Capecitabine after chemotherapy: who needs extra tablets?
Capecitabine is a chemotherapy tablet. In some women with triple negative breast cancer who still had cancer present at surgery after chemotherapy, a course afterwards has been shown to lower the chance of it returning. This page explains, in general terms, who it is considered for and what taking it involves.
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Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed September 2026, next review due September 2027
The short answer
Why would I take capecitabine after chemotherapy?
Capecitabine is a chemotherapy tablet. In some women with triple negative breast cancer who still had cancer present at surgery after chemotherapy, a course of capecitabine afterwards has been shown to lower the chance of the cancer returning. It is taken at home in cycles.
Who it is usually considered for
Mainly women with triple negative disease where cancer remained in the breast or nodes after chemotherapy given before surgery. It is not routinely offered to everyone who has finished chemotherapy.
What taking it involves
Tablets taken twice a day with food for a set number of days, then a break, repeated over several months. Your team gives you a written schedule and regular blood tests between cycles.
Who it does not suit
Women whose cancer cleared completely at surgery, those with certain kidney problems, and people with a rare inherited problem breaking the drug down. Your team checks these before starting.
This page gives general information only. Whether capecitabine is right for you is a decision for your oncologist.Taking it
How a course usually runs
Checks before starting
Blood tests, including kidney function, and a review of your other medicines. Some medicines interact with capecitabine, so give your team a full list.
Tablets twice a day with food
Taken morning and evening, within half an hour after a meal, for the number of days on your schedule. Swallow them whole with water.
A break between cycles
After the tablet days comes a rest period with no tablets. The pattern then repeats for the number of cycles your oncologist has planned.
Blood tests and reviews
Regular checks between cycles to catch side effects early and adjust the dose if needed. Keep these appointments even when you feel well.
Reporting side effects promptly
Stop the tablets and call your team if you develop certain side effects. Your written guidance explains which ones, and it is safer to pause and ask than to keep going.
Side effects
The effects to watch for
Tablets at home do not mean milder treatment. These are the effects most worth knowing about.
Sore hands and feet
Redness, soreness, swelling and peeling of the palms and soles is the most common reason doses are reduced. Moisturise from the first day and report it early.
Loose motions
Can come on during a cycle. More than a few episodes a day, or diarrhoea that keeps going, is a reason to stop the tablets and call your team.
Keep drinking fluids if this happens.Mouth sores
Soreness in the mouth can make eating difficult. Keep your mouth clean with a soft brush and tell your team if it stops you eating or drinking.
Tiredness and low counts
Tiredness is common, and blood counts can drop. Report any fever or signs of infection straight away rather than waiting for your next check.
Stop and call if
- You have a fever or shivering
- Loose motions are frequent or ongoing
- Hands or feet are too sore to use
Words you will hear
The vocabulary, in plain language
- Capecitabine
- A chemotherapy drug taken as tablets. Your body converts it into its active form.
- Hand-foot syndrome
- Redness, soreness and peeling of the palms and soles. The most common side effect.
- Residual disease
- Cancer still present at surgery after chemotherapy. The situation where capecitabine is most often considered.
- Adjuvant
- Given after surgery to lower the chance of the cancer returning.
- Dose reduction
- Lowering the dose to manage side effects. A routine step, not a sign of failure.
- DPD deficiency
- A rare inherited problem breaking the drug down, which can cause severe side effects. Your team may check for it.
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Being straight with you
What to expect honestly
Capecitabine lowers the chance of the cancer returning in the women it is offered to. It does not remove that chance, and it brings side effects that many people find wearing over a course of months.
Tablets are still chemotherapy
Taking treatment at home can make it feel less serious than a drip. It is genuine chemotherapy with genuine side effects, and it needs the same care in reporting problems.
Pausing is often the safest choice
Your written guidance tells you when to stop the tablets and call. Pausing for a side effect and restarting at an adjusted dose is normal practice, and it is far safer than continuing through a worsening problem.
Missing tablets
If you miss a dose, do not take extra to make up for it. Carry on with the next dose as scheduled and tell your team at your next check.
What this page cannot tell you
It cannot tell you whether capecitabine applies to you. That depends on your subtype, what was found at surgery and your health. Ask your oncologist what benefit they expect and what they will do if side effects become difficult.
Commonly believed
What people assume about chemotherapy tablets
Tablets must be gentler than chemotherapy through a drip.
Capecitabine is genuine chemotherapy. Taking it at home is more convenient, not milder, and its side effects need the same attention and prompt reporting as any other chemotherapy.
I should push through side effects to finish the course.
Continuing through severe loose motions or very sore hands can be harmful. Your guidance tells you when to stop and call. Pausing and restarting at an adjusted dose is the safe and normal approach.
If I miss a dose, I should take two next time.
Do not double up. Take the next dose at the usual time and let your team know. Taking extra raises the risk of side effects without adding benefit.
Everyone who finishes chemotherapy gets these tablets.
It is offered to particular women, mainly with triple negative disease where cancer remained at surgery. Many people finishing chemotherapy do not need it at all.
At home
Habits that make a course easier to manage
Set reminders for both doses
Use a phone alarm or a written chart for the morning and evening doses, and tick each one off. It stops missed or doubled doses, which are easy mistakes over several months.
Look after your hands and feet daily
Moisturise several times a day, wear soft socks and comfortable shoes, and avoid hot water and tight rings. Starting from the first day works better than waiting for soreness.
Keep a short symptom diary
Note loose motions, soreness, mouth problems and tiredness each day. It makes your reviews quicker and helps your oncologist decide whether a dose adjustment is needed.
Keep your team's number close
Save it in your phone and write it on the tablet box. If you need to stop the tablets, you will want to reach someone quickly rather than search for the number.
Questions we are asked
Common questions about capecitabine
How long is a course?
Several months, made up of repeating cycles of tablet days followed by a break. Your oncologist sets the exact number of cycles and gives you a written schedule. Keep it somewhere you can check it easily.
What should I do about sore hands and feet?
Moisturise often from the first day, avoid heat and friction, and wear comfortable shoes. Report soreness early, because the dose can be adjusted. Stop and call if your hands or feet become too sore to use.
Do I take it with food?
Yes, usually within half an hour after a meal, morning and evening. Swallow the tablets whole with water and follow the exact instructions on your prescription.
Can I take other medicines with it?
Some medicines interact, including certain blood thinners. Give your team a full list of everything you take, including herbal and ayurvedic preparations, before you start.
Will I lose my hair?
Significant hair loss is uncommon with capecitabine alone, though some thinning can happen. Its more noticeable effects tend to be on the hands, feet and gut.
What if I miss a dose?
Do not take extra to make up for it. Take the next dose at the usual time and tell your team at your next check.
Can I keep working?
Many people can, especially since it is taken at home. Tiredness and sore hands or feet may affect some jobs. Talk to your team and employer about what is realistic for you.
Where can I read more about this drug?
Your oncology team will give you written information about capecitabine, including side effects and when to stop and call. Use that as your main reference.
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Sources
- Cancer Research UK — Capecitabine
- National Cancer Institute — Breast cancer treatment (PDQ)
- Breast Cancer Now — Capecitabine
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.