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Oral chemotherapy

Capecitabine (Xeloda, Capegard, Xabine): The Oral Chemotherapy Tablet

Medically reviewed by Dr. Naresh Gundu, Medical Oncologist, MBBS (Chalmeda Anand Rao Institute of Medical Sciences, Karimnagar) · DNB Internal Medicine (Sir Gangaram Hospital, New Delhi) · DM Medical Oncology (AIIMS) · Last reviewed September 2026

Being handed a chemotherapy prescription to take at home can feel unsettling. Capecitabine works the same way as an intravenous drug called 5-FU — and its most distinctive side effect, hand-foot syndrome, is something you can catch early if you know what to look for.

Prescription-only medicine.

Capecitabine is a prescription-only medicine that must be prescribed and supervised by a specialist oncologist. It cannot be started, stopped, or adjusted based on anything read online or in this article. It is not suitable for everyone — see who this is not for below.

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In short

Capecitabine is an oral chemotherapy tablet that converts to 5-fluorouracil (5-FU) in the body — making it the tablet equivalent of a widely used intravenous drug. Its most distinctive side effect is hand-foot syndrome: redness, pain, and peeling on the palms and soles. It must be taken with food.

In detail

Is capecitabine the same as 5-FU?

Yes. Capecitabine is what is called a prodrug — after you swallow it, your body converts it into 5-fluorouracil (5-FU), the same active substance used in intravenous chemotherapy. The conversion happens mainly in tumour tissue, which means less of the active drug reaches healthy cells compared with a continuous IV drip.

The practical difference is delivery. A 5-FU regimen requires a hospital infusion, sometimes over many hours. Capecitabine is taken as a tablet at home, on a cycle your oncologist sets — typically a period of daily tablets followed by rest days.

Being a tablet does not make it a milder treatment. The side effects are real and need monitoring. Do not adjust the dose or skip tablets without speaking to your team.

In detail

Does capecitabine have to be taken with food?

Yes. Capecitabine must be taken with food or shortly after eating. Taking it on an empty stomach changes how it is absorbed into your system.

Swallow the tablets whole with a full glass of water — do not crush, break, or chew them. Your prescription card will state the exact timing and number of tablets for your dose.

If you vomit shortly after taking a dose, do not take a replacement — wait for the next scheduled dose and tell your team what happened.

Eligibility

Who should not take capecitabine?

Capecitabine is not suitable for everyone. Your oncologist decides eligibility based on your individual medical history, current medicines, and test results.

People with severely reduced kidney functionCapecitabine is processed by the kidneys, and severe impairment significantly raises the risk of toxicity.
Anyone with a confirmed deficiency of the enzyme DPD (dihydropyrimidine dehydrogenase), which the body needs to break down 5-fluorouracil safely. DPD testing may be carried out before treatment begins.
People who have had a severe allergic reaction to 5-fluorouracil (5-FU) or to capecitabine itself.
Those who are pregnant or breastfeedingCapecitabine can harm a developing baby.
People taking certain interacting medicines, particularly warfarin, without specialist review and close monitoring.

This list is not exhaustive. Eligibility is always decided by an oncologist on an individual basis.

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At a glance

What are the side effects of capecitabine?

Hand-foot syndromeRedness, warmth, swelling, and peeling on the palms and soles. The most distinctive side effect of capecitabine. Mild cases look like sunburn; severe cases cause blistering and pain that interferes with gripping or walking.

DiarrhoeaLoose motions that may start within the first few days of a cycle. Any clear increase from your usual pattern, blood in the stool, or inability to keep fluids down means call your team the same day — not your next appointment.

Mouth sores (mucositis)Soreness or small ulcers inside the mouth that make eating and drinking uncomfortable. Tell your team if eating becomes difficult or painful.

NauseaA feeling of sickness, most common in the first days of each cycle. Taking the tablet with food, as instructed, helps reduce it. Tell your team if nausea is severe or does not settle.

FatigueTiredness that goes beyond what rest relieves. Common with most chemotherapy. Plan rest into your day rather than pushing through.

Low blood countsCapecitabine can reduce white blood cells, red blood cells, and platelets. Your team will monitor this with regular blood tests. Fever, unusual bruising, or heavy bleeding needs same-day attention.

In detail

What does hand-foot syndrome feel like and what should you do?

Hand-foot syndrome — also called palmar-plantar erythrodysesthesia — begins as a warm, tight, or tingling feeling on the palms of your hands and the soles of your feet. The skin may look red, as though sunburned. Over days, without attention, it can progress to swelling, blistering, and peeling.

Keeping skin well moisturised from your first day of treatment helps slow this. Use a thick, unscented emollient on your hands and feet regularly. Avoid tight footwear, hot water, and anything that creates pressure or friction on the palms or soles.

Tell your team as soon as the skin begins to crack, blister, or peel, or if pain is interfering with walking or everyday tasks. Accurate grading is how your oncologist decides whether the dose needs adjusting. Do not wait for your next scheduled visit.

Question by question

Frequently asked questions

Which cancers is capecitabine used for?

Capecitabine is used most commonly in colorectal, breast, and gastric cancers, though it is also used in other tumour types. It is sometimes given alone and sometimes combined with other medicines or with radiation. Your oncologist can explain the specific reason it has been recommended for you and what it is intended to achieve in your situation.

What is the difference between Xeloda, Capegard, and Xabine?

All three are brand names for the same medicine — capecitabine — made by different manufacturers. Xeloda is made by Roche; Capegard and Xabine are Indian generic versions. The active molecule is identical. If your brand changes between cycles, tell your pharmacist so they can confirm the tablet strength matches what was previously prescribed.

How will I know if capecitabine is working?

Response is assessed through imaging — a CT scan or PET-CT — at intervals set by your oncologist, typically after a number of cycles. How you feel day to day is not a reliable guide, because some people experience side effects even when treatment is effective, and some feel relatively well when it is not. Ask your oncologist when the first assessment scan is planned.

How long will I be on capecitabine?

The duration depends on your cancer type, how you respond, and how well you tolerate the treatment. Some people receive a fixed number of cycles; others continue for as long as the treatment is controlling the disease. Ask your oncologist directly — knowing the plan and when it will be reviewed helps you and your family prepare for what comes next.

What if I cannot afford the full course?

Tell your oncologist or the hospital social worker before you miss a dose for financial reasons. Stopping without medical guidance is not safe. In India, manufacturer patient-assistance programmes and some government schemes offer subsidised access to capecitabine — your team may be able to connect you with these. Do not stop treatment without speaking to your team first.

Does sun exposure affect capecitabine?

Capecitabine can make your skin more sensitive to sunlight. Use a high-factor sunscreen on exposed skin, wear protective clothing, and limit direct sun during the hottest part of the day. If you already have hand-foot syndrome, sun on inflamed skin can worsen it. Ask your nurse whether there are specific precautions for your climate and the time of year.

Who would be treating you

The medical oncologists on the CION panel

Chemotherapy is prescribed, dosed and supervised by a medical oncologist. These are the six on the CION panel.

Dr. Naresh Gundu

Medical Oncologist

MBBS · DNB Internal Medicine (Sir Gangaram, New Delhi) · DM Medical Oncology (AIIMS)

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Dr. C. Raghavendra Reddy

Medical Oncologist

MBBS (Gold Medal) · DNB · DM (Medical Oncology, Gold Medal) · Kukatpally

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Dr. Bharati Devi Gorantla

Medical Oncologist

MBBS · MD · DM (Adyar, Chennai) · ECMO · MRCP SCE (UK)

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Dr. Owais Mohammed

Medical Oncologist

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Dr. T. Raghavender Reddy

Medical Oncologist

MBBS · DM (Medical Oncology) · MD (Radiation Oncology) · L.B. Nagar

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Dr. N. Kiranmayee

Medical Oncologist

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Which oncologist you see depends on the centre nearest you and on what your treatment involves. Tell us where you are and we will point you to the closest.

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Reading about a medicine is not the same as being told what to expect

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