Cabita
Generic Name
Capecitabine
Manufacturer
ACI Limited
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| cabita 500 mg tablet | ৳ 110.00 | ৳ 770.00 |
Description
Overview of the medicine
Cabita 500 mg tablet contains Capecitabine, an oral antineoplastic agent used in the treatment of various cancers, including colorectal, breast, and gastric cancers. It works by targeting and inhibiting the growth of cancer cells.
Uses & Indications
Dosage
Adults
The usual starting dose is 1250 mg/m² administered twice daily (morning and evening) for 14 days, followed by a 7-day rest period, given as 3-week cycles. Dosing may be adjusted based on body surface area, indication, and toxicity.
Elderly
No specific dose adjustments are typically required for elderly patients, but careful monitoring for adverse effects is recommended. Dosing should be individualized.
Renal_impairment
Dose reduction is necessary for patients with moderate renal impairment (creatinine clearance 30-50 mL/min). Capecitabine is contraindicated in severe renal impairment (creatinine clearance <30 mL/min).
How to Take
Administer orally with water within 30 minutes after a meal. Tablets should be swallowed whole; do not crush or chew.
Mechanism of Action
Capecitabine is a fluoropyrimidine carbamate prodrug that is enzymatically activated to 5-fluorouracil (5-FU). 5-FU exerts its cytotoxic effects by being metabolized to active nucleotides that inhibit thymidylate synthase, leading to DNA synthesis inhibition, and by incorporating into RNA and DNA, leading to impaired cellular function and cell death.
Pharmacokinetics
Onset
Not directly applicable for antineoplastics in terms of immediate effect; therapeutic effects develop over weeks of treatment.
Excretion
Excreted primarily via the kidneys (approximately 95% of a dose, mainly as inactive metabolites in urine). Fecal excretion is minimal.
Half life
Capecitabine: approximately 0.5-1 hour. Its active metabolite (5-FU) has a short half-life of 8-20 minutes.
Absorption
Rapidly and extensively absorbed from the gastrointestinal tract. Peak plasma concentrations of capecitabine are reached within 0.5-1.5 hours. Bioavailability is generally good.
Metabolism
Undergoes extensive metabolism, primarily in the liver by carboxylesterase to 5'-deoxy-5-fluorocytidine (5'-DFCR), then to 5'-deoxy-5-fluorouridine (5'-DFUR) by cytidine deaminase. Finally, 5'-DFUR is converted to 5-FU by thymidine phosphorylase, predominantly in tumor cells.
Side Effects
Contraindications
- Severe hypersensitivity to capecitabine, 5-fluorouracil, or any excipients
- Severe renal impairment (creatinine clearance <30 mL/min)
- Known dihydropyrimidine dehydrogenase (DPD) deficiency
- Pregnancy and lactation
- Severe hepatic impairment
Drug Interactions
Phenytoin
Elevated phenytoin plasma concentrations, leading to toxicity. Monitor phenytoin levels carefully.
Leucovorin
May enhance the toxicity of capecitabine, particularly gastrointestinal toxicity.
Other fluoropyrimidines
Increased toxicity due to additive effects.
Warfarin and coumarin-derived anticoagulants
Increased INR and bleeding risk. Close monitoring of coagulation parameters is essential.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of acute overdose include nausea, vomiting, diarrhea, mucositis, gastrointestinal irritation and bleeding, and bone marrow depression. Management involves supportive care and symptomatic treatment.
Pregnancy & Lactation
Capecitabine is classified as Pregnancy Category D. It can cause fetal harm when administered to a pregnant woman. It is contraindicated during pregnancy and breastfeeding due to potential harm to the infant. Effective contraception should be used during treatment and for a period after treatment.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Usually 24 to 36 months from the date of manufacture.
Availability
Available in pharmacies, hospitals, and specialized oncology centers
Approval Status
Approved by regulatory authorities (e.g., FDA, DGDA)
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Capecitabine has been extensively studied in numerous clinical trials for its efficacy and safety in various cancer types. Key trials have demonstrated its role in adjuvant and metastatic settings for colorectal and breast cancer.
Lab Monitoring
- Complete Blood Count (CBC) with differential (before each cycle and weekly during first cycle)
- Liver function tests (LFTs) including bilirubin (before each cycle)
- Renal function tests (RFTs) including creatinine clearance (before each cycle)
- Electrolytes (if diarrhea is severe)
Doctor Notes
- Emphasize patient education on early recognition and management of hand-foot syndrome and diarrhea.
- Monitor CBC, LFTs, and RFTs rigorously before and during treatment cycles.
- Adjust dose based on patient tolerability and renal function.
- Counsel patients on the importance of adherence to dosing schedule and taking medication with food.
Patient Guidelines
- Take the medicine exactly as prescribed by your doctor.
- Swallow tablets whole with water within 30 minutes after a meal.
- Do not crush or chew the tablets.
- Report any severe side effects immediately to your doctor, especially severe diarrhea or hand-foot syndrome.
- Use effective contraception during and for a period after treatment.
Missed Dose Advice
If a dose is missed, the patient should not take the missed dose and should not double the next dose. They should continue with the next scheduled dose.
Driving Precautions
Capecitabine may cause dizziness, fatigue, or visual disturbances. Patients should be cautious when driving or operating machinery until they know how the medicine affects them.
Lifestyle Advice
- Maintain good hydration, especially if experiencing diarrhea.
- Keep hands and feet moisturized to help prevent hand-foot syndrome.
- Avoid prolonged exposure to sun.
- Practice good oral hygiene to minimize stomatitis.
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