Introduction

Capcitab 500 mg (Capecitabine) is a powerful oral chemotherapeutic agent manufactured by Eskayef Pharmaceuticals Ltd, a leading pharmaceutical company in Bangladesh with over 31 years of experience in providing world-class medications. As a trusted anti-cancer medication supplier, Orio Pharma offers this high-quality product with worldwide delivery within 3-7 working days, ensuring patients receive timely access to this essential cancer treatment.

Understanding Capcitab (Capecitabine)

Capcitab contains Capecitabine, an innovative orally-administered chemotherapeutic agent classified as a nucleoside metabolic inhibitor with potent antineoplastic properties. What sets this medication apart is its unique mechanism as a prodrug that undergoes enzymatic conversion to fluorouracil directly in tumor tissues, where it effectively inhibits DNA synthesis and slows cancer cell growth.

This targeted approach allows Capcitab to deliver its cytotoxic effects precisely where needed, as the conversion is facilitated by thymidine phosphorylase—an enzyme found in significantly higher concentrations in many tumors compared to normal tissues or plasma.

How Capcitab Works Against Cancer

The exceptional efficacy of Capcitab stems from its sophisticated dual mechanism of action:

1. DNA Synthesis Inhibition: Once converted to fluorouracil, it metabolizes to 5-fluoro-2′-deoxyuridine 5-monophosphate (FdUMP), which binds with thymidylate synthase and folate cofactor to form a ternary complex. This binding prevents thymidylate formation—an essential precursor for DNA synthesis—effectively halting cancer cell division.
2. RNA Processing Disruption: The second active metabolite, 5-fluorouridine triphosphate (FUTP), interferes with RNA processing by being mistakenly incorporated during RNA synthesis. This metabolic error disrupts protein synthesis through the production of fraudulent RNA, further compromising cancer cell function.

Key Therapeutic Indications

Capcitab 500 mg is clinically indicated for multiple cancer types:

• Adjuvant Colon Cancer Treatment: For patients diagnosed with Dukes’ C colon cancer, providing a crucial therapy option following surgical intervention.
• Metastatic Colorectal Cancer: Recommended as first-line monotherapy when fluoropyrimidine therapy alone is the preferred treatment approach.
• Metastatic Breast Cancer: Effective in combination with docetaxel after failure of prior anthracycline-containing therapy, or as monotherapy for patients resistant to both paclitaxel and anthracycline-containing regimens.

Dosage & Administration Guidelines

Capcitab offers a convenient oral administration route, with specific dosing regimens based on the cancer type and treatment approach:

• Standard Monotherapy: 1250 mg/m² twice daily for 2 weeks, followed by a one-week rest period in 3-week cycles.
• Adjuvant Treatment: Recommended for a total duration of 6 months (8 complete cycles).
• Combination Therapy with Docetaxel: 1250 mg/m² twice daily for 2 weeks, followed by a 7-day rest period, combined with docetaxel (75 mg/m² as a 1-hour IV infusion every 3 weeks).

For patients with moderate renal impairment, dosage reduction of 25% is essential for safety. Capcitab tablets should be taken within 30 minutes after meals (breakfast and dinner) and swallowed whole with water for optimal absorption and efficacy.

Important Medical Considerations

Drug Interactions

Capcitab interacts with several medications, requiring careful monitoring:

• Anticoagulants: Regular monitoring of INR or prothrombin time is crucial for patients on concomitant anticoagulant therapy.
• Phenytoin: When used together with Capcitab, phenytoin levels should be monitored with possible dose adjustments.
• Leucovorin: May increase 5-fluorouracil concentration, potentially enhancing toxicity.
• CYP2C9 Substrates: Special caution is advised when co-administering with CYP2C9 substrates.
• Food: Can reduce both rate and extent of Capcitab absorption.

Contraindications

Capcitab is contraindicated in:

• Severe renal impairment
• Hypersensitivity to components
• Patients with leucopenia, neutropenia, or thrombocytopenia
• Those with severe reactions to previous fluoropyrimidine therapy
• Complete dihydropyrimidine dehydrogenase (DPD) deficiency
• Pregnant women or breastfeeding mothers

Pregnancy & Lactation

Capcitab carries Pregnancy Category D classification, indicating potential harm to the fetus. Women should be advised of these risks before starting treatment. Breastfeeding should be discontinued during treatment and for 2 weeks after the final dose, as the presence of Capcitab in breast milk and its potential impact on nursing infants remains unknown.

Safety Profile & Precautions

Healthcare providers must be vigilant about several important safety considerations:

• Coagulopathy: Regular monitoring of anticoagulant response is essential to prevent bleeding complications.
• Diarrhea Management: Treatment should be immediately interrupted for diarrhea until resolved or decreased to grade 1, with standard antidiarrheal treatments recommended.
• Cardiotoxicity: More common in patients with prior coronary artery disease history.
• DPD Deficiency: Patients showing signs of acute early-onset or unusually severe toxicity may have DPD deficiency, requiring dose modification or discontinuation.
• Dehydration and Renal Failure: Treatment should be stopped until dehydration is corrected to prevent acute renal failure.
• Dermatologic Toxicity: Severe reactions including Stevens-Johnson Syndrome require immediate and permanent discontinuation. Hand-and-foot syndrome may necessitate treatment interruption until resolved.
• Hyperbilirubinemia: Requires immediate treatment interruption until resolved or decreased in intensity.
• Hematologic Parameters: Treatment should not be initiated in patients with neutrophil counts <1.5×10⁹/L or thrombocyte counts <100×10⁹/L.

Common Side Effects

Patients should be monitored for:

• Gastrointestinal effects: Abdominal pain, diarrhea, vomiting, nausea, stomatitis
• Dermatological reactions: Rash, dry or itchy skin, hand-and-foot skin reaction
• Systemic effects: Fatigue, loss of appetite, fever
• Serious conditions: Infection, chest pain, Stevens-Johnson syndrome

Quality Assurance

Capcitab 500 mg is manufactured by Eskayef Pharmaceuticals Ltd., a renowned pharmaceutical company committed to maintaining the highest standards of quality and excellence. As a subsidiary of Transcom Group, Eskayef has established itself as an epitome of premium quality through providing world-class medicines across Bangladesh and worldwide for over three decades.

Storage Recommendations

For optimal potency and safety, Capcitab should be:

• Kept in a dry place
• Stored below 30°C
• Protected from light
• Kept out of reach of children

Why Choose Orio Pharma as Your Supplier

Orio Pharma, established in June 2019, specializes in anti-cancer and oncology medications with a mission to improve the lives of cancer patients worldwide. Our commitment to quality, integrity, innovation, and compassionate care makes us a trusted partner for healthcare professionals and patients alike. With our efficient worldwide delivery system, we ensure that life-saving medications reach patients promptly, typically within 3-7 working days after ordering.

For more information about Capcitab 500 mg or to place an order, please visit www.oriopharma.com or contact our dedicated customer service team today.