Xeloda: What to Expect, Side Effects, and More
Xeloda (chemical name: capecitabine) is U.S. Food and Drug Administration (FDA)-approved to treat metastatic and advanced-stage breast cancer — typically when the cancer has stopped responding to Taxol, Taxotere, and Adriamycin.
See Xeloda prescribing information.
How Xeloda works
Xeloda is an antimetabolite chemotherapy drug taken orally (as a pill). Antimetabolites kill cancer cells by replacing certain compounds a cancer cell needs to grow, causing the cancer cell to die as it gets ready to divide.
Xeloda is in an inactive form when you take it. Your liver — and then enzymes in the cancer cells — convert it to its active cancer-fighting form, 5-fluorouracil. (Cancer cells contain high levels of an enzyme that converts Xeloda to this active state.) This two-step activation process means that a higher concentration of the medicine ends up in the cancer tissue, rather than in healthy tissue.
Xeloda is often used in combination with other anticancer medicines.
What to expect during Xeloda treatment
Take Xeloda by mouth as directed by your doctor — usually twice daily (about 12 hours between doses).
It’s taken for the first 14 days of a 21-day cycle.
The dosage your doctor prescribes is based on several factors, including your body size. Do not take a higher or lower dose than your prescription indicates.
Take the tablets whole, with water, within 30 minutes after you eat a meal. Do not crush, chew, or split Xeloda tablets.
If you vomit after taking a dose, don’t take another pill. Take your next dose 12 hours later, as usual.
Xeloda side effects
Like almost all breast cancer medicines, Xeloda can cause side effects, some of them severe.
The most common side effects of Xeloda are:
excessive water loss from the body (dehydration)
irregular periods — this can include temporary cessation (usually resume after medication is completed) or permanent cessation of menstrual periods depending on your age and other factors
People with a mutation in the DPYD gene have a much higher risk of severe, sometimes life-threatening, side effects from Xeloda. Researchers estimate that out of 1,000 people who take Xeloda, at least 20 might have a DPYD mutation.
The DPYD gene provides instructions for making an enzyme called dihydropyrimidine dehydrogenase (DPD), which is involved in the breakdown of molecules called uracil and thymine when they are not needed. People with a DPYD mutation may have complete or partial DPD deficiency.
It’s recommended that people with a DPYD mutation either take a lower dose of Xeloda or receive a different medicine. In 2020, the European Society for Medical Oncology (ESMO) recommended genetic testing for anyone prescribed Xeloda. In the United States, the National Comprehensive Cancer Network (NCCN) and the American Society of Clinical Oncology (ASCO) do not recommend testing for DPYD mutations.
In 2025, the FDA updated the product label to include a warning about the risks of administering Xeloda to people with DPD deficiency.
Some people with a DPYD mutation may have seizures, intellectual disabilities, and autistic behaviors that affect their ability to communicate. Other people have no signs or symptoms.
If Xeloda is part of your treatment plan, it’s a good idea to talk to your doctor about your family’s medical history and ask if DPYD testing makes sense for you.
Real patient reviews
Members of our community discuss their experiences with Xeloda in the community forum. Here are some of their comments. Remember, it's very important to talk to your doctor about any side effects you're having and ask about ways to manage them.
“I started Xeloda in August and am now on my fourth cycle. No hand and foot problems thus far. I use Lubriderm lotion — just a light coat in the morning. My worst side effect is loss of appetite and nausea that comes and goes. I'm never really hungry — have to force myself to eat so as not to lose weight.” —beckymd
“Celebrating the completion of my first seven-day Xeloda journey…. Feeling not too bad except experiencing exhaustion and fast heartbeat for the last two days.” —walkingintheclouds
“I am also taking Xeloda to prevent recurrence. My dosage is 2500-3000 mg per day, two weeks on, one week off for six cycles. I am actually on the last cycle now, gladly so far it has not been too problematic for me. I did have hand-foot syndrome for two–three weeks during previous cycles….” —stephilosphy00
Read more in our Xeloda discussion forum.
Paying for Xeloda
The cost of Xeloda may vary. The price you’ll pay depends on your health insurance provider and plan, where you live, and the pharmacy you use.
If you have trouble paying for Xeloda, ask your pharmacist about financial assistance programs that may be able to help.
Learn more about financial assistance and medicine cost-lowering tips.
— Last updated on March 29, 2025 at 3:49 PM
