This leaflet provides information on a course of chemotherapy called oxaliplatin and capecitabine. It will explain what this is and when and how it will be given. It will also tell you about common side effects that you may experience. Contact telephone numbers and details of how to obtain further information on this chemotherapy are given at the end of the leaflet.
This leaflet should be read alongside the ‘General information for patients receiving chemotherapy’ folder. If you haven’t received this folder please ask your nurse for a copy.
What is oxaliplatin and capecitabine chemotherapy?
This is a course of treatment which consists of two drugs:
Why am I having this chemotherapy?
Your doctor has prescribed this chemotherapy because it has been found to be effective in treating your type of cancer.
How will my chemotherapy be given?
The oxaliplatin will be given through a drip connected to a small needle which is placed in your hand or arm. Alternatively it may be suggested that a fine tube called a PICC line is inserted into one of the large veins in your upper arm. This line can remain in place for the whole of your treatment. Your doctor will explain this to you in more detail. We also have a leaflet that tells you more about PICC lines.
The capecitabine is given as tablets.
How often will I have my chemotherapy?
For this treatment to be most effective it is given at specific time intervals. These are known as cycles.
This treatment may be given in two ways. Your doctor or nurse will explain how your treatment will be given.
Two weekly treatment
In each 2 week cycle you will be given oxaliplatin once. The capecitabine tablets are taken twice a day for 9 days, starting on the same day as the oxaliplatin. This is followed by a rest from treatment for 5 days.
Three weekly treatment
In each 3 week cycle you will be given oxaliplatin once. The capecitabine tablets are taken twice a day for 14 days, starting on the same day as the oxaliplatin. This is followed by a rest from treatment for 7 days.
In each 3 week cycle you will be given oxaliplatin once. The capecitabine tablets are taken twice a day for 21 days, starting on the same day as the oxaliplatin.
How often will I need to visit the hospital?
You will have 2 appointments for each treatment cycle:
Outpatient clinic appointment – you will have blood samples taken and we will check how you are feeling and discuss any problems you may have. This is so we can check how the chemotherapy is affecting you. If your blood results are ok, your chemotherapy will be prescribed. This appointment is usually a few days before your chemotherapy appointment.
Chemotherapy appointment – you will spend approximately 3 hours on one of the day case treatment areas. Please allow up to an hour longer for your first visit. You will be given anti sickness medication and your oxaliplatin chemotherapy. We will give you a supply of capecitabine tablets to take home.
Can I bring relatives and friends with me?
You are welcome to bring someone to stay with you during your treatment. Space is limited so there is not usually room for more than one person. Treatment areas are not suitable for young children.
How should I take the capecitabine tablets?
Capecitabine tablets should be taken twice a day (9-12 hours apart), You should take the tablets within 30 minutes of finishing your meal. The tablets should be swallowed whole with a glass of water. They must not be chewed or crushed
It is important that you wash your hands thoroughly after taking your tablets.
How many tablets will I need to take?
This will vary for each person. There are 2 different strength tablets which are different sizes. The bigger tablets are 500mg and the smaller tablets are 150mg. You will probably have to take a combination of big and small tablets. The amount you need to take will be clearly marked on the boxes. Remember to check each box to see how many tablets you need to take.
What should I do if I forget to take my tablets?
Do not take the extra tablets when your treatment should have finished. It is important that even if you have missed any doses you should finish the treatment at the planned time.
What if I take too many tablets?
Please contact Velindre Cancer Centre immediately for advice. The telephone number is at the end of the leaflet.
How should I store my capecitabine tablets?
You should store your tablets in their original packaging in a safe place away from children. They should be kept in a cool dry place.
Any unused tablets should be returned to the hospital pharmacy or your local chemist for safe disposal.
What are the possible side effects?
There are a number of possible side effects which can occur. The doctors, nurses and pharmacy team can give you advice or answer any questions you may have.
You should not lose your hair with this chemotherapy. However, some patients experience some hair thinning.
Nausea and vomiting are uncommon these days as we will give you anti-sickness medicines which are usually extremely effective. If you are sick more than once in 24 hours despite taking regular anti-sickness medicine, stop taking your capecitabine tablets and contact Velindre Cancer Centre for advice. The telephone number is at the end of the leaflet.
You are at an increased risk of picking up infections because your white blood cells which help fight infections can be reduced by this treatment.
If you develop an infection whilst your white blood cells are low, you are at risk of sepsis, this can be life threatening.
Contact Velindre Cancer Centre immediately if you develop any signs of infection, for example flu like symptoms or a temperature above 37.5°centigrade or if your temperature is below 35.5°. The telephone number is at the end of the leaflet.
You may have diarrhoea. If this occurs it is important that you drink plenty of fluids. We will give you medication to take if you get diarrhoea.
You should stop taking your capecitabine tablets and contact Velindre Cancer Centre immediately if:
You should also contact us if you have any problems with diarrhoea or an increase in bowel movements which lasts for more than 3 days.
Tiredness and fatigue
Chemotherapy can make you feel more tired than usual. It is important to listen to your body and rest if you need to, but carry out your normal activities if you feel able. Some people find it beneficial to take gentle exercise as well as rest.
Your mouth may become sore or you may notice small ulcers. Please follow the advice on caring for your mouth in the general chemotherapy leaflet. Your doctor may prescribe mouthwash or medication to prevent or clear any infection.
If your mouth becomes very painful, or you find it difficult to eat and drink, you should stop taking your capecitabine tablets and contact Velindre Cancer Centre for advice. The telephone number is on page 11.
Soreness to your hands and feet
You may experience mild pain, redness and swelling of your hands or feet. If this occurs we recommend using a non perfumed cream or lotion regularly. Please contact Velindre Cancer Centre if your hands or feet become painful. The telephone number is at the end of the leaflet.
Some patients will develop dry skin or a rash. Usually this can be easily treated with some non perfumed cream or lotion. Very rarely this rash can be severe. If you have a rash with blisters or is painful you should stop taking your capecitabine tablets and telephone Velindre Cancer Centre immediately for advice. The telephone number is at the end of the leaflet.
Very rarely some people having capecitabine chemotherapy experience heart problems. If you have a heart condition or you take any heart medication, please tell your doctor before you start chemotherapy.
If you have any chest pain you should stop taking your capecitabine tablets and seek urgent medical attention. Do not start taking your capecitabine again until you have spoken to the team at Velindre.
When oxaliplatin is given as a drip, some patients experience discomfort along the vein. This can occur at the time of treatment and may last for several days afterwards. Please tell your nurse if this occurs during your treatment. If it occurs when you’re at home try taking whatever painkillers you normally take for a headache. Contact Velindre Cancer Centre if you’re concerned. The telephone number is at the end of the leaflet.
This problem can be prevented by having a PICC line inserted. If you would like more information please speak to your nurse or doctor.
Nerve damage in your hands and feet
Oxaliplatin may cause tingling or numbness in your fingers or toes. 85 – 95% of people experience this to some degree. This is often triggered by exposure to cold, for example when you open the fridge or hold a cold drink. It may make it difficult for you to do up buttons or pick up small objects.
This usually lasts for no more than 7 days in between treatments. If the tingling or numbness does not go away between treatments there is a risk that this may become permanent. It is important that if you have this problem and if it lasts longer than 7 days please tell us at your next clinic appointment.
Unpleasant feeling in your throat
Oxaliplatin causes an unpleasant sensation in the throat in a small number of patients. This may result in a feeling of tightness in the throat or not being able to catch your breath. This will occur at the time of treatment or within a few hours. It may be brought on by cold so avoid ice-cold drinks for 24 hours after treatment.
We recommend that you wait for 20-30 minutes after your treatment before leaving the hospital. You should not drive yourself home and in cold weather we recommend your friend or relative heat the car before you get into it.
Please tell your nurse if you experience this whilst having your treatment. If it occurs after you leave the hospital please contact Velindre Cancer Centre immediately. The telephone number is on page 11.
If this happens, try to relax, breathe out through your mouth and in through your nose. Try to move to a warmer area and try a warm drink. This sensation should pass quickly. It is best to relax.We recommend that you wait for 20 - 30 minutes after your treatment before leaving the hospital. You should not drive yourself home. In cold weather we recommend your friend or relative heat the car before you get into it.
Allergic type reaction
A small number of patients experience an allergic type reaction. If this occurs you may feel hot or flushed, itchy, light-headed or generally unwell whilst receiving your treatment. This can be easily treated. Please tell your nurse immediately if you experience any of the above symptoms.
A diagnosis of cancer can increase your risk of developing a blood clot (thrombosis), and having cancer treatment may increase this risk further. It is important to tell your doctor immediately if you have symptoms such as pain, redness and swelling in your leg, or breathlessness and chest pain.
Blood clots can be very serious. However, most clots can usually be successfully treated with drugs to thin the blood. Your doctor or nurse can give you more information
Other side effects
Some patients experience sore or watery eyes. Please tell your doctor or nurse if this occurs.
A small number of patients experience jaw stiffness in the first few days after the oxaliplatin. Usually this only lasts for a few days. If this occurs please tell us at your next clinic visit.
Rarely patients may experience difficulty with their speech and/or movement of their arms and legs, immediately after, or a few hours after the infusion. If this happens we may keep you for observation on the unit; if you have left the hospital you will need to telephone the chemotherapy pager immediately.
Women sometimes find that chemotherapy affects their periods. They could become heavier, lighter or even stop.
It is important you do not become pregnant or father a child whilst having chemotherapy as it could damage the unborn baby.
This chemotherapy can increase your skin’s sensitivity to the sun. It is best to avoid strong sunlight and wear a hat and use a sun block when in the sun.
Is it alright to take other medicines with capecitabine?
Please tell your doctor, nurse or pharmacist if you take other medicines. There are a small number of medicines that you may have to avoid. Please tell you doctor, nurse or pharmacist if you take warfarin tablets.
Sometimes cancer drugs can have very serious side effects which rarely can be life threatening. It is important to inform Velindre cancer centre if you are concerned about any side-effects.
Manufacturer’s patient information leaflets
Velindre leaflets provide information about very common and commonly reported side-effects (we are unable to list all of the common side effects), for more information regarding these and the less common side-effects please refer to the manufacturers patient information leaflets, obtained from Velindre pharmacy and/or on the internet at www.medicines.org.uk. Sometimes patients may find these leaflets difficult to read however. Please ask if you would like a copy from your doctor or from Velindre pharmacy
Contact telephone numbers
Velindre Cancer Centre 029 2061 5888
Ask for the treatment helpline if you are unwell at home and need immediate attention at any time of the day or night. For example you should phone if you:
Pharmacy department 029 2061 5888 ext 6223
Monday – Friday 9am – 5pm for queries about your medicines
Macmillan freephone Helpline 0808 808 0000
Tenovus freephone 0808 808 1010
This information is also available in Welsh
This leaflet was written by health professionals. The information contained in this leaflet is evidence based. It has been approved by doctors, nurses and patients. It is reviewed and updated every 2 years.
Reviewed January 2016