This leaflet provides information on Capecitabine and Tucatinib. The leaflet will explain what this is and when and how it is 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 capecitabine 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.
Your ‘specialist team’ refers to your oncology team at Velindre Cancer Centre which includes doctors, specialist nurses and non-medical independent prescribers which may be a nurse or a pharmacist.
What are capecitabine and tucatinib?
Capecitabine is a chemotherapy treatment which is given as tablets.
Tucatinib is an anti-cancer drug. It is not chemotherapy. It works by slowing down or stopping the cancer’s growth. Tucatinib is given as tablets which are usually taken daily.
These medications are given in combination with a medication called Trastuzumab that is given as an injection. You will receive another leaflet about that medication.
Why am I having capecitabine and tucatinib?
Your Team has prescribed capecitabine and tucatinib because it has been found to be effective in treating your type of cancer.
How often will I receive my capecitabine and tucatinib?
For capecitabine treatment to be most effective it will be given at specific time intervals. These are known as cycles. A cycle of capecitabine lasts for 3 weeks. During this 3 week period you will take the tablets twice a day for 14 days, and then have 7 days rest. The cycle may be repeated several times. Your Team will discuss with you the exact number of cycles you will receive.
Tucatinib should be taken every day without a rest.
How often will I see the specialist team?
You will be reviewed by your specialist team before each cycle. You will either see your specialist team in clinic or you will speak to them virtually.
You will have regular blood tests 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 satisfactory, your chemotherapy will be prescribed.
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 and tucatinib 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. The capecitabine tablets are taken for 14 days followed by a 7 day rest.
Tucatinib tablets should be taken twice a day (12 hours apart). The tablets can be taken with or without food. The tablets should be swallowed whole with a glass of water. They must not be chewed or crushed. The tucatinib tablets are taken for 21 days without a rest.
It is important that you wash your hands thoroughly after taking your tablets. You can take these tablets together.
How many tablets will I need to take?
Capecitabine: 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 may 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.
Tucatinib: It is usual to have TWO 150mg tablets TWICE a day for 21 days but this dose may be changed by your doctor. The amount you need to take will be clearly marked on the boxes.
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 and tucatinib 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 (below 30oC).
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 with capecitabine and tucatinib The doctors, nurses and pharmacy team can give you advice or answer any questions you may have.
Hair loss
Capecitabine and tucatinib should not make you lose your hair. However, a small number of people may experience some hair thinning. We have a leaflet that tells you more about coping with hair loss. Please ask if you would like a copy.
Sickness
Capecitabine and tucatinib can cause nausea and vomiting. 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.
Infection
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.
Diarrhoea
Capecitabine and tucatinib can cause 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 and tucatinib 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.
Sore mouth
Capecitabine and tucatinib may make your mouth 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 mouthwashes or medication to prevent or clear any infection.
If your mouth becomes very painful or you are finding it difficult to eat and drink, you should stop taking your capecitabine and tucatinib tablets and contact Velindre Cancer Centre for advice. The telephone number is at the end of the leaflet.
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.
Skin problems
Some patients will develop dry skin or a rash whilst taking capecitabine and tucatinib. 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 and tucatinib tablets and telephone Velindre Cancer Centre immediately for advice. The telephone number is at the end of the leaflet.
Heart problems
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 do 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.
Blood clots
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 at your next clinic appointment if this occurs.
Women sometimes find that chemotherapy treatment affects their periods. They could become heavier, lighter or even stop altogether.
It is important you do not become pregnant or father a child whilst having chemotherapy treatment as chemotherapy could damage the unborn baby.
Capecitabine 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 and tucatinib?
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 your 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.
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.
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
This information is also available in Welsh
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
cancer helpline
Prepared June 2022