Uses of Capetero 150

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Capetero 150 is an anti-cancer drug, a precursor of Fluorouracil, indicated in the treatment of breast cancer, colorectal cancer,... So when using Capetero 150, what should be noted to be effective and effective? safe? Let's learn about Capetero 150 in this article.

1. What is Capetero 150?

Capetero 150 is a product of Hetero Labs Limited, made in the form of film-coated tablets with the active ingredient Capecitabine, content 150mg. Capecitabine (which has no pharmacological effect) is converted to Fluorouracil (an anti-metabolite) by enzymes at higher concentrations in cancer tissue than in surrounding tissues and plasma. Capecitabine is converted to 5'-deoxy-5-fluorouridine in the liver and then to 5-fluorouracil in the tissues. It is thought that high concentrations of the active drug in the tumor may result in less systemic toxicity. Fluorouracil is metabolized to 5-fluoro-2'-deoxyuridine 5'-monophosphate (FdUMP) and 5-fluorouridine triphosphate (FUTP) in both healthy and cancer cells.
The mechanism of action of Fluorouracil is unknown, but the main mechanism may be that FdUMP (drug deoxyribonucleotid) and folate cofactor bind to thymidylate synthase (TS) to form a covalently linked tertiary complex. It inhibits the formation of thymidylate from 2'-deoxyuridylate, thereby interfering with DNA synthesis. In addition, FUTP can bind to RNA instead of uridine triphosphate, creating aberrant RNA that affects protein synthesis.
Fluorouracil acts on G1 and S phases during mitosis.

2. Indications of the drug Capetero 150

Capetero 150 is indicated in the following cases:
Colorectal cancer: Capetero 150 is indicated as a monotherapy agent for the adjuvant treatment of patients with Dukes'C colorectal cancer after surgery. resection of the entire primary tumor. In addition, Capetero 150 is also indicated in the first-line treatment of patients with metastatic rectal cancer. Breast cancer: Combination of Capetero 150 with Docetaxel in the treatment of patients with metastatic breast cancer after failure of chemotherapy with anthracycline. Capetero 150 monotherapy is indicated in the treatment of patients with metastatic breast cancer who have been resistant to both paclitaxel and anthracycline-containing regimens or are resistant to paclitaxel or in whom further anthracycline therapy is contraindicated.

3. Contraindications of Capetero 150

Do not use Capetero 150 in the following cases:
Patients with hypersensitivity to Fluorouracil, Capecitabine or to any component of the drug. Patients with dihydropyrimidine dehydrogenase (DPD) deficiency. Patients with severe renal impairment (creatinine clearance less than 30ml/min). Patient has severe thrombocytopenia/leukopenia/neutropenia. Patient is taking Sorivudin or similar drugs like Brivudin.

4. Dosage and usage of Capetero 150

How to use:
Take Capetero 150 whole tablets with water, drink 2 times a day (morning and evening), 30 minutes after eating. If administered concomitantly with Docetaxel, Capetero 150 should be taken prior to the Capetero 150 dose. Dosage is calculated based on body surface area and is presented in the following table:

Standard starting dose:
Monotherapy (metastatic colorectal cancer, adjuvant treatment of rectal cancer, metastatic breast cancer): The recommended dose of Capetero 150 is 1250 mg/m2, twice daily. (morning and evening) equivalent to a total dose of 2500 mg/m2/day in a 3-week cycle (2 weeks of medication – 1 week of rest). Adjuvant therapy in patients with Dukes'C colorectal cancer: Use Capetero 150 for 6 months (1 cycle 3 weeks, total 8 cycles). Combination with Docetaxel (metastatic breast cancer): The recommended dose of Capetero 150 is 1250mg/m2, twice daily (morning and evening) for 2 weeks, then 1 week off, in combination with docetaxel 75mg/m2 each Once every 3 weeks. No dose adjustment is necessary in patients with mild to moderate hepatic impairment. Patients with renal impairment: No dose reduction is required in patients with mild renal impairment; Reduce initial dose by 25% (to 950 mg/m2 twice daily) in moderate renal impairment. Closely monitor patients with mild or moderate renal impairment to avoid increased undesirable effects
Elderly patients: Capetero 150 dose may need to be reduced by 20%-25%.

5. Undesirable effects of the drug Capetero 150

When taking Capetero 150, patients may experience undesirable effects (ADRs) as follows:
Very common side effects (ADR frequency > 10/100)
Cardiovascular: Edema; Central nervous system: fever, pain, fatigue; Skin: dermatitis, hand-foot syndrome (dose dependent); Digestive system: stomatitis, decreased appetite, anorexia, diarrhea (dose dependent), nausea, vomiting, abdominal pain, constipation; Hematology: anemia, leukopenia, neutropenia, thrombocytopenia; Liver: Increased bilirubin; Musculoskeletal system: dysarthria; Eyes: Eye irritation; Respiratory: Difficulty breathing. Undesirable effects frequency 5/100 < ADR < 10/100
Cardiovascular system: chest pain, venous occlusion; Central nervous system: headache, dizziness, somnolence, insomnia , mood disorders, depression; Skin: hair loss, nail detachment, redness, discolouration, erythema; Endocrine - metabolic: Dehydration; Digestive system: Dry mouth, motility disturbances, dyspepsia, upper gastrointestinal tract inflammation (colorectal cancer), bleeding, small bowel inflammation, taste disturbances; Musculoskeletal system: myalgia, back pain, muscle fatigue, arthralgia, lower extremity pain, neuropathy; Eyes: conjunctivitis, visual disturbances; Respiratory: Cough; Other: Viral infection. Undesirable effects with ADR frequency < 5/100:
Stomach ulcer, gastroenteritis, bloody diarrhea, duodenitis, dysphagia, hemoptysis, liver failure, cirrhosis, hepatitis; Angina, ascites, asthma, atrial fibrillation, bradycardia; Bronchitis , pneumonia - bronchi, bronchospasm; Exhaustion, cardiac arrest, heart failure, cardiomyopathy, cerebrovascular accident, cholestasis; Blood clotting disorders, colitis, deep vein occlusion; Sweating, arrhythmia, ECG changes, brain disease; Nosebleeds, fungal infections, hypokalemia, hypomagnesaemia; Increased or decreased blood pressure, hypersensitivity; Hypertriglyceridemia, purpura due to thrombocytopenia; Intestinal paralysis, infection, intestinal obstruction; Conjunctivitis - cornea, narrowing of the tear duct; Leukopenia, loss of consciousness, lymphedema, multifocal white matter inflammation in the brain, myocardial ischemia; Necrotizing bowel obstruction, oral candidiasis, pericardial effusion; Purpura due to thrombocytopenia, decreased blood cells; Photoreaction, pneumonia, pruritus, pulmonary embolism, post-irradiation skin reaction syndrome; Renal failure, respiratory failure, increased sweating, sepsis; Skin ulceration, tachycardia, thrombophlebitis, rectal enlargement, acromegaly, ventricular extrasystoles.

6. Notes when using Capetero 150

Capetero 150 should be used under the supervision of a specialist experienced in the treatment of antineoplastic agents. Healthcare professionals should inform patients and families of the adverse events of Capetero 150, especially nausea, vomiting, diarrhea, hand-foot syndrome. The doctor should be informed when symptoms such as nocturnal bowel movements or increased bowel movements up to 4 - 6 times a day, nausea with anorexia, vomiting 2 - 5 times a day or more, flat feet red and painful hands, mouth pain, edema, fever, etc. Capetero 150 should be used with caution in the elderly (≥ 80 years) because of the increased risk of adverse drug reactions and the need for close supervision. Capetero 150 should be used with caution in patients with mild to moderate hepatic impairment due to liver metastases. Liver function should be regularly monitored during treatment. There are no data on the use of Capetero 150 in patients with severe hepatic impairment. Caution and a dose reduction should be made when administering Capetero 150 to patients with moderate renal impairment (creatinine clearance 30 to 50 mL/min according to the Cockroft-Gault formula). The drug should be discontinued if grade 2, 3, and 4 side effects are observed. Capetero 150 should be carefully monitored in patients with a history of coronary heart disease because adverse cardiovascular effects have occurred with the use of pyrimidine flour. chemical. If Capetero 150 is used in patients taking Coumarin anticoagulants, the prothrombin time or clotting time must be regularly determined in order to adjust the dose of the anticoagulant. Capetero 150 may cause dizziness, fatigue and nausea. Patients taking this medicine should exercise caution when driving or operating machinery. Contraindicated in pregnant women as it is not known whether capecitabine and its metabolites cross the placenta. Healthcare professionals should advise patients of reproductive age to use contraception during treatment with Capetero 150. If the patient becomes pregnant during therapy, the risk to the fetus must be clearly explained to the patient. It is not known whether Capecitabine and its metabolites pass into milk, so if Capetero 150 is used, breast-feeding should be discontinued.

7. Drug interactions

Capetero 150 interacts with the following drugs:
Anticoagulants: Concomitant use of Capecitabine with Coumarin-derivative anticoagulants such as Warfarin and Phenprocoumon may alter anticoagulation and/or bleeding indices. This interaction may be due to the inhibition of CYP P450 2C9 by capecitabine and/or its metabolites. Phenytoin: Monitor phenytoin levels closely, if necessary reduce the dose in patients receiving Capetero 150. This interaction may be due to capecitabine and/or its metabolites inhibition of CYP P450 2C9. Leucovorin: May increase the concentration of 5-fluorouracil and increase the toxicity of Capetero 150. Fatal cases of diarrhea, necrotizing enterocolitis or dehydration have been reported in elderly patients receiving concomitant Fluorouracil and Leucovorin. CYP2C9 Substrates: Apart from Warfarin, there have been no formal drug interaction studies between CYP2C9 and capecitabine substrates so far, so caution should be exercised when these drugs are co-administered. Food: Food reduces the extent of absorption of Capetero 150.

8. Preservation of drugs

Store Capetero 150 in a cool, dry place, the temperature is below 300C, protect from light, keep out of reach of children.
The article has provided information about the uses, doses and notes when using Capetero 150. To ensure safety for your health and maximize the effectiveness of your treatment, you need to take Capetero 150 exactly as directed by your doctor.

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