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Capnat
Capnat Properties
About Capnat
Capnat (capecitabine) is an oral chemotherapy agent approved for the treatment of certain solid tumours, most notably metastatic breast cancer and metastatic colorectal cancer. It belongs to the class of antimetabolite drugs and is formulated as a 500 mg tablet that patients take by mouth. Capnat works by exploiting tumour-specific enzymatic pathways to convert the pro-drug into 5-fluorouracil (5-FU) directly within cancer cells, thereby limiting systemic exposure. In Singapore, the medication is available only with a prescription and is usually incorporated into combination regimens prescribed by oncologists.
What is Capnat?
Capnat is the brand name for the oral fluoropyrimidine pro-drug capecitabine. The product is manufactured by Lilly Oncology, a subsidiary of Eli Lilly and Company, and has been marketed internationally since the early -s. Capecitabine is classified as an antimetabolite chemotherapy; it interferes with DNA synthesis by mimicking the natural nucleobase pyrimidine. In Singapore, Capnat is listed on the Health Sciences Authority (HSA) register for the treatment of metastatic breast cancer and metastatic colorectal cancer after failure of prior therapies. Generic versions containing the same active ingredient are widely available and are bioequivalent to the branded tablet.
How Capnat Works
After ingestion, capecitabine is absorbed through the gastrointestinal tract and undergoes a three-step enzymatic conversion. First, hepatic carboxylesterases cleave the molecule to 5′-deoxy-5-fluorocytidine (5′-dFCR). Next, cytidine deaminase-present in many tissues-converts 5′-dFCR to 5′-deoxy-5-fluorouridine (5′-dFUR). The final step occurs preferentially within tumour cells, where thymidine phosphorylase (TP) catalyses the conversion of 5′-dFUR into the active chemotherapeutic 5-fluorouracil (5-FU). TP is markedly up-regulated in many solid tumours, providing a biochemical “switch” that concentrates 5-FU where it is most needed.
Once formed, 5-FU is incorporated into RNA and DNA, disrupting nucleic-acid metabolism. Incorporation into RNA impairs mRNA processing and protein synthesis, while conversion to fluorodeoxyuridine monophosphate (FdUMP) inhibits thymidylate synthase, a key enzyme for DNA replication. The combined effect halts tumour cell proliferation and triggers apoptosis.
Pharmacokinetically, capecitabine reaches peak plasma concentrations of its metabolites within 1-2 hours after a dose, and the half-life of 5-FU generated intracellularly is short, usually under 20 minutes. Renal excretion clears the majority of unchanged drug and metabolites, which explains the need for dose adjustment in patients with impaired kidney function.
Why Capnat Is Used for Cancer Treatment
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Metastatic Breast Cancer: Clinical trials demonstrated that capecitabine, given as a single agent or in combination with docetaxel, produces response rates comparable to intravenous 5-FU-based regimens while offering the convenience of oral administration. The drug’s activity is linked to its ability to generate high intra-tumour concentrations of 5-FU, exploiting the elevated TP levels typical of breast carcinoma tissue.
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Metastatic Colorectal Cancer: In the pivotal MOSAIC and X-ACT trials, capecitabine-based regimens achieved disease control rates similar to infusional 5-FU, with the added benefit of reduced hospital visits. TP overexpression in colorectal tumours enhances the conversion of capecitabine to 5-FU, making the oral route an effective alternative to continuous infusion protocols.
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Combination Therapy: Capnat is frequently paired with oxaliplatin (the “CAPOX” regimen) or with irinotecan (the “XELIRI” regimen). These combinations exploit synergistic mechanisms: oxaliplatin induces DNA cross-links that are less readily repaired when thymidylate synthase is inhibited by 5-FU metabolites, leading to greater tumour cell death.
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Patient Convenience: The oral formulation eliminates the need for indwelling catheters or infusion pumps, which reduces infection risk and improves quality of life. Studies have shown that patients receiving capecitabine report higher satisfaction scores regarding treatment convenience compared with intravenous fluoropyrimidines.
Off-Label and Investigational Uses of Capnat
Outside its approved indications, oncologists occasionally prescribe capecitabine for gastric, pancreatic, and oesophageal cancers, particularly when patients cannot tolerate intravenous 5-FU. Small phase II studies have reported objective response rates of 20-30 % in gastric cancer, suggesting a potential role in that setting. Additionally, capecitabine is being investigated as a radiosensitiser in conjunction with concurrent radiotherapy for locally advanced rectal cancer; early-phase data indicate improved tumour shrinkage without excessive toxicity.
Off-label use only under qualified healthcare provider supervision.
Is Capnat Right for You?
Capnant is best suited for adults with confirmed metastatic breast or colorectal carcinoma who have either progressed after standard first-line therapy or who prefer an oral regimen to avoid frequent clinic visits. Patients with severe renal impairment (creatinine clearance < 30 mL/min) or known hypersensitivity to fluoropyrimidines should not receive the drug. Those carrying dihydropyrimidine dehydrogenase (DPD) deficiency are at heightened risk of severe toxicity because they cannot metabolise 5-FU efficiently.
Elderly patients can be treated safely provided dose adjustments are made according to renal function and performance status. Pregnant or breastfeeding women are excluded because capecitabine is teratogenic in animal studies. In Singapore, the HSA requires a physician’s assessment of liver function, as hepatic impairment may also necessitate dose modification.
Taking Capnat Effectively
Capnat tablets are usually taken twice daily, preferably within 30 minutes after a meal to minimise gastrointestinal irritation. Consistency in timing helps maintain steady plasma levels of the active metabolites. Skipping a dose should be avoided; if a dose is missed, it is advisable to take it as soon as remembered, provided the next scheduled dose is still at least 12 hours away. Doubling up to compensate for a missed dose increases the risk of severe toxicity and should be avoided.
Patients should stay well hydrated and maintain a balanced diet, as dehydration can exacerbate hand-foot syndrome, a common side effect. Alcohol consumption does not directly interact with capecitabine but should be limited to reduce additional liver stress. For those travelling, a portable pill organizer and written schedule can help sustain adherence across time zones.
Understanding Side Effects and How to Manage Them
The toxicity profile of capecitabine stems largely from the systemic exposure to 5-FU. Hand-foot syndrome-characterised by redness, swelling, and painful peeling of the palms and soles-arises from accumulation of the drug in rapidly dividing skin cells. Early intervention with emollient creams, dose reductions, or temporary treatment breaks often alleviates symptoms. Diarrhoea reflects mucosal irritation in the gastrointestinal tract; patients should adopt a low-residue diet, stay hydrated, and use antidiarrhoeal agents such as loperamide at the first sign of loose stools.
Myelosuppression-a reduction in white blood cells, neutrophils, or platelets-occurs because bone-marrow progenitors are also targeted by 5-FU. Routine blood counts are essential; if neutropenia becomes severe (absolute neutrophil count < 500 µL), physicians may delay the next cycle or prescribe growth-factor support.
Rare but serious adverse events include cardiotoxicity (chest pain, arrhythmias) and severe mucositis. Any sudden chest discomfort, palpitations, or bleeding gums should prompt immediate medical evaluation. Most side effects are manageable with dose adjustments, supportive care, and close monitoring by the oncology team.
Buying Capnat from Our Online Pharmacy
Why Choose Our Service?
Our platform connects you with licensed international pharmacies that stock Capnat at prices close to the manufacturer’s wholesale cost. By eliminating unnecessary middle-man mark-ups, we make an essential cancer medication more affordable for Singaporean patients facing high out-of-pocket expenses.
Quality & Safety
We partner exclusively with pharmacies that operate under stringent regulatory frameworks recognized by the World Health Organization and the Singapore Health Sciences Authority. Every batch of Capnat is verified for authenticity, potency, and proper packaging before shipment.
Pricing & Access
Because Capnat is available as a generic in many jurisdictions, we can offer a cost reduction of up to 40 % compared with local retail prices. For patients who cannot obtain the medication through traditional channels, we also provide alternatives such as generic capecitabine from reputable manufacturers, ensuring continuity of care.
Discreet Delivery
Orders are shipped in unmarked, tamper-evident packaging with bubble-wrap protection. Standard airmail arrives within three to four weeks, while express delivery typically reaches Singapore in 5-7 days. Your privacy is protected at every step.
Frequently Asked Questions
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How long does it take to see a tumour response after starting Capnat? Radiological assessments are usually performed after two to three treatment cycles (approximately 6-9 weeks). Some patients experience symptom relief earlier, but objective tumour shrinkage is best documented with imaging.
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Can Capnat be taken with other oral medications? Concomitant use of drugs that affect the cytochrome P450 system, particularly strong inhibitors or inducers, may alter capecitabine metabolism. Always inform your oncologist about any additional medicines, including over-the-counter supplements.
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Is it safe to drink coffee while on Capnat? Moderate caffeine intake does not interfere with capecitabine’s action. However, excessive caffeine may exacerbate dehydration, which can increase the risk of hand-foot syndrome.
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What should I do if I develop a low-grade fever? A fever may signal infection stemming from neutropenia. Contact your healthcare provider promptly; they may order a complete blood count and decide whether to postpone the next dose.
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Does taking Capnat affect fertility? Chemotherapy agents, including capecitabine, can impair spermatogenesis temporarily. Men planning to father children should discuss sperm banking before initiating treatment.
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Are there dietary restrictions while on Capnat? No specific foods are prohibited, but a high-fiber diet can help mitigate diarrhoea. Avoid raw or undercooked meats and eggs to reduce infection risk when immune function is compromised.
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Can Capnat be used after surgery for colorectal cancer? In the adjuvant setting, capecitabine (often combined with oxaliplatin) is approved to reduce recurrence risk following curative resection. This usage follows a defined postoperative schedule.
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Why do some patients experience yellowing of the skin? Mild jaundice may develop if liver enzymes rise during treatment. Regular liver function tests allow early detection; dose adjustments are made if elevations are significant.
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Is there a risk of developing resistance to Capnat? Tumour cells can up-regulate thymidylate synthase or down-regulate thymidine phosphorylase, diminishing drug activation. Switching to a different fluoropyrimidine or adding targeted agents can overcome resistance in some cases.
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How does Capnat compare with intravenous 5-FU? Oral capecitabine achieves comparable systemic exposure to continuous 5-FU infusion but offers greater convenience and fewer infusion-related complications. Some studies suggest slightly higher rates of hand-foot syndrome with the oral regimen.
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Can I pause treatment if side effects become intolerable? Temporary treatment breaks are common practice. Your oncologist can schedule a dose reduction or a brief interruption, then resume at a lower dose once side effects subside.
Glossary
- Thymidine phosphorylase
- An enzyme that converts capecitabine’s intermediate 5′-deoxy-5-fluorouridine into 5-fluorouracil, preferentially expressed in many tumour tissues.
- Dihydropyrimidine dehydrogenase (DPD)
- The key enzyme responsible for breaking down 5-fluorouracil; deficiency leads to severe, sometimes life-threatening toxicity when fluoropyrimidines are administered.
- Hand-foot syndrome
- A dermatologic toxicity marked by redness, swelling, and painful peeling of the palms and soles, caused by accumulation of fluoropyrimidine metabolites in the skin.
- Thymidylate synthase
- An enzyme essential for DNA synthesis; inhibition by 5-FU metabolites disrupts the production of thymidine nucleotides, halting cell division.
- Pharmacokinetics
- The study of how a drug is absorbed, distributed, metabolised, and excreted by the body; determines onset, duration, and dosing intervals.
Disclaimer
The information provided about Capnat is for general knowledge only. It does not replace professional medical consultation. All treatment decisions, including those regarding off-label use, should be made under the supervision of a qualified healthcare provider. We assume all readers are responsible adults capable of making informed decisions about their health. Our online pharmacy offers access to Capnat for individuals who may have limited availability through traditional pharmacies, prescription-based insurance schemes, or who are seeking affordable generic alternatives. Always consult your doctor before starting, changing, or discontinuing any medication.
