Buy Xeloda
Xeloda
Xeloda Properties
About Xeloda
Xeloda is a prescription-only oral chemotherapy pill that delivers the active agent 5-fluorouracil (5-FU) to tumor cells after metabolic activation. Approved by Singapore’s Health Sciences Authority (HSA), Xeloda is indicated for metastatic colorectal cancer, gastric cancer, and breast cancer that has progressed after prior therapy. The drug contains the pro-drug capecitabine, which is absorbed in the gastrointestinal tract and converted step-wise to 5-FU, a fluoropyrimidine that interferes with DNA synthesis. Clinicians select Xeloda when a convenient oral regimen is preferred over intravenous 5-FU, and when patients meet specific disease-stage criteria. Off-label investigations have explored its use in pancreatic and pancreatic neuroendocrine tumors, but such applications remain experimental in Singapore.
What is Xeloda?
Xeloda is the brand name for the oral fluoropyrimidine capecitabine, manufactured by Roche. The medication belongs to the antimetabolite class of chemotherapeutic agents. In Singapore, Xeloda received HSA approval in 2001 for metastatic colorectal cancer and later for gastric and breast cancer indications. As a pro-drug, capecitabine is designed to generate high concentrations of 5-fluorouracil preferentially within tumor tissue, taking advantage of the elevated activity of thymidine phosphorylase in malignant cells. The typical adult dose is 1,250 mg/m² taken twice daily for two weeks followed by a one-week rest period, although a 500 mg tablet is commonly prescribed for dose adjustments or combination regimens. Because Xeloda is a prescription medication, it is dispensed only through licensed pharmacies and requires close monitoring by an oncologist.
How Xeloda Works
Capecitabine is absorbed intact from the small intestine and undergoes a three-step enzymatic conversion. First, hepatic carboxylesterase cleaves the drug to 5′-deoxy-5-fluorocytidine (5′-DFCR). Second, cytidine deaminase, present in the liver and tumor microenvironment, converts 5′-DFCR to 5′-deoxy-5-fluorouridine (5′-DFUR). Finally, thymidine phosphorylase-an enzyme over-expressed in many solid tumors-transforms 5′-DFUR into the active metabolite 5-fluorouracil (5-FU). Once formed, 5-FU inhibits thymidylate synthase, preventing the synthesis of thymidine monophosphate, a nucleotide essential for DNA replication. It also incorporates into RNA, disrupting transcription and protein synthesis. By concentrating 5-FU within malignant cells, Xeloda maximizes cytotoxicity while limiting systemic exposure, which partly explains the observed response rates of 30-40 % in metastatic colorectal cancer and 20-30 % in advanced breast cancer in phase III trials. The drug’s half-life is approximately 45 minutes for capecitabine itself, but the active metabolite 5-FU persists long enough to exert sustained antiproliferative effects.
Why Xeloda Is Used for Cancer Treatment Conditions
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Metastatic colorectal cancer
- Mechanistic rationale: Tumors of the colon often over-express thymidine phosphorylase, enhancing local conversion of capecitabine to 5-FU.
- Guideline position: Listed as a first-line option in the NCCN and ESMO guidelines when combined with oxaliplatin (CAPOX regimen).
- Comparative advantage: Oral administration avoids the need for central venous access required for continuous 5-FU infusion.
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Her2-negative metastatic breast cancer
- Mechanistic rationale: 5-FU interferes with DNA synthesis in rapidly dividing breast cancer cells, and capecitabine’s tumor-selective activation reduces systemic toxicity.
- Guideline position: Recommended after failure of anthracycline- and taxane-based regimens, often in combination with docetaxel (XL-DOC) or as monotherapy.
- Comparative advantage: Demonstrated comparable overall survival to intravenous 5-FU with improved patient convenience.
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Advanced gastric or gastro-oesophageal junction adenocarcinoma
- Mechanistic rationale: High thymidine phosphorylase activity in gastric tumors supports efficient pro-drug activation.
- Guideline position: Used in the peri-operative or metastatic setting, frequently combined with cisplatin (XP regimen).
- Comparative advantage: Provides a non-intravenous alternative that maintains efficacy while reducing infusion-related complications.
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Adjuvant therapy for stage III colorectal cancer (in selected patients)
- Mechanistic rationale: Post-surgical eradication of microscopic disease relies on sustained antimetabolite exposure.
- Guideline position: Considered an option when patients cannot tolerate intravenous 5-FU or when compliance with oral therapy can be assured.
Off-Label and Investigational Uses of Xeloda
Clinical trials have examined capecitabine in pancreatic adenocarcinoma, cholangiocarcinoma, and certain neuroendocrine tumors, showing modest activity but lacking robust approval in Singapore. Small phase II studies reported a 15-20 % partial response rate in refractory pancreatic cancer when capecitabine was combined with gemcitabine. Investigators have also explored its use as radiosensitizer in locally advanced rectal cancer, where pre-operative capecitabine-based chemoradiation achieved pathological complete response rates of 12-18 %. Off-label use should only be considered under the supervision of a qualified healthcare provider.
Is Xeloda Right for You?
Xeloda is appropriate for adults with confirmed metastatic or advanced solid tumours that have demonstrated sensitivity to fluoropyrimidines. Ideal candidates have adequate renal function (creatinine clearance ≥ 50 mL/min) and hepatic function (bilirubin ≤ 1.5 × ULN). Elderly patients can receive reduced dosing, often starting at 60-75 % of the standard dose, while maintaining efficacy. Xeloda is contraindicated in patients with known dihydropyrimidine dehydrogenase (DPD) deficiency, as they are at high risk for severe toxicity. Pregnant or breastfeeding women should avoid the drug because capecitabine is embryotoxic and can be excreted in breast milk. Patients with severe cardiac disease should be monitored closely, as fluoropyrimidines can precipitate coronary vasospasm. In practice, the decision to prescribe Xeloda integrates disease stage, prior treatment exposure, patient preference for oral therapy, and the ability to adhere to the cyclical dosing schedule.
Taking Xeloda Effectively
Xeloda tablets are taken within 30 minutes after a meal to improve gastrointestinal tolerance and reduce the risk of severe hand-foot syndrome. The standard regimen consists of 1,250 mg/m² (usually two 500 mg tablets per dose) taken twice daily for 14 days, followed by a 7-day drug-free interval. Patients should maintain consistent meal times to achieve stable plasma concentrations. If a dose is missed, it should be taken as soon as remembered unless the next scheduled dose is within 4 hours; in that case, skip the missed dose to avoid double-dosing. Hydration is essential-drinking at least 2 L of fluid daily helps mitigate renal toxicity. Alcohol should be limited, as concurrent use can exacerbate gastrointestinal side effects. For travel, patients can request a supply sufficient for the entire treatment cycle, and carry a physician’s letter confirming the indication, as some countries restrict import of chemotherapy agents.
Understanding Side Effects and How to Manage Them
Common adverse events-hand-foot syndrome, diarrhea, and mucositis-stem from 5-FU’s effect on rapidly dividing epithelial cells. Hand-foot syndrome presents as redness, swelling, or peeling on the palms and soles; mitigation includes using moisturising creams, avoiding tight shoes, and limiting friction. Loperamide at 2 mg initially, followed by 2 mg after each loose stool, can control diarrhea; however, patients should seek medical attention if stools exceed seven per day or contain blood. Mouth soreness benefits from gentle oral hygiene, bland soft foods, and saline rinses. Myelosuppression (neutropenia, thrombocytopenia) reflects bone-marrow sensitivity to antimetabolites; regular full-blood counts every two weeks are mandatory, and dose reductions are applied when grade 3-4 cytopenias occur. Rare but serious toxicities-cardiotoxicity and severe electrolyte disturbances-require immediate evaluation. Prompt reporting of any new or worsening symptom allows clinicians to adjust dosing or provide supportive care, preserving treatment efficacy while safeguarding safety.
Buying Xeloda from Our Online Pharmacy
Accessing Xeloda can be challenging in regions where oncology pharmacy inventories are limited. Our online pharmacy offers a streamlined pathway to obtain the medication through licensed international partners, ensuring compliance with Singapore’s HSA regulations.
Why Choose Our Service?
- Convenient ordering - Fill your prescription from the comfort of home and have it dispatched directly to your address.
- Expert verification - Our pharmacist team cross-checks dosage, indication, and patient eligibility before shipment, reducing the risk of errors.
Quality & Safety
We partner with WHO-certified suppliers and operate under strict Good Distribution Practice (GDP) standards, guaranteeing that every Xeloda batch meets potency and purity specifications established by Roche and approved by regulatory authorities.
Pricing & Access
Generic capecitabine alternatives are often priced lower, but Xeloda’s brand formulation provides a consistent bioavailability profile that some clinicians prefer for complex regimens. Our service negotiates competitive pricing, and registered patients enjoy a Lifetime 10 % discount on all reorders.
Discreet Delivery
Orders are packaged in unmarked, tamper-evident boxes. Standard shipping arrives within three weeks, while express delivery reaches you in about seven days, both with tracking numbers for full visibility.
Frequently Asked Questions
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How long does it take for Xeloda to start working? Clinical studies show radiographic tumor shrinkage typically appears after two to three treatment cycles (6-9 weeks), although symptomatic improvement may be noticed earlier.
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Can Xeloda be combined with targeted therapies? Yes. In metastatic colorectal cancer, Xeloda is often paired with bevacizumab or cetuximab, provided the patient’s RAS status is compatible. Combination regimens are supported by phase III trials showing improved progression-free survival.
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Is dose adjustment needed for patients with renal impairment? Patients with creatinine clearance < 50 mL/min require a 25-30 % dose reduction, and renal function should be monitored before each cycle.
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What dietary restrictions should I follow? Taking Xeloda with a high-fat meal can increase absorption, potentially heightening toxicity. A balanced meal with moderate protein and low-fat content is recommended for each dose.
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Why do I experience hand-foot syndrome, and can it be prevented? The syndrome arises from 5-FU-induced damage to the capillary endothelium of the skin. Preventive measures include regular moisturising, avoiding excessive pressure on the feet, and using cooling packs during dosing days.
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Will Xeloda affect my fertility? Capecitabine can cause temporary azoospermia in men and ovarian dysfunction in women. Patients desiring future children should discuss sperm banking or ovarian preservation before initiating therapy.
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Can I continue other medications while on Xeloda? Certain drugs-especially those metabolised by CYP3A4 (e.g., warfarin, certain statins)-may interact with capecitabine. Your oncologist should review all concomitant medications to adjust doses or substitute safer alternatives.
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Is there a risk of developing resistance to Xeloda? Tumor cells may up-regulate thymidine phosphorylase inhibitors or down-regulate the enzyme itself, diminishing conversion to 5-FU. Switching to alternative fluoropyrimidine regimens or adding targeted agents can overcome resistance in many cases.
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How is treatment response monitored? Imaging (CT or MRI) every 8-12 weeks, tumor markers (e.g., CEA for colorectal cancer), and clinical assessment of symptom relief are standard. Lack of response after two cycles usually prompts a regimen change.
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Can I take Xeloda during pregnancy? Capecitabine is classified as Pregnancy Category D; it poses a significant risk of fetal harm and is contraindicated. Women of child-bearing potential must use effective contraception throughout treatment and for at least three months after the last dose.
Glossary
- Thymidine phosphorylase
- An enzyme over-expressed in many solid tumours that converts the capecitabine metabolite 5′-DFUR into the active chemotherapeutic 5-fluorouracil.
- Hand-foot syndrome
- A dose-limiting dermatologic toxicity characterised by redness, swelling, and peeling of the palms and soles, caused by capecitabine’s effect on rapidly dividing skin cells.
- Bioavailability
- The proportion of an administered drug that reaches systemic circulation unchanged; Xeloda’s oral formulation is designed for high bioavailability of capecitabine.
- Dihydropyrimidine dehydrogenase (DPD) deficiency
- A genetic enzymatic defect that impairs breakdown of fluoropyrimidines, leading to severe, potentially fatal toxicity when capecitabine is administered.
Disclaimer
The information provided about Xeloda 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 Xeloda 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.
