Capecitastad 500mg filmomhulde tabletten

Capecitabine belongs to the group of medicines called "cytostatic agents", which stop the growth of cancer cells. Capecitabine contains 150 mg or 500 mg capecitabine, which itself is not a cytostatic agent. Only after being absorbed by the body is it changed into an active anti-cancer agent (more in tumour tissue than in normal tissue).

Capecitabine is prescribed by doctors for the treatment of colon, rectal, gastric, or breast cancers. Furthermore, Capecitabine is prescribed by doctors to prevent new occurrence of colon cancer after complete removal of the tumour by surgery.

Capecitabine may be used either alone or in combination with other agents.

DO NOT take Capecitabine

• if you are allergic (hypersensitive) to capecitabine or any of the other ingredients of Capecitabine. You must inform your doctor if you know that you have an allergy or over-reaction to Capecitabine

• if you are pregnant or nursing
• if you have blood disorders
• if you have liver ailments or kidney problems
• if you have a known deficiency for the enzyme dihydropyrimidine dehydrogenase (DPD), or
• if you are being treated now or have been treated in the last 4 weeks with brivudine, sorivudine or similar classes of substance as part of herpes zoster (chickenpox or shingles) therapy.

Take special care with Capecitabine

Before treatment with Capecitabine, make sure your doctor knows if you

• have liver or kidney diseases
• have or had other illnesses, such as heart problems or chest pain
• have brain diseases
• have calcium imbalances
• have diabetes

Taking other medicines

Before starting treatment, please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription. This is extremely important, as taking more than one medicine at the same time can strengthen or weaken the effect of the medicines. You need to be particularly careful if you are taking any of the following:

• gout medicines (allopurinol)
• blood-thinning medicines (coumarin, warfarin)
• certain anti-viral medicines (sorivudine and brivudine) or
• medicines for seizures or tremors (phenytoin).

Taking Capecitabine with food and drink

You should take Capecitabine no later than 30 minutes after meals.

Pregnancy and breast-feeding

Before starting treatment, you must tell your doctor if you are pregnant, if you think you are pregnant or if you intend to become pregnant. You should not take Capecitabine if you are pregnant or think you might be.

You should not breast-feed if you are taking Capecitabine.

Ask your doctor or pharmacist for advice before taking any medicine.

Driving and using machines

Capecitabine may make you feel dizzy, nauseous or tired. It is therefore possible that Capecitabine could affect your ability to drive a car or operate machinery.

Important information about some of the ingredients of Capecitabine

This medicinal product contains lactose. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product.

Method of administration

Capecitabine tablets should be swallowed with water.

Dosage

Your doctor will prescribe a dose and treatment regimen that is right for you. The dose of Capecitabine is based on your body surface area. This is calculated from your height and weight. The usual dose for adults is 1250 mg/m2 of body surface area taken two times daily (morning and evening).

Two examples are provided here: A person whose body weight is 64 kg and height is 1.64 m has a body surface area of 1.7 m2 and should take 4 tablets of 500 mg and 1 tablet of 150 mg two times daily. A person whose body weight is 80 kg and height is 1.80 m has a body surface area of 2.00 m2 and should take 5 tablets of 500 mg two times daily.

Duration of treatment

Capecitabine tablets are usually taken for 14 days followed by a 7 day rest period (when no tablets are taken). This 21 day period is one treatment cycle.

In combination with other agents the usual dose for adults may be less than 1250 mg/m2 of body surface area, and you may need to take the tablets over a different time period (e.g. every day, with no rest period).

Your doctor will tell you what dose you need to take, when to take it and for how long you need to take it.

Your doctor may want you to take a combination of 150 mg and 500 mg tablets for each dose.

• Take the tablets in the combination prescribed by your doctor for your morning and evening doses.
• Take the tablets within 30 minutes after the end of a meal (breakfast and dinner).
• It is important that you take all your medication as prescribed by your doctor.

If you take more Capecitabine than you should

Contact your doctor before taking the next dose.

If you forget to take Capecitabine

Do not take the missed dose at all and do not double the next one. Instead, continue your regular dosing schedule and check with your doctor.

If you stop taking Capecitabine

There are no side-effects caused by stopping treatment with Capecitabine. In case you are using coumarin anticoagulants (e.g. phenprocoumon), stopping Capecitabine might require that your doctor adjusts your anticoagulant dose.

If you have any further questions on the use of this product, ask your doctor or pharmacist.

Like all medicines, Capecitabine can cause side effects, although not everybody gets them.

When Capecitabine is used alone, the most common side effects which may affect more than 1 person in 10 are:

• diarrhoea, feeling sick (nausea), vomiting, stomatitis (sores in mouth and throat) and abdominal pain
• hand-and-foot skin-reaction (palms of the hands or soles of the feet tingle, become numb, painful, swollen or red), rash, dry or itchy skin
• tiredness
• loss of appetite (anorexia)

These side effects can become severe; therefore, it is important that you always contact your doctor immediately when you start to experience a side effect. Your doctor may instruct you to decrease the dose and/or temporarily discontinue treatment with Capecitabine. This will help reduce the likelihood that the side effect continues or becomes severe.

STOP taking Capecitabine immediately and contact your doctor if any of these symptoms occur:

• Diarrhoea: if you have an increase of 4 or more bowel movements compared to your normal bowel movements each day or any diarrhoea at night.
• Vomiting: if you vomit more than once in a 24-hour time period.
• Feeling sick (nausea): if you lose your appetite, and the amount of food you eat each day is much less than usual.
• Stomatitis: if you have pain, redness, swelling or sores in your mouth.
• Hand-and-foot skin-reaction: if you have pain, swelling, and redness of hands and/or feet

• Fever or Infection: if you have a temperature of 38°C or greater, or other signs of infection.
• Chest pain: if you experience pain localised to the centre of the chest, especially if it occurs during exercise.

If caught early, these side effects usually improve within 2 to 3 days after treatment discontinuation. If these side effects continue, however, contact your doctor immediately. Your doctor may instruct you to restart treatment at a lower dose.

Other less common and usually mild side-effects which may affect between 1 and 10 people in 100 have been seen: decreases in the number of white blood cells or red blood cells, skin rashes, slight hair loss, weariness, fever, weakness, drowsiness, headache, numbness or tingling sensations, taste changes, dizziness, sleeplessness, swelling in the legs, constipation, dehydration, cold sores, inflammation of the nose and throat, chest infection, depression, problems with the eyes, inflammation of the veins (thrombophlebitis), shortness of breath, nose bleeds, cough, runny nose, bleeding from the gut, heartburn, excess wind, dry mouth, skin discolouration, nail disorder, pain in the joints, chest or back and loss of weight.

If you are concerned about these or any other unexpected effect(s), talk to your doctor. If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.

Keep out of the reach and sight of children

Do not store above 30°C

Do not use Capecitabine after the expiry date which is stated on the outer pack and label.

Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.

What Capecitabine contains

Capecitabine 150 mg film-coated tablets

The active substance is capecitabine (150 mg per film-coated tablet).

Capecitabine 500 mg film-coated tablets

The active substance is capecitabine (500 mg per film-coated tablet).

The other ingredients are:

Tablet core: anhydrous lactose, croscarmellose sodium, hypromellose, microcrystalline cellulose, magnesium stearate.

Tablet coating: hypromellose, titanium dioxide (E171), yellow and red iron oxide (E172), talc.

What Capecitabine looks like and contents of the pack

Capecitabine 150 mg film-coated tablets

Light peach coloured, oblong shaped, biconvex, film-coated tablets, debossed with “150” on one side and plain on other side.

Capecitabine 150 mg film-coated tablet pack contains 30, 60, 120, 180, 240 film-coated tablets

Capecitabine 500 mg film-coated tablets

Peach coloured, oblong shaped, biconvex, film-coated tablets, debossed with “500” on one side and plain on other side.

Capecitabine 500 mg film-coated tablet pack contains 60, 120, 180, 240 film- coated tablets

Marketing Authorisation Holder and Manufacturer

STADA Arzneimittel AG

Stadastrasse 2-18,

61118 Bad Vilbel

Germany

MARKETING AUTHORISATION NUMBER(S)

Capecitastad 150mg filmomhulde tabletten RVG 109391

Capecitastad 500mg filmomhulde tabletten RVG 109392

This medicinal product is authorised in the Member States of the EEA under the following names:

<{Name of the Member State}> <{Name of the medicinal product}> <{Name of the Member State}> <{Name of the medicinal product}>

This leaflet was last approved in maart 2012.