Xeloda

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2023-12-15 07:39

Xeloda: instructions for use and reviews

1. Release form and composition
2. Pharmacological properties
3. Indications for use
4. Contraindications
5. Method of application and dosage
6. Side effects
7. Overdose
8. Special instructions
9. Application during pregnancy and lactation
10. Use in childhood
11. For violations of liver function
12. In case of impaired renal function
13. Use in the elderly
14. Drug interactions
15. Analogs
16. Terms and conditions of storage
17. Terms of dispensing from pharmacies
18. Reviews
19. Price in pharmacies

Latin name: Xeloda

ATX code: L01BC06

Active ingredient: capecitabine (capecitabine)

Manufacturer: F. Hoffmann-La Roche Ltd, Switzerland

Description and photo update: 2019-13-08

Prices in pharmacies: from 10,310 rubles.

Buy

Xeloda is a drug with an antitumor effect.

Release form and composition

Xeloda is available in the form of film-coated tablets: oblong, biconvex, “XELODA” engraved on one side; 150 mg each - light milky pink (light peach) color, engraving on the other side of the tablet - "150"; 500 mg - milky pink (peach) color, engraving on the other side of the tablet - "500" (in blisters of 10 pcs., 6 or 12 blisters in a cardboard box; in polyethylene bottles of 60 or 120 pcs., 1 each bottle in a cardboard box).

The composition of 1 tablet includes:

Active ingredient: capecitabine - 150 or 500 mg;
Auxiliary components (150/500 mg, respectively): magnesium stearate - 2.7 / 9 mg, lactose - 15.6 / 52 mg, microcrystalline cellulose - 7.2 / 24 mg, hypromellose (3 mPa.s) - 4.5 / 15 mg, croscarmellose sodium - 6/20 mg;
Sheath (150/500 mg, respectively): Opadry pink 03A14309 / Opadry pink 03A14309 (talc, hypromellose (6 mPa.s), titanium dioxide (E171), dye iron oxide yellow (E172), dye iron oxide red (E172)) - 8.5 / 18 mg.

Pharmacological properties

Pharmacodynamics

Capecitabine is a fluoropyrimidine carbamate derivative and an oral cytostatic agent. This substance is activated in the tumor tissue and has a selective cytotoxic effect on it.

In vitro, capecitabine has no cytotoxic effect, but in vivo it is converted to fluorouracil (FU), which undergoes further metabolism.

Fluorouracil is formed mainly in tumor tissue under the action of thymidine phosphorylase (tumor angiogenic factor), which minimizes the systemic effect of this substance on healthy tissues of the body.

With the sequential enzymatic biotransformation of capecitabine into FU, higher concentrations of the drug are created in the tumor tissues (in comparison with the surrounding healthy tissues). After oral administration of capecitabine in colorectal cancer patients (N = 8), the concentration of FU in tumor tissue was 3.2 times higher than that in adjacent healthy tissues (range, 0.9 to 8).

The ratio of FU concentration in plasma and healthy tissues is 8.9 (range is from 3 to 25.8), concentration in plasma and tumor tissue is 21.4 (range is from 3.9 to 59.9). In a primary colorectal tumor, the activity of thymidine phosphorylase is 4 times higher than that in adjacent healthy tissues.

In tumor cells of patients with colorectal cancer, as well as cancer of the stomach, ovaries, cervix and breast, there is a higher content of thymidine phosphorylase, which is capable of converting 5'-DFUR (5'-deoxy-5-fluoruridine) into FU than in the corresponding healthy tissues.

Healthy and tumor cells metabolize FU to 5-fluoruridine triphosphate and 5-fluoro-2-deoxyuridine monophosphate. These metabolites are capable of damaging cells through two different mechanisms:

nuclear transcriptional enzymes during the synthesis of RNA may mistakenly include 5-fluoruridine triphosphate instead of uridine triphosphate. This metabolic "mistake" leads to disruption of RNA processing and protein synthesis;
folate cofactor N5-10-methylenetetrahydrofolate and 5-fluoro-2-deoxyuridine monophosphate can bind to thymidylate synthase and form a covalently linked tertiary complex. The result of this process is the suppression of the formation of thymidylate, an essential precursor of thymidine triphosphate. In turn, thymidine triphosphate is extremely important for DNA synthesis, therefore, a lack of this substance can cause inhibition of cell division.

Pharmacokinetics

Suction

When taken orally, capecitabine is absorbed quickly and completely and is transformed into the metabolites 5'-DFUR and 5'-DFCT (5'-deoxy-5-fluorocytidine). When the substance is taken with food, the rate of its absorption decreases, however, the AUC of 5'-DFUR and the next FU metabolite changes insignificantly.

In the case of taking capecitabine at a dose of 1250 mg / m ² after meals on the 14th day, _{Cmax of} capecitabine, FU, FBAL, 5'-DFCT and 5'-DFUR were 4.47, respectively; 0.95; 5.46; 3.05 and 12.1 μg / ml. To reach the maximum concentration, it took 1.5, respectively; 2; 3.34; 2 and 2 hours. AUC0-∞ was 7.75, respectively; 2.03; 36.3; 7.24 and 24.6 μg x h / ml.

Protein binding

In an in vitro study in human blood plasma, it was found that for capecitabine, FU, 5'-DFCT and 5'-DFUR, the bond with proteins is 54, 10, 10 and 62%, respectively.

Metabolism

The primary metabolism of capecitabine occurs under the influence of carboxylesterase in the liver to the metabolite 5'-DFCT. Under the action of cytidine deaminase, which is mainly found in the liver and tumor tissues, 5'-DFCT is transformed into 5'-DFUR. Subsequently, the transformation to an active cytotoxic metabolite of FU occurs mainly in the tumor tissue under the action of thymidine phosphorylase (tumor angiogenic factor).

AUC for FU in plasma is 6–22 times less than for intravenous bolus administration of FU at a dose of 600 mg / m ². The cytotoxicity of capecitabine metabolites appears only when converted to FU and FU metabolites.

Further FU is catabolized with the formation of inactive metabolites: FUN2 (dihydro-5-fluorouracil), α-fluoro-β-alanine (FBAL) and 5-fluoroureidopropionic acid (FUPA). This process occurs under the influence of DPD (dihydropyrimidine dehydrogenase), the activity of which determines the reaction rate.

Withdrawal

The half-life of capecitabine, FU, FBAL, 5'-DPCR and 5'-DFUR from the body is 0.85; 0.76; 3.23; 1.11 and 0.66 hours, respectively.

The pharmacokinetics of capecitabine was studied at doses of 502-3514 mg / m ² per day. The pharmacokinetic parameters of capecitabine, 5'-DFUR and 5'-DFCT on the 1st and 14th days were the same. AUC FU increased by the 14th day by 30–35% and did not increase any more (22nd day). For therapeutic doses, the pharmacokinetic parameters of capecitabine and its metabolites (except for FU) are dose-dependent.

When capecitabine is taken orally, its metabolites are mainly excreted in the urine. Almost the entire dose of capecitabine taken (95.5%) is excreted in the urine. With feces, approximately 2.6% is excreted. The main metabolite in the urine is FBAL (it accounts for 57% of the dose taken). Approximately 3% of the dose taken is excreted unchanged in the urine.

Combination therapy

No effect of capecitabine on the C _max and AUC of docetaxel or paclitaxel, as well as the effect of these substances on the pharmacokinetics of 5'-DFUR, was not found.

Special clinical groups

Gender, the patient's general condition index, the presence or absence of liver metastases before the start of therapy, the concentration of serum albumin, total bilirubin, ALT and ACT activity did not have a statistically significant effect on the pharmacokinetic properties of FU, 5'-DFUR, and FBAL.

Patients with liver failure on the background of metastatic liver damage

In patients with mild to moderate metastatic liver dysfunction, there are no clinically significant changes in the bioactivation and pharmacokinetics of capecitabine. No pharmacokinetic information is available in patients with severe hepatic impairment.

Patients with impaired renal function

Pharmacokinetic studies have shown that with varying degrees of renal failure, there is no dependence of the pharmacokinetics of the unchanged drug and FU on creatinine clearance (CC). However, CC has an effect on the value of AUC 5'-DFUR (with a decrease in CC by 50%, AUC increases by 35%) and FBAL (with a decrease in CC by 50%, AUC increases by 114%).

Elderly patients

The pharmacokinetics of FU and 5'-DFUR do not change with age. At the same time, an increase in FBAL AUC is observed in elderly patients: an increase in patients' age by 20% causes an increase in FBAL AUC by 15%. Probably, the reason for this fact is the change in kidney function.

Race

The pharmacokinetics of capecitabine in Caucasians do not differ from those in Negroid patients.

Indications for use

Breast cancer (metastatic or locally advanced): monotherapy for cancer that is resistant to chemotherapy with taxanes or anthracycline drugs, or if there are contraindications to their use; combined treatment with docetaxel in case of ineffectiveness of chemotherapy, including an anthracycline drug;
Stomach cancer: first-line therapy for advanced stomach cancer;
Colorectal cancer: therapy for metastatic colorectal cancer; adjuvant treatment of stage III colon cancer after surgery.

Contraindications

Absolute:

Diagnosed deficiency of DPD (dihydropyrimidine dehydrogenase);
Initial platelet count <100 × 10 ⁹ / l and / or neutrophils <1.5 × 10 ⁹ / l;
Severe renal failure (with creatinine clearance below 30 ml per minute);
The presence of contraindications to one of the drugs in the combination treatment;
Simultaneous use with sorivudine and its structural analogues such as brivudine;
Pregnancy and lactation;
Children's age (for this group of patients, there are no data on the safety and efficacy of Xeloda);
Hypersensitivity to fluorouracil or the presence of anamnestic data on the development of unexpected or severe side effects during treatment with fluoropyrimidine derivatives;
Hypersensitivity to drug components.

Relative (Xeloda is prescribed with caution):

Cardiac ischemia;
Renal failure of moderate severity;
Liver failure;
Lactose intolerance, hereditary lactase deficiency, glucose-galactose malabsorption;
Combined use with oral coumarin anticoagulants;
Age from 60 years.

Instructions for the use of Xeloda: method and dosage

Xeloda should be taken orally with water, preferably no later than half an hour after a meal.

When conducting monotherapy for colorectal cancer, breast cancer and colon cancer, Xeloda is usually prescribed 2 times a day (in the morning and evening) at 1250 mg / m ² (2500 mg / m ² per day). 14 days of taking the drug alternate with a 7-day break.

Along with other drugs, the following dosage regimen of Xeloda is prescribed:

Breast cancer: 2 times a day at 1250 mg / m ^{2 (} 14 days of taking the drug alternate with a 7-day break) simultaneously with docetaxel (intravenous infusion for 1 hour 75 mg / m ² once every 21 days). Premedication is indicated before the administration of docetaxel;
Colorectal cancer and stomach cancer: 2 times a day at 800-1000 mg / m ² for 14 days, followed by a 7-day break, or continuously at 625 mg / m ² 2 times a day. The use of immunobiological drugs has no effect on the Xeloda dose. Before the administration of oxaliplatin and cisplatin, premedication and antiemetic drugs are prescribed to ensure adequate hydration. The recommended duration of the course of adjuvant therapy for stage III colon cancer is 6 months (8 courses).

Recommended schemes for using Xeloda as part of a combination treatment:

Combination with cisplatin: Xeloda - 2 times a day at 1000 mg / m ² (14 days of taking the drug alternate with a 7-day break), the first dose is prescribed in the evening on the first day of the therapy cycle, the last - in the morning on the fifteenth day. Cisplatin - once every 21 days at 80 mg / m ² as an intravenous infusion for 2 hours, the first infusion is carried out on the first day of the cycle;
Combination with bevacizumab and / or oxaliplatin: Xeloda - 2 times a day at 1000 mg / m ² (14 days of taking the drug alternate with a 7-day break), the first dose is prescribed in the evening on the first day of the therapy cycle, the last one in the morning on the fifteenth day. Bevacizumab - once every 21 days at 7.5 mg / kg as an intravenous infusion for 30-90 minutes, the first infusion is performed on the first day of the cycle. Oxaliplatin - 130 mg / m ² as an intravenous infusion for 2 hours, the drug is administered after bevacizumab;
Combination with epirubicin and platinum preparation: Xeloda - continuously 2 times a day at 625 mg / m ². Epirubicin - 1 time in 21 days, 50 mg / m ² intravenous bolus, starting from the first day of the cycle. Platinum preparation - 1 time in 21 days 130 mg / m ² oxaliplatin or 60 mg / m ² cisplatin in the form of intravenous infusion for 2 hours, the first dose is prescribed on the first day of the cycle;
Combination with irinotecan: Xeloda - 2 times a day at 1000 mg / m ² (14 days of taking the drug alternate with a 7-day break). Irinotecan - once every 21 days at 250 mg / m ² as an intravenous infusion for 30 minutes, the first infusion is prescribed on the first day of the cycle;
Combination with bevacizumab and irinotecan: Xeloda - 2 times a day, 800 mg / m ² (14 days of taking the drug alternate with a 7-day break). Irinotecan - once every 21 days, 200 mg / m ² as an intravenous infusion for 30 minutes, the first infusion is prescribed on the first day of the cycle. Bevacizumab - once every 21 days at 7.5 mg / kg as an intravenous infusion for 30-90 minutes, the first infusion is prescribed on the first day of the cycle.

The toxic effect of Xeloda can be eliminated by symptomatic treatment and / or by adjusting the dose of the drug (by interrupting the course or reducing the dose). After reducing the dose, you cannot increase it in the future.

In cases where the toxic effect does not pose a serious threat to the patient's life, therapy can be continued at the initial dose or without interrupting the course (therapy is interrupted in case of grade 2 and 3 toxicity). With the disappearance of symptoms of toxicity, or its decrease to 1 degree, treatment with the drug can be resumed in full dose or its correction can be carried out.

If signs of grade 4 toxicity occur, therapy should be canceled or temporarily interrupted until symptoms decrease or stop to grade 1, then Xeloda can be resumed at 1/2 of the initial dose.

If undesirable phenomena develop, the attending physician should be notified of this. If moderate or severe toxicity occurs, you should immediately stop taking Xeloda.

In the case of the appointment of a combination treatment, while waiting for a delay in the use of one of the drugs, therapy should not be started.

If, during the combination therapy, toxicity is observed that, in the doctor's opinion, is not associated with taking Xeloda, the drug that caused the disorder is corrected without changing the dose of Xeloda.

With metastases in the liver and moderate or mild functional disorders of the liver, a change in the initial dose is not required, while such patients need careful observation. The safety and efficacy of the drug in severe hepatic impairment have not been studied.

It is recommended to reduce the initial dose to 75% of 1250 mg / m ² with an initial moderate renal failure (with creatinine clearance of 30-50 ml per minute). With mild renal failure (with creatinine clearance 51-80 ml per minute), the initial dose should not be adjusted.

It should be borne in mind that in old and senile age, severe adverse events of grade 3 and 4 usually develop more often than in young patients. In this regard, patients in this age group require careful monitoring.

With simultaneous use with docetaxel in patients over 60 years old, an increase in the incidence of grade 3 and 4 adverse events was noted. For this group of patients, the initial dose of Xeloda is recommended to be reduced to 75% (2 times a day at 950 mg / m ²).

When combined with irinotecan, it is recommended to reduce the initial dose of Xeloda to 800 mg / m ² 2 times a day in patients aged 65 and over.

Side effects

During the use of Xeloda, disorders may develop from various systems of the body, manifested with different frequencies: ≥1 / 10 - very often, from ≥1 / 100 to <1/10 - often, from ≥1 / 1000 to <1/100 - infrequently.

Side effects during monotherapy:

Nervous system: often - paresthesia, dizziness (except for vertigo), headache, taste perversion (dysgeusia);
Subcutaneous tissue and skin: very often - dermatitis, palmar-plantar syndrome (in the form of edema, paresthesia, skin peeling, hyperemia, blistering); often - hair loss (complete or partial), rash, dry skin, limited skin hyperemia; possibly - skin cracks (presumably associated with taking Xeloda);
Digestive system: very often - abdominal pain, vomiting, diarrhea, nausea, stomatitis (including ulcerative); often - pain in the epigastric region, constipation, dyspeptic disorders;
Laboratory indicators: often - increased bilirubin (hyperbilirubinemia);
Organ of vision: often - inflammation of the conjunctiva, increased lacrimation;
Metabolism and nutrition: very often - anorexia; often - decreased appetite, dehydration;
General disorders: very often - drowsiness, fatigue; often - weakness, fever, asthenia.

Disorders associated with manifestations of toxicity (there is at least an indirect link between the development of such side effects and the use of Xeloda):

Cardiovascular system: cardialgia (including angina pectoris), edema of the lower extremities, tachycardia, cardiomyopathy, myocardial infarction, myocardial ischemia, heart failure, supraventricular arrhythmias (including atrial fibrillation, ventricular extrasystoles), sudden death;
Digestive system: dry mouth, flatulence, disorders associated with ulceration / inflammation of the mucous membranes (in the form of gastritis, esophagitis, colitis, duodenitis, gastrointestinal bleeding);
Respiratory system: cough, shortness of breath;
Nervous system: insomnia, taste disturbances, encephalopathy, confusion, symptoms of cerebellar disorders (in the form of ataxia, dysarthria, impaired coordination and balance);
Connective tissue and musculoskeletal system: myalgia, joint pain (one or more) and back;
Mind: depression;
Organ of vision: eye irritation;
Subcutaneous tissues and skin: photosensitization reactions, nail changes, focal skin peeling, itching, increased skin pigmentation, a syndrome similar to radiation dermatitis;
Lymphatic system and blood: low content of all blood corpuscles, anemia, myelosuppression;
Parasitic and infectious diseases: infectious complications associated with myelosuppression, violations of the integrity of the mucous membranes and / or weakening of immunity in the form of local and fatal systemic infections (bacterial, fungal or viral etiology) and sepsis;
General disorders: increased drowsiness, asthenia, pain in the extremities, chest pain (noncardiac etiology).

When Xeloda was used concurrently with other drugs, the safety profile when administered for various indications and in various combinations did not differ, however, in this case, disorders characteristic of monotherapy may develop more often.

Some side effects are often observed with chemotherapy (for example, peripheral sensory neuropathy with docetaxel or oxaliplatin, increased blood pressure with bevacizumab therapy), but their worsening cannot be ruled out when taking Xeloda.

When carrying out combined treatment, the following disorders can develop in addition to those with monotherapy:

Nervous system: very often - dysesthesia, peripheral sensory neuropathy, peripheral neuropathy;
Respiratory system: very often - sore throat, perversion of the sensitivity of the pharynx; often - dysphonia, nosebleeds, rhinorrhea;
Cardiovascular system: very often - embolism / thrombosis, increased blood pressure;
Connective tissue and musculoskeletal system: very often - pain in the jaw;
Lymphatic system and blood: very often - febrile neutropenia, leukopenia;
Nutrition and metabolism: very often - weight loss;
Parasitic and infectious diseases: often - oral candidiasis;
General disorders: very often - temperature intolerance; often - pain, fever.

During clinical and post-marketing studies, cases of cholestatic hepatitis and liver failure were reported (a causal relationship with Xeloda therapy has not been established).

During combined treatment with other chemotherapeutic drugs, frequent development of myocardial infarction / ischemia and hypersensitivity reactions have been reported.

Changes in laboratory parameters during the use of Xeloda are manifested as hyperbilirubinemia, hypokalemia, hyponatremia, hyperglycemia, hypercreatininemia, hyper- / hypocalcemia, decreased hemoglobin, decreased number of neutrophils, granulocytes, platelets, lymphocytes, increased activity of alanine aminotransferase, aspartate aminotransferase, aspartate aminotransferase.

During post-marketing use of Xeloda, in very rare cases, unspecified stenosis of the lacrimal canaliculus was recorded. With the same frequency in clinical and post-marketing studies, cases of cholestatic hepatitis and liver failure were recorded.

Overdose

In case of an acute overdose of Xeloda, nausea, vomiting, diarrhea, inflammation of the mucous membrane, irritation of the gastrointestinal tract and bleeding, as well as suppression of bone marrow function, may occur.

In such cases, it is recommended to carry out a standard set of therapeutic and supportive measures that are aimed at correcting clinical symptoms and preventing possible complications.

special instructions

During therapy, patients should be closely monitored for manifestations of toxicity.

Most of the violations are reversible and do not require complete abolition of Xeloda, although dose adjustment or temporary withdrawal of the drug may be required.

With treatment, diarrhea may develop, sometimes severe. Patients with severe diarrhea should be closely monitored, and if dehydration develops, rehydration should be done to replace electrolyte loss. For medical reasons, standard antidiarrheal drugs should be prescribed as early as possible. If necessary, the dose of Xeloda must be reduced.

Dehydration should be eliminated or prevented at the very onset. It can develop rapidly with anorexia, asthenia, nausea, vomiting, or diarrhea. If dehydration is grade 2 or higher, you should immediately interrupt therapy and rehydrate. Until its completion and the correction or elimination of the factors that led to its development, the drug cannot be resumed.

Xeloda's spectrum of cardiotoxicity includes heart failure, angina pectoris, myocardial infarction, cardiac arrest, arrhythmias, and electrocardiogram changes. These disorders are most characteristic in patients with a history of ischemic heart disease.

Manifestation of cutaneous toxicity may be palmar-plantar syndrome. When it develops up to 2 or 3 degrees, therapy should be interrupted until the symptoms disappear or decrease to 1 degree. With the development of grade 3 syndrome, subsequent doses of Xeloda should be reduced. Vitamin B6 (pyridoxine) is not recommended for symptomatic or secondary prophylactic therapy of palmoplantar syndrome.

Xeloda can lead to the development of hyperbilirubinemia. Treatment should be interrupted if hyperbilirubinemia> 3 × ULN (upper limit of normal) or increased activity of hepatic aminotransferases (alanine aminotransferase, aspartate aminotransferase)> 2.5 × ULN.

It is possible to resume therapy when the level of bilirubin and the activity of hepatic aminotransferases falls below the specified limits.

According to the instructions, Xeloda has a moderate or slight effect on the ability to drive vehicles and mechanisms. It should be borne in mind that during therapy, undesirable phenomena such as dizziness, nausea or weakness may develop.

Application during pregnancy and lactation

The use of Xeloda during this period is prohibited.

During the period of drug treatment and for at least 3 months after its termination, it is necessary to use reliable methods of contraception. In the event of pregnancy during therapy, the patient should receive full information about the potential threat to the fetus.

Pediatric use

It is forbidden to use Xeloda to treat children under the age of 18.

For violations of liver function

For patients with mild or moderate liver dysfunction and liver metastases, adjustment of the initial dose of Xeloda is not required, but such patients should be closely monitored. There is no information about the treatment with the drug in patients with severe hepatic impairment.

With impaired renal function

With renal failure of mild severity (CC from 51 to 80 ml / min), it is not required to adjust the initial dose of Xeloda. When treating patients with initial renal failure of moderate severity (CC from 30 to 50 ml / min), it is necessary to reduce the initial dose to 75% of the standard.

If, during dose adjustment, adverse events of 2, 3 or 4 degrees of toxicity are observed, the drug must be temporarily discontinued and careful monitoring of the patient's condition must be ensured. Dose adjustments in moderate renal impairment should be carried out with both mono- and combination therapy with capecitabine.

It is forbidden to use Xeloda in severe renal failure (CC less than 30 ml / min).

Use in the elderly

When treating patients over 60 years old, Xeloda is prescribed with caution.

Drug interactions

With the simultaneous appointment of Xeloda with some drugs, the following effects may occur:

Coumarin anticoagulants: violations of clotting and / or bleeding indicators during therapy or after its termination (you need to carefully monitor clotting indicators and, depending on them, adjust the dose of anticoagulant);
Substrates of cytochrome P ₄₅₀: the combination has not been studied, caution should be exercised when administered together;
Antacids: an increase in the concentration of capecitabine and one of the metabolites (5'-DFCT) in the blood plasma;
Phenytoin: an increase in its concentration in plasma;
Sorivudine and its analogues: fatal increase in the toxicity of capecitabine (the combination is not recommended; Xeloda can be prescribed 4 days after the end of therapy with sorivudine or its structural analogues);
Leucovorin (calcium folinate): increased toxicity of capecitabine.

Analogs

Xeloda analogues are: Capecitabine, Capecitabine-TL, Capecitover, Tutabin.

Terms and conditions of storage

Keep out of reach of children at temperatures up to 30 ° C.

The shelf life is 3 years.

Terms of dispensing from pharmacies

Dispensed by prescription.

Reviews about Xelode

Reviews of Xeloda indicate that this drug is effective both in the treatment of cancer in the mammary glands and intestines, and in the treatment of damage to other tissues (for example, the liver). Users note that during treatment, the growth of metastases stops, which was not achieved by chemotherapy.

Also, patients taking Xeloda 500 mg tablets report frequent side effects (eg, vomiting or nausea).

Price for Xeloda in pharmacies

The price of Xeloda 500 mg (120 tablets per pack) is approximately 14,800 rubles.

Xeloda: prices in online pharmacies

Drug name

Price

Pharmacy

Xeloda 500 mg film-coated tablets 120 pcs.

RUB 10310

Buy

Maria Kulkes Medical journalist About the author

Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".

Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!