Capixet (Capecitabine 500 mg Tablets) Price in Bangaldesh

Rx Prescripttion Only-YMYL Medical Content

Capixet 500 mg

Capecitabine 500mg tablets – Everest Pharmaceuticals Ltd.

Approved as an oral chemotherapy for metastatic breast cancer (alone or in combination), and for colorectal cancer — including as adjuvant treatment after surgery for stage III colon cancer, and for metastatic colorectal cancer, often combined with other chemotherapy agents.

Equivalent

Disease-free survival vs IV 5-FU/leucovorin in adjuvant colon cancer (X-ACT trial)

Oral

Converts to active 5-FU in the body — avoids IV infusion lines/pumps

~25%

Objective response rate as monotherapy in metastatic breast cancer

25+ yrs

In clinical use — one of the most established oral chemotherapy agents

Confirm cancer type and treatment setting

Used for breast cancer (often after anthracycline/taxane-based chemo) or colorectal cancer (adjuvant after surgery, or metastatic, frequently combined with other agents like oxaliplatin).

Discuss DPD enzyme testing with your oncologist

A small percentage of people have reduced activity of the DPD enzyme, which breaks down this drug — in these individuals, standard doses can cause severe or life-threatening toxicity. Testing availability varies by region.

Review current medications, especially blood thinners

Capecitabine can significantly increase the effect of warfarin and similar blood thinners, raising bleeding risk — this combination requires close monitoring or adjustment.

Discuss your goals of care

Weigh the oral, at-home dosing convenience against managing hand-foot syndrome, diarrhea, and the cyclical schedule — and how this fits with any combination drugs you may also be receiving.

Important safety information — boxed warning: Capecitabine, when taken with warfarin or similar blood thinners, can significantly increase bleeding risk and has been associated with serious bleeding events and death due to altered blood clotting (INR changes). Anyone on a blood thinner needs close monitoring if capecitabine is started, changed, or stopped. Separately, people with dihydropyrimidine dehydrogenase (DPD) enzyme deficiency can experience severe, sometimes fatal, toxicity from this medication.

Medical Oncologist Review

Board-certified oncologist · 12+ years in thoracic malignancies

“Capecitabine has been a workhorse in oncology for over two decades — it gave patients an oral alternative to infusional 5-FU, with comparable effectiveness. The two things I always emphasize are hand-foot syndrome management early, before it becomes severe, and flagging any blood thinner use right away, since that interaction is one of the more serious and sometimes under-recognized risks with this drug.”

Content reviewed against FDA prescribing information, NCCN Guidelines v2.2024, and published Phase III trial data. Last updated June 2026.

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Questions to ask my healthcare provider

What questions should I ask my oncologist about starting capecitabine?

Here are key questions to bring to your oncologist about starting capecitabine — the warfarin interaction and DPD deficiency questions are particularly worth raising early, since they’re easy to overlook compared to more “obvious” chemotherapy concerns.

Before confirming capecitabine as your treatment

What is this treating specifically, and is it being used alone or combined with other chemotherapy drugs (like oxaliplatin)?
Is this adjuvant treatment (after surgery, to reduce recurrence risk) or for metastatic/advanced disease — and how does that affect what “success” looks like?
What other treatment options exist for my situation, and why is capecitabine being recommended?

About the boxed warning — blood thinner interaction and DPD

Am I currently taking warfarin or any other blood thinner? If so, how will that be managed — closer monitoring, dose adjustments, or a different anticoagulant?
Is DPD enzyme testing available to me before starting, and if not, how will early toxicity be monitored without it?
What are the early warning signs of severe toxicity related to DPD deficiency — severe mouth sores, profound diarrhea, very low blood counts — that would mean stopping immediately rather than waiting it out?

About the dosing schedule

Can you walk me through the cycle — how many days I take it, how many days off, and how long each cycle lasts?
Should I take it with food, and does timing matter relative to my other medications?
What happens if I miss a dose, or vomit shortly after taking it?
How is my dose calculated, and could it change between cycles based on how I tolerate it?

About hand-foot syndrome — often the most disruptive day-to-day issue

What does early hand-foot syndrome look like, and what can I do from day one to reduce its severity (moisturizers, avoiding friction/heat, etc.)?
At what point does it become serious enough to need a dose reduction or pause?
Are there things I should avoid during treatment — hot showers, tight shoes, activities that put pressure on hands and feet?

About diarrhea and mouth sores

Should I have anti-diarrheal medication on hand from the start?
What mouth care routine is recommended to help prevent or manage stomatitis?
What level of diarrhea (frequency, presence of blood, dehydration signs) requires an urgent call versus just calling during business hours?

About cardiac considerations

Do I have any heart history that’s relevant here? What cardiac symptoms (chest pain, palpitations, shortness of breath) should prompt immediate attention?

About monitoring overall

How often will I have blood tests, and what specifically is being checked (blood counts, kidney function, liver function)?
What scans or other tests will track whether this is working, and on what timeline?

About my specific situation

Does my kidney function affect my dose? (This matters more for capecitabine than for many oral cancer drugs.)
If I’m of childbearing potential, what precautions are needed during treatment?
How does this fit with any other medications I take regularly, beyond blood thinners?

About the longer road

If side effects become difficult to manage, is dose reduction common, and does that affect how well it works?
If this treatment line doesn’t work or stops working, what’s typically considered next?
Are there patient assistance programs through Roche/Genentech if cost is a concern?

A practical tip: Because the warfarin interaction is one of the more serious and sometimes under-recognized risks with this drug, it’s worth proactively mentioning every medication you take — including ones prescribed by other doctors for unrelated conditions — rather than assuming your oncologist already has your full medication list. A quick phone call to your pharmacist to cross-check your full regimen against capecitabine can also catch things that might otherwise slip through.

compare with other therapies

Compare capecitabine vs intravenous 5-FU for colorectal cancer

Capecitabine and intravenous 5-FU are, in a sense, the same drug delivered two different ways — capecitabine is an oral prodrug that the body converts into 5-FU through a series of enzymatic steps. So this comparison is less about different mechanisms (like our other comparisons) and more about delivery method, administration burden, and how the conversion process changes the side effect profile.

The core relationship

Capecitabine is absorbed in the gut and converted to 5-FU in three enzymatic steps, with the final step occurring via an enzyme (thymidine phosphorylase) that’s often more concentrated in tumor tissue than in healthy tissue. The theoretical advantage is that capecitabine may deliver relatively more active drug directly to the tumor compared to systemic IV 5-FU, which circulates throughout the body before reaching the tumor.

How each is given — the biggest practical difference

	Capecitabine	IV 5-FU
Route	Oral tablets, taken at home	Intravenous, given in a clinic/infusion center
Access required	None	Often a central line or port, especially for infusional regimens
Typical schedule	14 days on, 7 days off (21-day cycle)	Varies — bolus (Mayo regimen) or continuous infusion over 46-48 hours (common in FOLFOX)
Clinic visits	Minimal — pick up prescription, periodic check-ins	Frequent — each infusion cycle requires a clinic visit

The infusional 5-FU regimens commonly used in colorectal cancer (like FOLFOX) typically involve a portable pump that patients carry home for 1-2 days after each clinic visit, then return to have it disconnected — an added layer of logistics that capecitabine avoids entirely.

Efficacy — broadly equivalent, established by direct comparison

The X-ACT trial directly compared capecitabine to bolus 5-FU/leucovorin (the Mayo Clinic regimen) as adjuvant treatment after surgery for stage III colon cancer. Capecitabine showed disease-free survival and overall survival at least equivalent to — and in some analyses slightly favoring — the IV regimen, which is why it became an accepted alternative in treatment guidelines.

For metastatic colorectal cancer, capecitabine-based combination regimens (such as CAPOX/XELOX, combining capecitabine with oxaliplatin) have shown similar efficacy to infusional 5-FU-based combinations (such as FOLFOX) in multiple studies and meta-analyses — neither has been shown to be clearly superior to the other in this setting.

Side effect profile — this is where the real differences show up

	Capecitabine	IV 5-FU (bolus)	IV 5-FU (infusional)
Hand-foot syndrome	More common, often more pronounced	Less common	Present but generally less than capecitabine
Diarrhea	Common	Common	Common
Neutropenia (low white cells)	Less common	More common	Intermediate
Mucositis/stomatitis	Less common	More common	Intermediate
Catheter-related risks (infection, clotting)	None — no IV access needed	None (if bolus without port)	Present — relevant to port/line maintenance
Cardiac toxicity (coronary spasm)	Present — shared fluoropyrimidine class effect	Present	Present
DPD deficiency risk	Present — applies since it converts to 5-FU	Present	Present

The shift away from bolus 5-FU/leucovorin toward infusional regimens (and capecitabine as an oral alternative) was driven partly by the better tolerability profile of infusional/oral dosing compared to bolus dosing — bolus regimens tend to cause more blood count suppression and mouth sores, while capecitabine’s main trade-off is hand-foot syndrome and diarrhea.

Quality of life — genuinely a “depends on the person” question

Some patients strongly prefer capecitabine because it avoids:

Port placement (a minor surgical procedure with its own risks)
Carrying an infusion pump
Frequent trips to an infusion center

Others find the responsibility of self-administration — remembering the complex on/off schedule, managing hand-foot syndrome at home, and recognizing when side effects need attention — more burdensome than having treatment “happen to them” during a supervised clinic visit. There’s also a psychological dimension: some patients feel more reassured by direct clinical oversight during IV treatment, while others feel more in control with an oral medication taken at home.

Practical factors that often guide the choice

Adherence concerns — if there’s a concern about a patient reliably following the complex capecitabine schedule (timing with food, the 14-day-on/7-day-off pattern), IV administration ensures the dose is given as intended
Vascular access difficulties — patients with poor venous access or who’ve had complications with prior ports may prefer avoiding IV-based regimens
Geographic distance from infusion centers — capecitabine’s at-home dosing reduces travel burden significantly
Existing hand-foot syndrome or peripheral neuropathy concerns — may steer away from capecitabine-based regimens

Bottom line

These aren’t really “different drugs” in the way most of our comparisons have been — they’re the same active agent (5-FU) delivered through different routes, with broadly equivalent efficacy established through direct trial comparison (X-ACT). The decision usually comes down to logistics (clinic access, IV access, pump tolerance) and which side-effect trade-off — hand-foot syndrome and diarrhea (capecitabine) versus blood count suppression, mouth sores, and catheter-related considerations (IV 5-FU) — fits better with your situation and preferences. This is a good example of where your own lifestyle and practical constraints are just as relevant to the decision as the clinical data itself.

How does testing work

How is hand-foot syndrome from capecitabine managed and prevented?

Hand-foot syndrome (also called palmar-plantar erythrodysesthesia, or PPE) is one of the most common and disruptive side effects of capecitabine — but it’s also one of the more manageable ones when caught early, which makes prevention and early recognition genuinely worthwhile.

Starting before symptoms appear — prevention

The most effective approach is starting good skin care before you notice any problems, ideally from day one of treatment:

Moisturize frequently — thick, fragrance-free emollient creams (often urea-based, around 10-40% urea) applied multiple times daily to palms and soles. Some oncology centers recommend this proactively for all patients starting capecitabine, not just those who develop symptoms.
Avoid heat exposure to hands and feet — this means lukewarm rather than hot showers/baths, avoiding hot tubs, and being cautious with dishwashing in hot water.
Reduce friction and pressure — avoid tight shoes, high heels, prolonged walking/running, gripping tools tightly, or activities involving repetitive hand pressure (gardening, manual labor, certain exercise equipment).
Protect skin from sun — UV exposure can worsen skin reactions on exposed hands.
Some centers use celecoxib (a COX-2 inhibitor) preventively, based on studies suggesting it may reduce incidence, though this would be your oncologist’s call based on your overall health.

Recognizing early signs

The earliest signs are often subtle — tingling, numbness, mild redness, or a feeling of tightness/sensitivity on palms and soles, sometimes described as feeling like a mild sunburn. This is the point where reporting it to your care team matters most, because catching it at this stage is far easier to manage than waiting until it progresses.

How severity is graded and managed

Oncology teams typically grade hand-foot syndrome on a scale:

Grade 1 (mild changes — redness, swelling, or peeling without pain): usually managed with intensified moisturizing and continued treatment, often with the addition of topical urea cream or mild topical steroids.
Grade 2 (changes with pain that limit some daily activities — like typing or walking): often prompts a temporary dose reduction or brief treatment pause, alongside topical treatments and sometimes oral pain relief.
Grade 3 (severe changes — blistering, peeling, cracking, or pain that limits self-care like dressing or bathing): typically requires stopping treatment until it heals, followed by a dose reduction when restarting.

Day-to-day comfort measures once symptoms develop

Cool compresses or soaking hands/feet in cool (not cold) water can ease discomfort
Loose, soft socks and well-fitting shoes
Avoiding activities that increase blood flow to hands/feet (vigorous exercise, hot environments) during flare-ups
Keeping nails trimmed to avoid additional skin trauma

The key practical point

Because dose adjustments based on hand-foot syndrome severity are a normal and expected part of managing this medication — not a sign that something has gone wrong — letting your oncology team know about symptoms early (at the tingling/redness stage) gives them the best chance to adjust your plan in a way that keeps you on treatment with less disruption, rather than waiting until it becomes severe enough to force a longer pause.

This is a good one to bring up specifically at your next visit if you haven’t already discussed a proactive skin care routine — many patients aren’t told about this until symptoms appear, when starting early would have helped more.

Medical disclaimer: This page is for informational purposes only and does not constitute medical advice, diagnosis, or treatment. Osimertinib is a prescription medication that must only be used under the supervision of a qualified oncologist. Clinical outcomes data is drawn from published Phase III trials; individual results vary. Always consult your healthcare provider and refer to the full prescribing information before making any treatment decisions. Emergency: call your local emergency services or poison control immediately if you experience serious adverse effects.