Capecitabine how big a dose


My wife was put on Capecitabine today after they found she not only has bone mets but also liver.
This is secondary breast cancer.

The registrar today agreed that Capecitabine would be the way forward on top of the Zollodronic acid.

But that she should stop tamoxifan when on chemo.

Luckily my wife asked an unrelated question about the Zollodex implants she has been having.

The onco was surprised and said she should not be on that and take Capecitabine!

She then went and consulted with the main man who said “oh no she should be OK tell her not to have any more implants”

So we were not filled with confidence.

Anyway, my wife has been prescribed 2000mg twice a day of Capecitabine which seems to be a huge does and from on-line reading would trigger just about every bad side effect.

Considering they did not want her to go on chemo due to her other conditions and we were told that Capecitabine has less side effects and was ‘more gentle’ it seems odd that she is to take 4000mg a day!

Anyway, due to the concern we are going to contact her GP, the oncologist and maybe the chemo nurses tomorrow and not start the Capecitabine until we have confirmed the does.

Anyone add anything to this?
Is anyone on this big does.

Both very confused.



Hi, I too have bone mets, I was diagnosed with them in 2003. I’m sorry to hear your wife’s been diagnosed with secondaries. I have been on Capecitabine, at a higher dose than your wife’s, 2,300 mgs (each dose so 4,600mgs a day) since last Spring. I will stay on the tablets for as long as they continue working. So far I’ve had a great response to this chemo, it’s my first as I had many years of hormonal treatments. The only side effect I’ve had are dry hands and feet but I moisturise them daily and it’s not been a huge problem.
For me it’s been a very gentle chemo, I know many others who like me have found this to be a good treatment. I have lots of energy and haven’t had any tiredness, illness at all.
As a general rule your wife should not need to have Zoladex whilst she’s on chemo as she’s fairly unlikely to have a period. She will have been taken off Tamoxifen as it’s very unusual to receive both chemo and hormone treatment. Your wife’s chemo dose should have been calculated by her weight, her height. The good thing is the dose can be lowered if your wife has any adverse side effects. There are quite a few posts on this chemo on the Secondaries forum…we tend to call it by it’s other name there, Xeloda…Good Luck to your wife, I hope she has a great response to the chemo. PS…I would recommend your wife moisturises her hands and feet before they become a problem…it’s a common side effect but I haven’t found it to be a real problem…honest!

Hi Mike

Sorry to hear about your wife’s progression.

I think you are right to question the treatment plan in view of the registrar’s superficial knowledge of your wife’s treatment history and any possible conflict with her Zoladex implants. Will the hormone-targetting treatment be abandonned altogether or is there is a substitute for the Zoladex? I’m not familiar hormone therapies myself so am not aware of all the options, but am sure that others will be able to advise you.

I’m on 3300mg a day of Capecitabine which is a medium dosage. My onc explained that studies have shown that the medium dosage is equally effective to the maximum dosage. As they found that they usually had to lower the higher dose for the majority of patients, the hospital’s protocol is to prescribe the medium dosage. I have found it a million times better than my previous chemo and have had a reduction in my lung and liver mets.

You may also want to post this in the Treatment/Medical board on the Secondary Breast Cancer forums.

Good luck with your meetings!

Thanks both

Most kind for the fast reply, I guess you know how we are feeling here LOL

OK, she has decided not to take it today but to use today to speak with her GP who is super interested!
She will also speak with the chemo nurses at the hospital for more clarification.
I did some digging last night and only stopped when my eyes hurt.
I found a sit that shows how the body surface area is calculated for prescribing.
And I found the tech details for the chemo with a chart that shows how much to give based on this.
If anything my wife has been put on a lower does than maximum! maybe its the medium does you mention!
So it looks ok.
I don’t expect one day will make much difference.

Yes the Tamoxifan has been stopped while she is on chemo, we were told that this would be restarted once the chemo ends.
18 weeks later!!!

She has suffered so much with all this I guess some of the more horrid side effects have put us off somewhat but I think we need to try it as we have to go after this bl**dy stuff before it sets up home anywhere else!
It does look from my research that Capecitabine is a targeted drug in that it seeks out cancer cells and any other cell damage is collateral.

My wife is diabetic and has a condition called Hidradenitis (16 years) which causes open wounds, only her good immune system has saved her from that so taking chemo which will flatten that is a worry and is the reason why they did not want to give it her.

This forum has been a great help.

Good luck to you all


Hi Mike,
I too have mets to liver and bones.I was on 5000mg of Capecitabine,which worked very well for me and shrank all my tumours.They did have to lower the last couple of doses to 4000mg because my feet were sore but apart from that I was ok on it.After four weeks of being off,it my feet have recovered.
The dosage does go by your weight.
I hope your wife has good results with it too.
Alli x

Thanks Alli

Well she spoke with her GP who said is was better safe than sorry and she has contacted the onco to ask for clarification.
I suspect the 4000mg will be right.



Hi Mike, sorry to hear about the problems with your wife’s treatment. I just wanted to say that being a fellow diabetic, I managed my insulin/chemo treatments reasonably well so try not to worry about this extra complicatio. I adjusted insulin dosages accordingly with steroid tablets and how I felt.

All the best