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Xeloda Side Effects

Generic Name: capecitabine

Note: This page contains side effects data for the generic drug capecitabine. It is possible that some of the dosage forms included below may not apply to the brand name Xeloda.

In Summary

Common side effects of Xeloda include: nausea, vomiting, increased serum alkaline phosphatase, hyperbilirubinemia, increased serum transaminases, palmar-plantar erythrodysesthesia, diarrhea, stomatitis, paresthesia, neutropenia, thrombocytopenia, and anemia. Other side effects include: erythema. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to capecitabine: oral tablet

As well as its needed effects, capecitabine (the active ingredient contained in Xeloda) may cause unwanted side effects that require medical attention.

Severity: Major

If any of the following side effects occur while taking capecitabine, check with your doctor immediately:

More common:
  • Abdominal or stomach pain
  • diarrhea
  • nausea
  • numbness, pain, tingling, or other unusual sensations in the palms of the hands or bottoms of the feet
  • pain, blistering, peeling, redness, or swelling of the palms of the hands or bottoms of the feet
  • pain, redness, swelling, sores, or ulcers in your mouth or on your lips
  • unusual tiredness or weakness
  • vomiting
Less common or rare:
  • Abdominal or stomach cramping or pain (severe)
  • agitation
  • back pain
  • bleeding and bruising
  • bleeding gums
  • blood in the urine or stools
  • bloody nose
  • bloody or black, tarry stools
  • blurred vision
  • burning, dry, or itching eyes
  • chest pain
  • chills
  • clumsiness or unsteadiness
  • cold
  • collapse
  • coma
  • confusion
  • constipation
  • convulsions
  • cough or hoarseness (accompanied by fever or chills)
  • cough producing mucus
  • coughing or spitting up blood
  • dark urine
  • decreased frequency or amount of urine
  • difficulty with breathing
  • difficulty with swallowing or pain in the back of throat or chest when swallowing
  • discharge from the eyes
  • drowsiness
  • dry mouth
  • excessive tearing
  • extra heartbeats
  • eye redness, irritation, or pain
  • fainting
  • fast or irregular heartbeat
  • fever or chills
  • flu-like symptoms
  • hallucinations
  • headache, sudden and severe
  • heavier menstrual periods
  • high fever
  • hot, red skin on the feet or legs
  • inability to speak
  • increased menstrual flow or vaginal bleeding
  • increased thirst
  • irritability
  • itching in the genital or other skin areas
  • lightheadedness
  • light-colored stools
  • loss of consciousness
  • lower back or side pain (accompanied by fever or chills)
  • muscle aches or cramps
  • muscle spasms
  • nosebleeds
  • numbness or tingling in the hands, feet, or lips
  • painful or difficult urination (accompanied by fever or chills)
  • painful, swollen feet or legs
  • pain, tenderness, or swelling in the upper abdominal or stomach area
  • pale skin
  • paralysis
  • pinpoint red spots on the skin
  • problems with coordination
  • prolonged bleeding from cuts
  • rapid, shallow breathing
  • red or dark brown urine
  • redness, pain, or swelling of the eye, eyelid, or inner lining of the eyelid
  • scaling
  • seizures
  • severe constipation
  • skin rash or itching
  • slow or irregular heartbeat
  • slurred speech
  • sneezing, sore throat, or stuffy nose
  • sores, ulcers, or white spots on the lips or in the mouth
  • stiff neck
  • stomach bloating, burning, or cramping
  • swelling of the face, fingers, feet, or lower legs
  • swelling of the lymph nodes
  • swollen glands
  • temporary blindness
  • tiredness or weakness
  • trouble with speaking
  • troubled breathing or tightness in the chest
  • unexplained nosebleeds
  • unusual bleeding or bruising
  • unusual lump or swelling in the chest
  • vomiting blood or material that looks like coffee grounds
  • weakness in the arm or leg on one side of the body, sudden and severe
  • weight gain or loss
  • white patches in the mouth or throat or on the tongue
  • white patches with diaper rash
  • yellow eyes or skin

Severity: Minor

Some capecitabine side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

Less common:
  • Burning, crawling, itching, numbness, prickling, “pins and needles”, or tingling feelings
  • changes or discoloration in the fingernails or toenails
  • difficulty with moving
  • discouragement
  • dizziness
  • headache
  • heartburn
  • increased sensitivity of the skin to sunlight
  • muscle pain
  • pain
  • pain and redness of the skin at the place of x-ray treatment
  • pain in the joints or limbs
  • red, sore eyes
  • sunken eyes
  • thirst
  • trouble sleeping
  • weakness
  • wrinkled skin
  • Bone pain
  • change in color of treated skin
  • difficulty with walking
  • discouragement
  • feeling of constant movement of self or surroundings
  • feeling sad or empty
  • full or bloated feeling or pressure in the stomach
  • general feeling of discomfort or illness
  • hot flushes
  • impaired balance
  • increased sweating
  • joint pain
  • lack of appetite
  • loss of interest or pleasure
  • muscle weakness
  • noisy breathing
  • pain in the rectum
  • pain, swelling, or redness in the joints
  • passing less gas
  • rough, scratchy sound to voice
  • runny nose
  • sensation of spinning
  • shakiness in the legs, arms, hands, or feet
  • shivering
  • sores on the skin
  • swelling of abdominal or stomach area
  • tremor or shaking of the hands or feet
  • trouble concentrating
  • voice changes

For Healthcare Professionals

Applies to capecitabine: oral tablet


Hematologic side effects including lymphopenia (58% to 94%), anemia (44% to 74%), neutropenia (16% to 22%), and thrombocytopenia (15% to 21%) have been reported. Cases of severe hypertriglyceridemia induced by capecitabine (the active ingredient contained in Xeloda) have also been reported.[Ref]


Gastrointestinal side effects including diarrhea (50%), nausea (44%), vomiting (26%), stomatitis (23%), abdominal pain (17%), constipation (9%), and dyspepsia (6%) have been reported. A case of capecitabine-induced pancreatitis has also been reported.[Ref]


Dermatologic side effects including hand and foot syndrome (35% to 45%), dermatitis (23% to 31%), nail disorder (4%), alopecia, erythematous rash, pruritus, eruptive multiple lentigo maligna-like lesions, radiation recall dermatitis, pyogenic granulomas, photoeruption, hyperpigmentation, and inflammatory responses in actinic keratosis have been reported. A case of leopard-like vitiligo and a case of subacute cutaneous lupus erythematosus have also been reported.[Ref]


Hepatic side effects including hyperbilirubinemia (34%) and hepatic failure have been reported.[Ref]


Metabolic side effects including anorexia (20%) and dehydration (5%) have been reported.[Ref]

Nervous system

Nervous system side effects including paresthesia (12%), headache (7%), dizziness (5%), and insomnia (3%) have been reported. A case of cerebellar ataxia has also been reported.[Ref]


Ocular side effects including eye irritation (10%) and lacrimal duct stenosis have been reported.[Ref]


Cardiovascular side effects including edema (6%) have been reported. Three cases of severe angina-like chest pain possibly or probably related to capecitabine (the active ingredient contained in Xeloda) treatment have been reported. One case of capecitabine-induced coronary vasospasm has also been reported.[Ref]


Musculoskeletal side effects including myalgia (4%) have been reported.[Ref]


Other side effects including a case of tumor lysis syndrome have been reported.[Ref]


1. Bar-Sela G, Haim N "Uncontrolled hypertriglyceridemia induced by capecitabine: case report and review of the literature." Cancer Chemother Pharmacol 63 (2008): 779-82

2. "Product Information. Xeloda (capecitabine)." Roche Laboratories, Nutley, NJ.

3. "Multum Information Services, Inc. Expert Review Panel"

4. Jones KL, Valero V "Capecitabine-induced pancreatitis." Pharmacotherapy 23 (2003): 1076-8

5. Peramiquel L, Dalmau J, Puig L, Roe E, Fernandez-Figueras MT, Alomar A "Inflammation of actinic keratoses and acral erythrodysesthesia during capecitabine treatment." J Am Acad Dermatol 55(5 Suppl) (2006): S119-20

6. Schmid-Wendtner MH, Wendtner CM, Volkenandt M, Heinemann V "Clinical picture: Leopard-like vitiligo with capecitabine." Lancet 358 (2001): 1575

7. Fernandes NF, Rosenbach M, Elenitsas R, Kist JM "Subacute cutaneous lupus erythematosus associated with capecitabine monotherapy." Arch Dermatol 145 (2009): 340-1

8. Lam MS, Kaufman DA, Russin MP "Capecitabine-associated cerebellar ataxia." Am J Health Syst Pharm 65 (2008): 2032-5

9. Kuppens IE, Boot H, Beijnen JH, Schellens JH, Labadie J "Capecitabine induces severe angina-like chest pain." Ann Intern Med 140 (2004): 494-5

10. Goldsmith YB, Roistacher N, Baum MS "Capecitabine-induced coronary vasospasm." J Clin Oncol 26 (2008): 3802-4

11. Kurt M, Eren OO, Engin H, Guler N "Tumor lysis syndrome following a single dose of capecitabine (May)." Ann Pharmacother 38 (2004): 902

It is possible that some side effects of Xeloda may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.