Before starting chemotherapy you should be given a 24-hour contact number, or told where to get emergency care by your treatment team. You may need antibiotics.
Sometimes your doctor may recommend injections of drugs called growth factors. This helps the body produce more white blood cells to reduce your risk of infection.
Anaemia
Having too few red blood cells is called anaemia. If you feel particularly tired, breathless or dizzy, let your treatment team know.
Bruising and bleeding
Capecitabine can reduce the number of platelets, which help the blood to clot. You may bruise more easily, have nosebleeds or your gums may bleed when you brush your teeth. Tell your treatment team if you experience any of these symptoms.
Diarrhoea
Diarrhoea is common during treatment and can sometimes be severe.
Tell your chemotherapy nurse or treatment team as they can prescribe medication and may consider stopping your capecitabine for a time to help control it.
Speak to them immediately if you have any of the following symptoms:
- Four or more episodes of diarrhoea in 24 hours
- Blood in your stools when you go to the toilet
- Tummy (abdominal) pain
Skin reactions
Hand-foot syndrome, often called Palmar-Plantar syndrome, is a common side effect of some chemotherapy drugs used to treat breast cancer.
The palms of the hands and the soles of the feet can become red and sore. Sometimes you may also notice a tingling sensation, numbness or some swelling.
The skin on your hands and feet may also become red, dry and flaky. This should improve if the treatment is delayed or if the dose is reduced.
Your treatment team can recommend moisturising creams to help with skin reactions.
Nausea and vomiting
You may feel sick (nausea) during treatment.
Although most people will not be sick (vomit), anti-sickness drugs can help reduce or stop this happening, so take these as prescribed. Steroids may also be given to make the anti-sickness drugs work more effectively.
Contact your treatment team or GP if symptoms don’t go away.
Sore mouth
Your mouth and gums can become sore and small ulcers may develop. This is usually worse if you’re taking capecitabine at the same time as other chemotherapy drugs.
Your chemotherapy nurse or treatment team will advise you about suitable mouthwashes or medicine if these problems occur.
Looking after your mouth, including your teeth and gums, is very important during treatment.
It’s advisable to see your dentist for a dental check-up before chemotherapy begins and to avoid dental treatment during chemotherapy if possible.
If you do need to have dental treatment during chemotherapy, talk with your oncologist about the best time to have this.
Loss of appetite
You can lose your appetite while taking capecitabine. Your sense of taste can also change and some foods and drink may taste different.
Talk to your treatment team about this. They will give you advice and information to help, or refer you to a dietitian if needed.
Find out more about diet during treatment.
Extreme tiredness
Cancer-related fatigue is extreme tiredness that doesn’t go away with rest or sleep. It’s a very common side effect of breast cancer treatment and may affect you physically and emotionally.
If you think you have fatigue, tell your GP or treatment team. They can assess you and offer advice on how to manage your energy levels.
Find out more about managing fatigue.
Hair loss
When used on its own, capecitabine occasionally causes some temporary hair thinning. It very rarely causes complete hair loss.
If capecitabine is taken in combination with another chemotherapy drug, most people will lose all their hair including eyebrows, eyelashes and body hair.
Find out more about hair loss.
Rare side effects
Allergic reaction
Very occasionally allergic reactions to a drug can occur. Reactions can vary from mild to severe, although severe reactions are uncommon.
If you have any swelling, wheezing, chest pain or difficulty breathing after taking capecitabine, let your treatment team or chemotherapy nurse know immediately.
DPD deficiency (very rare)
DPD is a type of protein (enzyme) made naturally in the body.
Not having enough DPD can cause chemotherapy to build up in the body, resulting in severe side effects. In very rare cases this can be life-threatening.
It’s recommended that everyone starting capecitabine has a blood test to check levels of DPD.
If you’re found to have low levels of DPD, known as a DPD deficiency, you may not be given the drug.
At your pre-assessment appointment, a member of the oncology team will explain the blood test.
Cancer Research UK has more information on DPD deficiency.
