Comparative Pharmacology
Head-to-head clinical analysis: ADRUCIL versus CAPECITABINE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ADRUCIL versus CAPECITABINE.
ADRUCIL vs CAPECITABINE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Fluorouracil (5-FU) is a pyrimidine analog that inhibits thymidylate synthase, interfering with DNA synthesis. It is metabolized to its active metabolites, which incorporate into RNA and DNA, causing cytotoxicity primarily in S-phase cells.
Capecitabine is a prodrug that is enzymatically converted to 5-fluorouracil (5-FU) in the body, which inhibits thymidylate synthase and incorporates into RNA and DNA, leading to cytotoxic effects.
12 mg/kg IV bolus daily for 4 days, then if no toxicity, 6 mg/kg IV on days 6, 8, 10, and 12; or 15 mg/kg IV weekly; or 500-600 mg/m2 IV every 3-4 weeks.
Oral, 1250 mg/m2 twice daily for 2 weeks followed by a 1-week rest period.
None Documented
None Documented
Clinical Note
moderateCapecitabine + Digoxin
"Capecitabine may decrease the cardiotoxic activities of Digoxin."
Clinical Note
moderateCapecitabine + Digitoxin
"Capecitabine may decrease the cardiotoxic activities of Digitoxin."
Clinical Note
moderateCapecitabine + Deslanoside
"Capecitabine may decrease the cardiotoxic activities of Deslanoside."
Clinical Note
moderateCapecitabine + Acetyldigitoxin
"Capecitabine may decrease the cardiotoxic activities of Acetyldigitoxin."
Biphasic elimination: initial t1/2α ~10-20 minutes, terminal t1/2β ~20-24 hours. Accumulation occurs with continuous infusion.
The terminal elimination half-life of capecitabine is approximately 0.75 hours. For its active metabolite 5-fluorouracil, the half-life is about 0.7 hours. Clinically, this short half-life necessitates twice-daily dosing to maintain therapeutic levels.
Primarily hepatic metabolism; renal excretion of metabolites accounts for ~60-80% of the dose. Unchanged fluorouracil excreted renally is <10%. Fecal excretion is minimal (<5%).
Capecitabine is predominantly eliminated renally. Approximately 95.5% of the administered dose is recovered in urine, with 61% as unchanged capecitabine and its metabolites. Fecal excretion accounts for about 2.6%. Biliary elimination is minimal (<1%).
Category C
Category D/X
Antimetabolite
Antimetabolite