What is the prescription for CapeOX (capecitabine and oxaliplatin) therapy, including premedications?

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CapeOX (Capecitabine and Oxaliplatin) Prescription with Premedications

The standard CapeOX regimen consists of oxaliplatin 130 mg/m² IV over 2 hours on day 1 and capecitabine 850-1000 mg/m² twice daily orally for 14 days, repeated every 3 weeks. 1, 2

Detailed Prescription

Oxaliplatin Component:

  • Oxaliplatin 130 mg/m² IV infusion over 2 hours on day 1 of each 3-week cycle 1, 2
  • Administer in a separate bag from any other medications 3
  • Continue treatment for 3-4 months (or sooner if significant neurotoxicity ≥ grade 2 develops) 1, 2

Capecitabine Component:

  • Capecitabine 850-1000 mg/m² PO twice daily for 14 days followed by 7 days rest 1, 2
  • North American patients may require the lower end of the dosing range (850 mg/m²) due to greater toxicity compared to European patients 1, 2
  • Dose reduction may be required for patients with diminished creatinine clearance 1

Premedications

For Oxaliplatin:

  • Antiemetic prophylaxis:
    • 5-HT3 antagonist (e.g., ondansetron 8-16 mg IV) 30 minutes before oxaliplatin 3
    • Dexamethasone 8-12 mg IV 30 minutes before oxaliplatin 3
  • Avoid ice chips or cold beverages during infusion and for 5 days after to reduce acute neurotoxicity 3

For Capecitabine:

  • No specific premedications required for capecitabine administration 4
  • Take with water within 30 minutes after a meal to improve tolerability 4

Monitoring and Toxicity Management

  • Perform baseline CBC, comprehensive metabolic panel, and liver function tests before each cycle 3
  • Monitor for peripheral sensory neuropathy - consider dose reduction or discontinuation of oxaliplatin if grade ≥2 neuropathy develops 2, 3
  • Assess for hand-foot syndrome, diarrhea, and stomatitis which are common toxicities with capecitabine 5, 6
  • Delay treatment if neutrophils <1.5 × 10⁹/L or platelets <75 × 10⁹/L 3

Special Considerations

  • Discontinue oxaliplatin after 3-4 months of therapy while maintaining capecitabine until disease progression 1, 2
  • Oxaliplatin may be reintroduced if it was discontinued for neurotoxicity rather than disease progression 1, 2
  • Monitor closely during first cycle for toxicity, especially in elderly patients, with dose adjustments as indicated 2, 6
  • No isolation precautions are required for patients taking capecitabine 7

Common Pitfalls to Avoid

  • Do not use PET/CT to monitor treatment response; use CT with contrast or MRI instead 1
  • Avoid cold food/drinks during oxaliplatin infusion and for several days after to prevent triggering acute neuropathy 3
  • Do not continue oxaliplatin beyond 3-4 months if significant neurotoxicity develops 1, 2
  • Avoid combination therapy involving cytotoxics, anti-EGFRs, and anti-VEGFs unless specifically indicated 1

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

CapeOX Protocol for BSA 1.8 m²

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Research

Capecitabine and oxaliplatin in advanced colorectal cancer: a dose-finding study.

Annals of oncology : official journal of the European Society for Medical Oncology, 2001

Guideline

Management of Patients Taking Capecitabine

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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