From the FDA Drug Label
Infections: laryngitis (1.0), bronchitis (0.2), pneumonia (0.2), bronchopneumonia (0.2), keratoconjunctivitis, sepsis (0.3), fungal infections (including candidiasis) (0.2) The incidence of candidiasis in patients treated with Xeloda is 0.2% 1.
From the Research
Candidiasis is a potential side effect of Xeloda, occurring in approximately 2-5% of patients, and can be treated with antifungal medications such as fluconazole, nystatin, or clotrimazole, while continuing Xeloda therapy under medical supervision. The incidence of candidiasis with Xeloda therapy is relatively low, and it typically manifests as oral thrush or vaginal yeast infections. Patients taking Xeloda should monitor for symptoms such as white patches on the tongue or inside the cheeks, redness or soreness in the mouth, vaginal itching or discharge, and report these to their healthcare provider promptly. The risk increases in patients who are also taking steroids, have diabetes, or are immunocompromised, as noted in studies on the epidemiology and risk factors for invasive candidiasis 2. Candidiasis associated with Xeloda occurs because the medication can suppress the immune system and alter the normal balance of microorganisms in the body, allowing opportunistic fungi like Candida to overgrow. Some key points to consider in the management of candidiasis in patients on Xeloda include:
- Monitoring for symptoms of candidiasis and prompt reporting to healthcare providers
- Treatment with antifungal medications as needed, with options including fluconazole, nystatin, or clotrimazole, as discussed in a review of therapeutic tools for oral candidiasis 3
- Consideration of the patient's overall health status and potential risk factors for candidiasis, such as immunosuppression or diabetes
- The importance of prevention and early treatment to reduce the risk of complications from candidiasis, as highlighted in a review of candidiasis predisposing factors, prevention, diagnosis, and alternative treatment 4. In terms of specific treatment options, a study comparing vaginal nystatin and oral fluconazole for the treatment of recurrent vulvovaginal candidiasis found that both treatments were effective, but nystatin may be more effective for treating infections caused by C. glabrata or fluconazole-resistant Candida 5. Overall, while candidiasis is a potential side effect of Xeloda, it can be effectively managed with prompt treatment and monitoring, and patients should be aware of the risks and symptoms to report to their healthcare providers.