CAPECITABINE AND FOLATES

A patient died after treatment with capecitabine possibly because the concurrent use of folic acid enhanced capecitabine toxicity. The maximum tolerated dose of capecitabine is decreased by folinic acid.
The UK manufacturers say that the maximum tolerated capecitabine dose when
C used alone in the intermittent regimen is 3000 mg/m2, but it is reduced to
2000 mg/m2 if folinic acid 30 mg twice daily is also given. Consider the use of folate supplements as a contributory factor in the case of troublesome capecitabine adverse effects.
(11)
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