Drug interactions
Capecitabine + Leucovorin
Severity: Major
Capecitabine and Leucovorin: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Leucovorin stabilizes the binding of the active fluorouracil metabolite to thymidylate synthase, which enhances the cytotoxic effect of fluoropyrimidines. This can increase toxicities of capecitabine such as diarrhea, mucositis, hand-foot syndrome and myelosuppression.
What this interaction means in plain words
Capecitabine and Leucovorin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Capecitabine belongs to Oncology; Leucovorin belongs to Miscellaneous.
Why it happens
Leucovorin increases reduced folate pools, stabilizing the fluorodeoxyuridylate-thymidylate synthase complex and potentiating fluoropyrimidine activity.
What to do
Avoid combining unless it is part of a specifically designed regimen, as capecitabine labeling advises caution. If used, monitor closely for severe diarrhea and myelosuppression and reduce the capecitabine dose as needed.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Capecitabine
Other interactions of Leucovorin
- Fluorouracil + Leucovorin Major
- Glucarpidase + Leucovorin Major
- Leucovorin + Phenobarbitone Moderate
- Leucovorin + Phenytoin Moderate
Frequently asked questions
Can I take Capecitabine with Leucovorin?
MediHelp rates the interaction as major. Capecitabine and Leucovorin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Leucovorin stabilizes the binding of the active fluorouracil metabolite to thymidylate synthase, which enhances the cytotoxic effect of fluoropyrimidines. This can increase toxicities of capecitabine such as diarrhea, mucositis, hand-foot syndrome and myelosuppression.
How serious is the interaction between Capecitabine and Leucovorin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid combining unless it is part of a specifically designed regimen, as capecitabine labeling advises caution. If used, monitor closely for severe diarrhea and myelosuppression and reduce the capecitabine dose as needed.
What other medicines interact with Capecitabine?
MediHelp also lists interactions of Capecitabine with, for example, Adenovirus types 4 and 7 live, Arsenic trioxide, Axicabtagene ciloleucel. The full list is on the Capecitabine page.
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