Xeloda Is an Oral Chemotherapy Used to Treat Breast Cancer and Colorectal Cancer

Xeloda (Capecitabine) is a prescription oral chemotherapy medication made by Genentech (Roche) that converts to the cancer-fighting drug 5-fluorouracil (5-FU) inside your body. It's one of the most widely prescribed oral chemotherapy drugs in the world.

Whether you've just been prescribed Xeloda or you're researching it for a loved one, this guide covers everything you need to know — what it treats, how to take it, who should avoid it, and what it costs in 2026.

What Is Xeloda?

Xeloda is the brand name for Capecitabine, a type of chemotherapy called a fluoropyrimidine. Unlike traditional chemotherapy that's given through an IV at a clinic, Xeloda is a pill you take at home.

Capecitabine is a prodrug, meaning it's not active when you swallow it. Once absorbed, your body converts it through several steps into 5-fluorouracil (5-FU), which is the active cancer-fighting compound. The final activation step happens preferentially in tumor tissue, thanks to an enzyme called thymidine phosphorylase that's found at higher levels in cancer cells. For more on this process, see our guide on how Xeloda works.

Xeloda comes in two tablet strengths:

• 150 mg tablets
• 500 mg tablets

Generic Capecitabine is also available from multiple manufacturers.

What Is Xeloda Used For?

Xeloda is FDA-approved for three main uses:

1. Metastatic Breast Cancer

Xeloda can be used alone (monotherapy) in patients whose cancer has not responded to paclitaxel and anthracycline-based chemotherapy. It can also be used in combination with Docetaxel after anthracycline failure.

2. Adjuvant Colon Cancer Treatment

After surgery for Dukes' C (stage III) colon cancer, Xeloda is used as adjuvant therapy to help prevent the cancer from coming back. It has been shown to be a convenient oral alternative to IV 5-FU/leucovorin regimens.

3. Metastatic Colorectal Cancer

Xeloda is approved as a first-line treatment for metastatic colorectal cancer when fluoropyrimidine therapy alone is preferred.

Off-Label Uses

Oncologists also prescribe Capecitabine off-label for several other cancers, including:

• Pancreatic cancer (often combined with Gemcitabine)
• Gastric and gastroesophageal junction cancer
• Hepatobiliary cancers
• Ovarian cancer
• Neuroendocrine tumors (in the CAPTEM regimen with Temozolomide)

How Is Xeloda Taken?

Xeloda is taken by mouth, typically in 3-week (21-day) cycles:

• Days 1–14: Take Xeloda twice daily (morning and evening)
• Days 15–21: Rest period — no medication

Then the cycle repeats.

Dosing Details

• The typical dose is 1,000–1,250 mg/m² twice daily, based on your body surface area (BSA)
• Total daily doses typically range from about 2,000 mg to 5,000 mg per day
• Take each dose within 30 minutes after a meal (breakfast and dinner) with a full glass of water
• Swallow tablets whole — do not crush, chew, or cut them

Your oncologist will calculate your exact dose based on your height, weight, kidney function, and how well you tolerate the medication. Dose reductions are common and don't mean the treatment isn't working — they help you stay on treatment longer with fewer complications.

Who Should Not Take Xeloda?

Xeloda is not safe for everyone. You should not take Capecitabine if you have:

• Known allergy to Capecitabine or 5-fluorouracil
• Severe kidney impairment (creatinine clearance below 30 mL/min)
• Complete DPD deficiency — Dihydropyrimidine dehydrogenase (DPD) is an enzyme your body needs to break down Capecitabine. People who lack this enzyme are at risk of severe, potentially fatal toxicity. DPD testing is recommended before starting treatment.
• Pregnancy or breastfeeding — Xeloda can cause serious harm to an unborn baby

Patients with moderate kidney impairment (creatinine clearance 30–50 mL/min) may need a reduced dose. Elderly patients (80+) may experience more severe side effects and may start at a lower dose. For more on side effects, see our Xeloda side effects guide.

How Much Does Xeloda Cost?

Xeloda can be expensive, but the cost varies significantly depending on whether you use brand or generic, your insurance, and which pharmacy you use.

Without Insurance

• Brand-name Xeloda: $800–$3,500 per 3-week cycle
• Generic Capecitabine: $200–$800 per cycle, or as low as $150–$400 with discount cards

With Insurance

Most commercial insurance plans and Medicare Part D cover Capecitabine, though it's often on a specialty tier. Prior authorization is commonly required. Expect copays or coinsurance — Medicare Part D patients may pay 25–33% coinsurance until reaching catastrophic coverage.

Ways to Save

• Genentech Co-pay Assistance Program — For commercially insured patients taking brand Xeloda. Call 1-866-422-2377 or visit genentech-access.com.
• Genentech Patient Foundation — Provides free Xeloda to eligible uninsured or underinsured patients.
• Discount cards — GoodRx, SingleCare, and other tools can lower generic Capecitabine prices significantly.
• Non-profit assistance — PAN Foundation, HealthWell Foundation, and CancerCare offer co-pay help for oral chemotherapy.

For a complete breakdown, read our guide on how to save money on Xeloda.

Final Thoughts

Xeloda is a well-established oral chemotherapy that gives cancer patients the convenience of home-based treatment. It's FDA-approved for breast and colorectal cancers and widely used off-label for other cancers.

The key things to remember: take it with food, follow the 14-days-on/7-days-off cycle, report side effects early, and make sure you've been tested for DPD deficiency before starting.

If you're having trouble finding Xeloda at your pharmacy, Medfinder can help you check real-time availability near you. And if you want to understand how this medication works at a deeper level, check out our guide on Xeloda's mechanism of action.