Diarrhoea (which may be severe), nausea and vomiting, abdominal pain, stomatitis, and palmar-plantar erythrodysesthesia syndrome (erythema and desquamation of hands and feet) occur commonly with Capecitabine, and may be dose-limiting. Other common adverse effects include fatigue, asthenia, and anorexia. Rashes, alopecia, erythema, dryness of the skin, pruritus, skin pigmentation disorders, and nail disorders can occur. Other adverse effects are fever, pain, arthralgia, constipation, dyspepsia, paraesthesia, headache, dizziness, insomnia, hypo or hypercalcaemia, and dehydration. Dermatitis, cardiotoxicity, and bone-marrow depression have all been reported. Hyperbilirubinaemia has occurred. Doses should be reduced in patients with moderate renal impairment.
Severe hypertriglyceridaemia has been reported with oral Capecitabine; patients had high baseline triglyceride concentrations at the start of Capecitabine. Despite the introduction of lipid-lowering therapy, triglyceride concentrations remained above baseline, and only decreased several weeks after stopping Capecitabine.