Jagged little pill

So today's Xeloda prescription was the first one to arrive from my new mail order pharmacy (due to an insurance change). And when I popped open the bottle, the normally peach pills were... white.

I felt like I couldn't just take them without looking into it. Mistakes do happen, what if that's the wrong drug or not a safe dose for me. I'm picturing a big warehouse full of robots filling the orders... and robots can go rogue! I've seen the movies.

Anyway, it's just a different manufacturer so crisis averted. However, during my search I came across the below good description of how Xeloda works. I think sometimes people don't understand that there are hundreds, probably thousands, of chemotherapy drugs. And many of them do very different things. Science is amazing. If only my old biology teacher, Dr. Lllllllungo could see me now.

From: http://chemocare.com/chemotherapy/drug-info/Xeloda.aspx

How Xeloda Works:
Cancerous tumors are characterized by cell division, which is no longer controlled as it is in normal tissue.  "Normal" cells stop dividing when they come into contact with like cells, a mechanism known as contact inhibition.  Cancerous cells lose this ability.  Cancer cells no longer have the normal checks and balances in place that control and limit cell division.  The process of cell division, whether normal or cancerous cells, is through the cell cycle.  The cell cycle goes from the resting phase, through active growing phases, and then to mitosis (division).

The ability of chemotherapy to kill cancer cells depends on its ability to halt cell division.  Usually, the drugs work by damaging the RNA or DNA that tells the cell how to copy itself in division.  If the cells are unable to divide, they die.  The faster the cells are dividing, the more likely it is that chemotherapy will kill the cells, causing the tumor to shrink.  They also induce cell suicide (self-death or apoptosis).

Chemotherapy drugs that affect cells only when they are dividing are called cell-cycle specific.  Chemotherapy drugs that affect cells when they are at rest are called cell-cycle non-specific.  The scheduling of chemotherapy is set based on the type of cells, rate at which they divide, and the time at which a given drug is likely to be effective.  This is why chemotherapy is typically given in cycles.

Chemotherapy is most effective at killing cells that are rapidly dividing.  Unfortunately, chemotherapy does not know the difference between the cancerous cells and the normal cells. The "normal" cells will grow back and be healthy but in the meantime, side effects occur.  The "normal" cells most commonly affected by chemotherapy are the blood cells, the cells in the mouth, stomach and bowel, and the hair follicles; resulting in low blood counts, mouth sores, nausea, diarrhea, and/or hair loss.  Different drugs may affect different parts of the body.

Xeloda belongs to the category of chemotherapy called antimetabolites.  Antimetabolites are very similar to normal substances within the cell.  When the cells incorporate these substances into the cellular metabolism, they are unable to divide.  Antimetabolites are cell-cycle specific.  They attack cells at very specific phases in the cycle.  Antimetabolites are classified according to the substances with which they interfere.

• Folic acid antagonist: Methotrexate. 

• Pyrimidine antagonist: 5-Fluorouracil, Foxuridine, Cytarabine, Xeloda, and Gemcitabine.

• Purine antagonist: 6-Mercaptopurine and 6-Thioguanine. 

• Adenosine deaminase inhibitor: Cladribine, Fludarabine and Pentostatin.

Note:  We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.