Capecitabine Folinates

Folinic acid - may enhance the effect of capecitabine and concurrent use should be avoided or dosage adjustments may be necessary. 

Fluoropyrimidine-based prodrugs A new development are the oral prodrugs ftorafur and capecitabin. Both substances have already proved effective. Capecitabin should not be combined with folinic acid. 

Studies in patients with refractory advanced cancer have shown that folinic acid 30 mg twice daily does not have a major effect on the pharmacokinetics of capecitabine. However, the pharmacodynamics of capecitabine were affected as determined by the more frequent occurrence of dose-limiting gastrointestinal disorders or hand-foot syndrome. The UK manufacturers say that the maximum tolerated capecitabine dose when used alone in the intermittent regimen is 3000 mg/m, but it is reduced to 2000 mg/m if folinic acid 30 mg twice daily is also given. ... 

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