Summary for doctors
- Every 21 days; no infusion pump [1].
- Adjuvant stage 3: 4 cycles (3 months) at low risk (T1-3 and N1) and 8 cycles (6 months) at high risk [2].
- Capecitabine is reduced with a creatinine clearance below 50 and contraindicated below 30.
Dose and schedule
CAPOX / XELOX
Colorectal cancer (adjuvant and metastatic), gastric cancerCycle length: Every 21 days
Colorectal cancer (adjuvant and metastatic), gastric cancer
| Drug | Dose | Route | Schedule |
|---|---|---|---|
| Oxaliplatin | 130 mg/m² | IV over 2 hours | Day 1 |
| Capecitabine | 1000 mg/m² twice a day | Oral, within 30 minutes after food | Evening of day 1 to morning of day 15 |
Doses as in the NO16968 study [1].
Evidence: IDEA (2018), Capecitabine Plus Oxaliplatin Compared With Fluorouracil and Folinic Acid As Adjuvant Therapy for Stage III Colon Cancer (2011)
Doses follow the trial protocol, guideline or official drug label (source given in the notes of each regimen). Before prescribing, check blood counts, renal and hepatic function, drug interactions and the patient’s condition, and adjust the dose according to the drug label.
Premedication and supportive care
- Antiemetics: a 5-HT3 antagonist and dexamethasone on day 1.
- DPYD: before the first fluoropyrimidine dose, consider testing for DPD deficiency (DPYD genotype); in carriers of one reduced-function allele the starting dose is reduced by about 50%, and these drugs are contraindicated in complete deficiency [3].
- Moisturising cream for the hands and feet, and avoiding cold in the days after oxaliplatin.
Monitoring and dose adjustment
- Kidney: creatinine clearance 30 to 50: capecitabine starting dose 75%; below 30: contraindicated.
- Grade 2 or higher hand-foot syndrome, diarrhoea or mucositis: hold capecitabine until recovery and, after the second occurrence, continue at 75% of the dose; missed doses are not made up.
- Warfarin: capecitabine raises the INR; close monitoring or low-molecular-weight heparin.
- Neuropathy: as for FOLFOX.
Main evidence
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NO16968: in stage 3 colon cancer, CAPOX increased 3-year disease-free survival from 66.5% (fluorouracil/leucovorin) to 70.9% [1]. IDEA: with CAPOX, three months of treatment was almost equivalent to 6 months in the whole group, with much less neuropathy [2].
Related cancer types
Treatment regimens (physicians)
References
3 referencesShow all references, 3 with a study cardClose the reference list
Numbers in the text, such as [1], refer to these sources. Sources with a “Study card” button are summarised in the site’s evidence library.
- 1
- 2
- 3Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for Dihydropyrimidine Dehydrogenase Genotype and Fluoropyrimidine Dosing: 2017 Update
This page is based on reputable scientific sources and was last updated on 28 October 2026. The content of this website is for educational and informational purposes only and does not replace consultation, diagnosis or treatment by a specialist physician. Consult your treating physician about any treatment decision.
Printed from the website; the full and up-to-date version: https://drdabiri.com/en/regimens/capox/