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Capecitabine GI Toxicity Management — SCE Palliative Medicine MCQ

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EasyNausea & VomitingCapecitabine GI Toxicity ManagementSCE Palliative Medicine

A 65-year‑old man with advanced colorectal cancer develops nausea and vomiting while on capecitabine. He has been instructed to contact the oncology team if he develops gastrointestinal toxicity. What is the most important immediate action?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: DStop capecitabine immediately and contact the oncology team

Option D is correct. The UK capecitabine SmPC states that patients must interrupt treatment immediately if moderate or severe toxicity such as vomiting occurs ([medicines.org.uk](https://www.medicines.org.uk/emc/product/14544/smpc?utm_source=openai)). NHS Acute Oncology and chemotherapy toxicity protocols reinforce that systemic anticancer therapy including capecitabine must be stopped promptly when significant GI toxicity appears, with urgent contact of the oncology team ([rightdecisions.scot.nhs.uk](https://www.rightdecisions.scot.nhs.uk/acute-oncology-guidelines/systemic-anticancer-treatment-toxicity/step-2-find-the-symptoms/diarrhoea/is-the-patient-on-chemotherapy/chemotherapy-induced-diarrhoea/?utm_source=openai)). Option C is dangerous and contradicts all guidance. Option A (self‑reduction) bypasses oncology management. Option E fails to acknowledge the need to interrupt therapy and risks progression to dehydration or mucositis. Option B is inappropriate—IV 5‑FU has similar metabolic risks and switching without medical review is unsafe.

Reference: Capecitabine SmPC (eMC), ~2025; NHS Acute Oncology guidance on chemotherapy‑induced toxicity, 2025, https://www.medicines.org.uk/emc/product/14544/smpc