warning--should they want to put you on antivirals for shingles, etc

[Lani]

while on capecitabine there may be ab adverse interaction between capecitabine and at least one antiviral

Nat Rev Clin Oncol. 2010 Jan;7(1):55-8.
Interaction between capecitabine and brivudin in a patient with breast cancer.
Baena-Cañada JM, MartÃ*nez MJ, GarcÃ*a-Olmedo O, Jiménez-Bárcenas R, Muriel-Cueto P; Medscape.

Medical Oncology Unit, Puerta del Mar University Hospital, Avenida Ana de Viya 21, 11009 Cádiz, Spain.
Background. A 66-year-old woman with metastatic mammary carcinoma, who was being treated with capecitabine, contracted a herpes zoster infection that was treated with the antiviral drug brivudin. A drug-drug interaction between brivudin and capecitabine caused medullar aplasia, serious toxic effects to the intestinal mucous membrane, hand-foot syndrome, onycholysis and dental pigmentation.Investigations. Physical examination, blood analysis, blood cultures, chest X-ray, bone marrow aspiration and biopsy.Diagnosis. Serious adverse event secondary to inhibition of dihydropyrimidine dehydrogenase by a drug-drug interaction between capecitabine and brivudin.Management. Intravenous hydration, imipenem, red blood cell and platelet transfusions, filgrastim, omeprazole, care of the mouth and feet, topical anesthetics, systemic analgesics and parenteral nutrition.

PMID: 20029444