5-Fluorouracil can cross brain-blood barrier and cause encephalopathy: should we expect the same from capecitabine? A case report on capecitabine-induced central neurotoxicity progressing to coma

Cancer Chemother Pharmacol. 2006 Aug;58(2):276-8. doi: 10.1007/s00280-005-0159-4. Epub 2005 Dec 7.


Purpose: Capecitabine is a relatively new oral fluoropyrimidine currently licensed for the treatment of colorectal and breast cancer.

Results: It has the advantage of oral administration with good tolerability and comparable activity to intravenous 5-fluorouracil. Central neurotoxicity has been described in 5-fluorouracil-treated patients but there is little data regarding capecitabine. We report here a case of reversible capecitabine-induced encephalopathy progressing to coma.

Discussion: Literature on fluoropyrimidine-related neurotoxicity will also be reviewed and possible mechanisms of the drug or its metabolites crossing the blood-brain barrier will be discussed.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / pharmacokinetics*
  • Blood-Brain Barrier*
  • Capecitabine
  • Central Nervous System Diseases / chemically induced*
  • Coma / chemically induced*
  • Deoxycytidine / adverse effects
  • Deoxycytidine / analogs & derivatives*
  • Deoxycytidine / pharmacokinetics
  • Fluorouracil / adverse effects
  • Fluorouracil / pharmacokinetics*
  • Humans


  • Antineoplastic Agents
  • Deoxycytidine
  • Capecitabine
  • Fluorouracil