Uncontrolled hypertriglyceridemia induced by capecitabine: case report and review of the literature

Capecitabine, a prodrug of 5-fluorouracil (5-FU), is rarely associated with severe hypertriglyceridemia. We present a patient with severe capcitabine-induced hypertriglyceridemia, with the literature review. A 50-year-old woman with metastatic breast carcinoma was treated with oral capecitabine. She was also receiving bezafibrate due to hyperglycenemia. Pretreatment lipid profile revealed slight elevation of serum triglycerides and total cholesterol. A repeat lipid profile performed 5 weeks after the start of capecitabine treatment revealed a marked increase in the serum triglyceride and cholesterol levels. The dose of bezafibrate was increased, atorvastatin was added, and the next cycle of capecitabine was withheld. When the triglyceride and cholesterol levels had decreased, capecitabine was started with reduced dose. However, at the end of this cycle, the triglyceride and the cholesterol levels increased again. Monitoring of the lipid profile should be considered in cancer patients receiving capecitabine, particularly those with a known diagnosis of dyslipidemia.