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Getting Oral Chemotherapy
Many types of chemotherapy (chemo) are given by infusion or injection, but some are given by mouth. Oral chemo is just as strong as chemo given by infusion or injection and can have the same side effects.
- What is oral chemo?
- Which cancers are treated with oral chemo?
- How often will I need to take oral chemotherapy?
- How and when to take oral chemo
- Will I still need to see my doctor if taking oral chemo?
- Special handling for oral chemo
- How long does oral chemo stay in the body?
- What are the side effects of oral chemo?
- Questions to ask before starting oral chemo
- Oral chemo costs
What is oral chemo?
Oral chemo is chemo that can be taken by mouth as pills, capsules, or liquids. Like other types of chemo, oral chemo may be given in rounds or cycles. This cuts down on the harm to healthy cells and allows them to recover from the side effects of the chemo. However, some types of oral chemo are given continuously, requiring close monitoring of side effects.
Examples of oral chemo include capecitabine, cyclophosphamide, and etoposide.
Which cancers are treated with oral chemo?
With more types of oral chemo now available, it’s being used more often than ever. But it isn’t an option for every type of cancer, and it may not be right for everyone. Cancers often treated with oral chemo include some forms of:
- Breast cancer
- Colorectal cancer
- Small cell lung cancer
- Leukemia
- Lymphoma
- Multiple myeloma
Oral chemo may be used for other types of cancer as well.
How often will I need to take oral chemotherapy?
Oral chemo is often given in cycles, just like chemo infusions. You may need treatments daily (sometimes multiple times a day), weekly, or monthly, but they’re usually given in on-and-off cycles. This means, for example, that you may take chemo the first 2 weeks and then have a week off, making it a cycle that will start over every 3 weeks. The time off lets your body build healthy new cells and regain its strength.
Sometimes, oral chemo is given continuously, without breaks or time off. This keeps a steady level of medicine in your blood and gives cancer cells constant exposure to the chemo as they grow and divide.
Your cancer care team will tell you how many cycles are planned and how long they expect your treatment to last. How often you’ll need to take oral chemo and how long your treatment lasts will depend on:
- The kind of cancer you have
- The goals of the treatment
- The types of chemo being used
- How your body responds to them
How and when to take oral chemo
The success of oral chemo taken at home depends on you – it’s important to take the right dose of the chemo, at the right time, just as you’ve been told. Your cancer care team is there to help you do this.
Oral chemo doses are designed to keep a steady level of the chemo in your body to kill the cancer cells. Not taking your chemo the right way can affect how well it works. Your care team should give you clear instructions on how much and when to take your oral chemo. You need to take the exact dosage, at the exact right time, for exactly as long as you’re supposed to do so. Sometimes dose changes are needed, but don’t make any changes unless your doctor tells you to do so.
If you miss a dose or are late taking one, tell your doctor or nurse about it. They need to know about this when deciding if treatment is working. It may also help the doctor decide whether to change how much of the medicine you take or when you take it.
Sometimes there are food and drug interactions that can change how well the chemo works, making it less effective or causing additional side effects. Make sure you know:
- If you need to avoid any other medicines, food, vitamins, herbs, supplements, skin lotions, or other treatments before you begin oral chemo
- If the tablets or capsules can be opened, broken, or crushed
- If you can mix them with food or liquid to take them
Will I still need to see my doctor if taking oral chemo?
Even though you take oral chemo at home, you will still need to see your cancer care team. They will:
- Watch for changes in the cancer
- Check how you are doing with your chemo plan
- Do blood tests and scans to see how your body and the cancer are doing with the chemo.
Special handling for oral chemo
Chemo you swallow is just as strong as other forms of chemo. Many are also considered hazardous. There are usually special precautions for storing and handling oral chemo. For example:
- You might be told to be careful not to let others come into contact with the chemo or your body fluids while taking it and for a time after taking it.
- Sometimes you need to wear gloves when touching the pills or capsules.
- Some chemo has to be kept in the bottle or box they came in.
- Some types of chemo and the packages they come in need to be disposed of in a certain way.
- Some might have to be taken back to the pharmacy to be thrown away safely.
To learn more, see Chemotherapy Safety.
How long does oral chemo stay in the body?
Many people wonder how long the actual chemo stays in their body and how it’s removed. Your kidneys and liver break down most chemo medicines which then leave your body through urine or stool. How long it takes your body to get rid of the chemo depends on many things, including the type of chemo you get, other medicines you take, your age, and how well your kidneys and liver work. Your cancer care team will tell you if you need to take any special precautions because of the chemo you are taking.
What are the side effects of oral chemo?
The side effects of oral chemo vary from medicine to medicine and from person to person. Your cancer care team may not be able to tell you what side effects you’ll have, but they can tell you what to watch for.
If you do have side effects, tell your team about them as soon as they happen, so they can help you manage them. Your doctor may change how much you take or give you other medicines to help you feel better.
If you aren’t sure about a side effect and can’t reach your doctor, don’t take your chemo until you talk to someone on your cancer care team.
Taking chemo at home gives you more freedom without having a lot of treatment visits. You may not be seeing your doctor and nurses very often but be sure to call them with any questions or concerns you have.
Questions to ask before starting oral chemo
Be sure to talk to your care team about what steps to take if you have problems with your medication, including:
- What to do if you miss a dose
- What to do if you lose or misplace a pill
- What to do if you have trouble swallowing, throw up, or feel sick to your stomach
- How to reach your care team if you have trouble late at night or on the weekend
Oral chemo costs
Oral chemo can be expensive. Make sure you ask your doctor about the cost of your treatment so you are not surprised when you get to the pharmacy or when you get your bill.
Depending on the type of chemo, some insurances don't cover the full cost or may not cover it at all. Sometimes you can get assistance, but many people have to pay more of their own money for oral chemo than they would for chemo infusions. If you have health insurance, this might mean a higher co-pay. Make sure you know how much you’ll have to pay for each treatment. You can call the American Cancer Society at 1-800-227-2345 for more information about financial assistance.
- Written by
- References
Developed by the American Cancer Society medical and editorial content team with medical review and contribution by the American Society of Clinical Oncology (ASCO).
Chu E, DeVita VT. Physician's Cancer Chemotherapy Drug Manual, 2019. Burlington, MA: Jones & Bartlett Learning; 2019.
Olsen MM, Naseman RW. Chemotherapy. In Olsen MM, LeFebvre KB, Brassil KJ, eds. Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice. Pittsburgh, PA: Oncology Nursing Society; 2019:61-90.
Oncology Nursing Society (ONS). Toolkit for Safe Handling of Hazardous Drugs for Nurses in Oncology. Accessed at https://www.ons.org/sites/default/files/2018-06/ONS_Safe_Handling_Toolkit_0.pdf on November 5, 2019.
Last Revised: May 15, 2025
American Cancer Society medical information is copyrighted material. For reprint requests, please see our Content Usage Policy.
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