Floxuridine Brand Name– FUDR
What is Floxuridine
Floxuridine is a cell cycle-phase specific antineoplastic agent used almost exclusively via hepatic artery administration to treat colon carcinoma metastatic to the liver.
Floxuridine is a deoxyribonucleoside derivative of fluorouracil (5-FU). Floxuridine is preferred over 5-FU for intrahepatic administration because a greater percentage of floxuridine is removed from the systemic circulation with one pass through the liver, potentially limiting systemic toxicity.
Floxuridine is a fluorinated pyrimidine and acts as an antimetabolite, but its mechanism of action is distinct from the other antimetabolites such as methotrexate, cytarabine, mercaptopurine, or thioguanine.
Floxuridine was given FDA approval in 1970. In January 2000, the manufacturer of FUDR(R) announced that sterile floxuridine was no longer available.
Generic formulations of floxuridine have subsequently been approved.
Indications
- colorectal cancer
- hepatocellular cancer
For the treatment of colorectal cancer metastatic to the liver
Side Effects
- abdominal pain
- acute cerebellar syndrome
- agranulocytosis
- alopecia
- anaphylactoid reactions
- anemia
- angina
- anorexia
- cholecystitis
- confusion
- diarrhea
- elevated hepatic enzymes
- erythema
- euphoria
- fever
- gastritis
- GI bleeding
- glossitis
- headache
- hepatic necrosis
- hyperbilirubinemia
- infection
- injection site reaction
- lacrimation
- lethargy
- leukopenia
- maculopapular rash
- malaise
- nausea
- nystagmus
- pancytopenia
- peptic ulcer
- pharyngitis
- phlebitis
- photophobia
- photosensitivity
- pruritus
- rash
- skin hyperpigmentation
- stomatitis
- thrombocytopenia
- thromboembolism
- thrombosis
- visual impairment
- vomiting
- weakness
- xerosis
Monitoring Parameters
- CBC with differential
- LFTs
- neurologic function
Contraindications
- accidental exposure
- bone marrow suppression
- breast-feeding
- dental disease
- dental work
- dihydropyrimidine dehydrogenase (DPD) deficiency
- GI bleeding
- hepatic disease
- hepatitis
- herpes infection
- infection
- intramuscular injections
- leukopenia
- malnutrition
- neutropenia
- ocular exposure
- pregnancy
- radiation therapy
- renal impairment
- requires a specialized care setting
- requires an experienced clinician
- stomatitis
- thrombocytopenia
- vaccination
- varicella
- viral infection
Interactions
- Allopurinol
- Amlodipine; Celecoxib
- Anticoagulants
- Antithrombin III
- Apixaban
- Argatroban
- Betrixaban
- Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
- Bismuth Subsalicylate; Metronidazole; Tetracycline
- Bivalirudin
- Celecoxib
- Cimetidine
- Dabigatran
- Dalteparin
- Danaparoid
- Desirudin
- Diclofenac
- Diclofenac; Misoprostol
- Diflunisal
- Diphenhydramine; Ibuprofen
- Diphenhydramine; Naproxen
- Drospirenone; Ethinyl Estradiol; Levomefolate
- Edoxaban
- Enoxaparin
- Esomeprazole; Naproxen
- Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
- Etodolac
- Famotidine; Ibuprofen
- Fenoprofen
- Flurbiprofen
- Fondaparinux
- Fosphenytoin
- Heparin
- Hydrocodone; Ibuprofen
- Hydroxyurea
- Ibuprofen
- Ibuprofen; Oxycodone
- Ibuprofen; Pseudoephedrine
- Indomethacin
- Ketoprofen
- Ketorolac
- Lansoprazole; Naproxen
- Lepirudin
- Lesinurad; Allopurinol
- Leucovorin
- Levoleucovorin
- Levomefolate
- Live Vaccines
- Meclofenamate Sodium
- Mefenamic Acid
- Meloxicam
- Methotrexate
- Metronidazole
- Nabumetone
- Naproxen
- Naproxen; Pseudoephedrine
- Naproxen; Sumatriptan
- Nonsteroidal antiinflammatory drugs
- Oxaprozin
- Palifermin
- Penicillamine
- Pentosan
- Pexidartinib
- Phenytoin
- Piroxicam
- Riluzole
- Rivaroxaban
- Rofecoxib
- Sulindac
- Tinzaparin
- Tolmetin
- Tuberculin Purified Protein Derivative, PPD
- Valdecoxib
- Warfarin
