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Fluorouracil 5 FU Brand Names
Adrucil | Carac | Efudex | Fluoroplex | Tolak
What is Fluorouracil 5 FU
Fluorouracil 5 FU is a fluorinated pyrimidine and acts as an antimetabolite antineoplastic agent.
It differs from the naturally occurring product, uracil, by the addition of a fluoride at position 5.
Fluorouracil is a component of chemotherapy regimens for many solid tumors, including breast, colorectal, gastrointestinal, and head and neck cancers. The clinical pharmacology of 5-FU is complex and the pharmacokinetics are complicated by intra- and inter-patient variability, nonlinear elimination, and erratic bioavailability.
The toxicities and efficacy of 5-FU differ depending upon the route of administration of the drug.
A meta-analysis of 5-FU studies in the treatment of colorectal cancer found that continuous infusion led to a superior response and overall survival rate with a decreased incidence of severe hematologic toxicity as compared to bolus injection.
However, there was an increased incidence of hand-foot syndrome with the continuous infusion as compared to the bolus injection.
Fluorouracil commonly is given intravenously but is also used topically for malignant keratoses of the skin.
Fluorouracil was approved by the FDA in 1962.
In October 2000, a new formulation of fluorouracil cream using a microsponge delivery system (Carac™) was FDA-approved.
The new delivery system allows for once daily dosing and a sustained release of fluorouracil.
Indications
- actinic keratosis
- anal cancer
- basal cell carcinoma
- breast cancer
- colorectal cancer
- gastric cancer
- head and neck cancer
- pancreatic cancer
Side Effects
- acute cerebellar syndrome
- agranulocytosis
- alopecia
- anaphylactoid reactions
- anemia
- angina
- anorexia
- bleeding
- bowel ischemia
- chest pain (unspecified)
- confusion
- conjunctivitis
- contact dermatitis
- coronary vasospasm
- diarrhea
- dysgeusia
- edema
- eosinophilia
- epistaxis
- erythema
- esophagitis
- euphoria
- GI bleeding
- headache
- ichthyosis
- infection
- injection site reaction
- insomnia
- irritability
- lacrimation
- leukocytosis
- leukopenia
- maculopapular rash
- myocardial infarction
- nail discoloration
- nasal irritation
- nausea
- nystagmus
- ocular irritation
- ocular pain
- ocular pruritus
- oral ulceration
- palmar-plantar erythrodysesthesia (hand and foot syndrome)
- palpitations
- pancytopenia
- peptic ulcer
- pharyngitis
- phlebitis
- photophobia
- photosensitivity
- pruritus
- pulmonary embolism
- rash
- sinusitis
- skin erosion
- skin hyperpigmentation
- skin irritation
- skin ulcer
- spontaneous fetal abortion
- ST-T wave changes
- stomatitis
- telangiectasia
- teratogenesis
- thrombocytopenia
- thromboembolism
- urticaria
- ventricular tachycardia
- vomiting
- xerosis
Monitoring Parameters
- CBC with differential
- LFTs
- neurologic function
Contraindications
- accidental exposure
- biliary tract disease
- bleeding
- bone marrow suppression
- breast-feeding
- children
- dental disease
- dental work
- diarrhea
- dihydropyrimidine dehydrogenase (DPD) deficiency
- GI bleeding
- hepatic disease
- infection
- intrathecal administration
- jaundice
- leukopenia
- malnutrition
- occlusive dressing
- ocular exposure
- pregnancy
- radiation therapy
- renal impairment
- skin abrasion
- stomatitis
- sunlight (UV) exposure
- thrombocytopenia
- vaccination
- vomiting
Interactions
- Allopurinol
- Amlodipine; Celecoxib
- Anticoagulants
- Antithrombin III
- Apixaban
- Argatroban
- Betrixaban
- Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
- Bismuth Subsalicylate; Metronidazole; Tetracycline
- Bivalirudin
- Bosentan
- Celecoxib
- Cimetidine
- Dabigatran
- Dalteparin
- Danaparoid
- Dapsone
- Desirudin
- Diclofenac
- Diclofenac; Misoprostol
- Diflunisal
- Diphenhydramine; Ibuprofen
- Diphenhydramine; Naproxen
- Dronabinol
- Drospirenone; Ethinyl Estradiol; Levomefolate
- Edoxaban
- Enoxaparin
- Erdafitinib
- Esomeprazole; Naproxen
- Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
- Ethotoin
- Etodolac
- Famotidine; Ibuprofen
- Fenoprofen
- Flurbiprofen
- Fondaparinux
- food
- Fosphenytoin
- Glimepiride
- Glimepiride; Pioglitazone
- Glimepiride; Rosiglitazone
- Heparin
- Hydantoins
- Hydrocodone; Ibuprofen
- Hydroxyurea
- Ibuprofen
- Ibuprofen; Oxycodone
- Ibuprofen; Pseudoephedrine
- Indomethacin
- Interferon Alfa-2a
- Interferon Alfa-2b
- Interferon Alfa-2b; Ribavirin
- Ketoprofen
- Ketorolac
- Lamotrigine
- Lansoprazole; Naproxen
- Lepirudin
- Lesinurad
- Lesinurad; Allopurinol
- Leucovorin
- Levoleucovorin
- Levomefolate
- Live Vaccines
- Meclofenamate Sodium
- Mefenamic Acid
- Meloxicam
- Methotrexate
- Metronidazole
- Nabumetone
- Naproxen
- Naproxen; Pseudoephedrine
- Naproxen; Sumatriptan
- Neomycin
- Nonsteroidal antiinflammatory drugs
- Oxaprozin
- Palifermin
- Penicillamine
- Pentosan
- Phenytoin
- Piroxicam
- Porfimer
- Pyrimethamine
- Pyrimethamine; Sulfadoxine
- Ramelteon
- Rivaroxaban
- Rofecoxib
- Siponimod
- Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
- Sulindac
- Terbinafine
- Tinidazole
- Tinzaparin
- Tolmetin
- Trimethoprim
- Trimetrexate
- Tuberculin Purified Protein Derivative, PPD
- Valdecoxib
- Warfarin
