Fluorouracil (fluorouracil)

Dosage and dosage schedules of fluorouracil should be individualized based on the tumor type, specific regimen, clinical response, and concomitant comorbidities. Clinicians should consult published protocols for the dosage of fluorouracil and other chemotherapeutic agents and the method and sequence of administration.

If grade 3 or 4 diarrhea or mucositis, grade 4 myelosuppression, or grade 2 or 3 palmar-plantar erythrodysesthesia (hand-foot syndrome) occurs, withhold fluorouracil. When the toxicity has resolved or improved to grade 1, resume fluorouracil at a reduced dosage.

Withhold fluorouracil if cardiotoxicity (i.e., angina, myocardial infarction or ischemia, arrhythmia, heart failure) develops in patients with no history of coronary artery disease or cardiac dysfunction. Therapy with the medication also should be withheld if hyperammonemic encephalopathy or neurologic effects (i.e., acute cerebellar syndrome, confusion, disorientation, ataxia, visual disturbance) develop. The manufacturers state there is no recommended dosage for resumption of fluorouracil following development of cardiotoxicity, hyperammonemic encephalopathy, or neurologic effects.

Fluorouracil is administered IV as a bolus or infusion. Do not inject the entire contents of the fluorouracil vial directly. The 2.5- or 5-g pharmacy bulk package of fluorouracil is intended for preparation of individual doses of the medication and is not for direct IV infusion; after the vial has been entered, any unused portion should be discarded within 4 hours. An established IV line should be used to administer fluorouracil by direct IV injection. For IV infusion regimens, the medication should be administered via a central venous catheter using a controlled-infusion device (e.g., pump). Store fluorouracil injection in the original carton at 20-25degreesC; protect from light and do not freeze.

No dosing information is available for this tab.

No dosing information is available for this tab.

There is no enhanced messaging for this drug.

There are no contraindication interactions for this drug.

There are no severe interactions for this drug.

There are no moderate interactions for this drug.

*None.

There are no contraindication contraindications for this drug.

There are no severe contraindications for this drug.

There are no moderate contraindications for this drug.

Reported adverse effects for fluorouracil come from postmarketing reports and include pancytopenia, gastrointestinal ulceration, nausea, vomiting, anaphylaxis and generalized allergic reactions, nystagmus, headache, dry skin, fissuring, photosensitivity (manifested by erythema or increased skin pigmentation), vein pigmentation, lacrimal duct stenosis, visual changes, lacrimation, photophobia, euphoria, thrombophlebitis, epistaxis, and nail changes.

There are no severe adverse reactions for this drug.

There are no less severe adverse reactions for this drug.

No enhanced messaging available.

Safety and effectiveness of fluorouracil have not been established in pediatric patients.

Fluorouracil may cause fetal harm when administered to pregnant females. The medication has been shown to be embryotoxic and teratogenic in animals at dosages lower than a human dose of 12 mg/kg. Fetal malformations included cleft palate, skeletal defects, and deformed appendages, paws, and tails. In monkeys, doses greater than an approximate human dose of 12 mg/kg resulted in abortion.

There are no adequate and controlled studies using fluorouracil in pregnant females. If the medication is used during pregnancy or if the patient becomes pregnant while receiving fluorouracil, the patient should be informed of the potential hazard to the fetus.

It is not known whether fluorouracil or its metabolites are distributed into milk. Because many medications are distributed into human milk and because of the potential for serious adverse reactions to fluorouracil in nursing infants, a decision should be made whether to discontinue nursing or the medication, taking into account the importance of the medication to the nursing mother.

The manufacturer makes no specific dosage recommendations for geriatric patients.

Reported clinical experience with fluorouracil has not identified any differences in safety or effectiveness between geriatric patients and younger adults.