fluorouracil
enUKfluor·o·u·ra·cil
F0208100 (flo͝or′ō-yo͝or′ə-sĭl, flôr′-)fluorouracil
(ˌflʊərəʊˈjʊərəsɪl)fluor•o•u•ra•cil
(ˌflʊər əˈyʊər ə sɪl, ˌflɔr-, ˌfloʊr-)n.
| Noun | 1. | fluorouracil - an antimetabolite used to treat certain cancers |
n.
fluorouracil
enUKfluorouracil:
see metabolitemetabolite,organic compound that is a starting material in, an intermediate in, or an end product of metabolism. Starting materials are substances, usually small and of simple structure, absorbed by the organism as food. These include the vitamins and essential amino acids.
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fluorouracil
[¦flu̇r·ō′yu̇r·ə‚sil]fluorouracil
enUKfluorouracil
[floor″o-u´rah-sil]fluorouracil (5-fluorouracil, 5-FU)
Pharmacologic class: Antimetabolite
Therapeutic class: Antineoplastic
Pregnancy risk category D
Action
Inhibits DNA and RNA synthesis, leading to death of rapid-growing neoplastic cells. Cell-cycle-S-phase specific.
Availability
Cream: 1%, 5%
Injection: 50 mg/ml in 10-ml ampules and 10-, 20-, and 100-ml vials
Solution: 1%, 2%, 5%
Indications and dosages
➣ Advanced colorectal cancer
Adults: 370 mg/m2 I.V. for 5 days, preceded by leucovorin 200 mg/m2 daily for 5 days; may be repeated q 4 to 5 weeks. No single daily dose should exceed 800 mg.
➣ Colon, rectal, breast, gastric, and pancreatic cancer
Adults: Initially, 12 mg/kg/day I.V. for 4 days; then 6 mg/kg I.V. on days 6, 8, 10, and 12. Maximum dosage is 800 mg/day. For maintenance, start 30 days after last dose. If no toxicity, use dosage from first course. If toxicity occurs, give 10 to 15 mg/kg/week as single dose after toxicity subsides. Don't exceed 1 g/week.
➣ Actinic (solar) keratoses
Adults: 1% solution or cream applied once or twice daily to lesions on head, neck, or chest; 2% to 5% solution or cream may be needed for other areas.
➣ Superficial basal cell carcinoma
Adults: 5% solution or cream applied b.i.d. for 3 to 6 weeks (up to 12 weeks)
Contraindications
• Hypersensitivity to drug or its components
• Bone marrow depression
• Dihydropyrimidine dehydrogenase enzyme deficiency (with topical route)
• Poor nutritional status
• Serious infection
• Pregnancy or breastfeeding
Precautions
Use cautiously in:
• renal or hepatic impairment, infections, edema, ascites
• obese patients.
Administration
See Consult facility's cancer protocols to ensure correct dosage, administration technique, and cycle length.
• Give antiemetic before fluorouracil, as ordered, to reduce GI upset.
• Know that drug may be given without dilution by direct I.V. injection over 1 to 3 minutes.
• For I.V. infusion, dilute with dextrose 5% in water, sterile water, or normal saline solution in plastic bag (not glass bottle). Infusion may be given over a period of 24 hours or more.
See Be aware of the importance of leucovorin rescue with fluorouracil therapy, if prescribed.
• Check infusion site frequently to detect extravasation.
• Use nonmetal applicator or appropriate gloves to apply topical form.
• Avoid applying topical form to mucous membranes or irritated skin.
• Don't use occlusive dressings over topical form.
• Know that pyridoxine may be given with fluorouracil to reduce risk of palmar-plantar erythrodysesthesia (hand-foot syndrome).
Adverse reactions
CNS: confusion, disorientation, euphoria, ataxia, headache, weakness, malaise, acute cerebellar syndrome or dysfunction
CV: angina, myocardial ischemia, thrombophlebitis
EENT: vision changes, photophobia, lacrimation, lacrimal duct stenosis, nystagmus, epistaxis
GI: nausea, vomiting, diarrhea, stomatitis, anorexia, GI ulcer, GI bleeding
Hematologic: anemia, leukopenia, thrombocytopenia
Skin: alopecia, maculopapular rash, melanosis of nails, nail loss, palmar-plantar erythrodysesthesia, photosensitivity, local inflammation reaction (with cream), dermatitis
Other: fever, anaphylaxis
Interactions
Drug-drug. Bone marrow depressants (including other antineoplastics): additive bone marrow depression
Irinotecan: dehydration, neutropenia, sepsis
Leucovorin calcium: increased risk of fluorouracil toxicity
Live-virus vaccines: decreased antibody response to vaccine, increased risk of adverse reactions
Drug-diagnostic tests. Alanine aminotransferase, alkaline phosphatase, aspartate aminotransferase, bilirubin, lactate dehydrogenase, urinary 5-hydroxyindoleacetic acid: increased levels
Albumin, granulocytes, platelets, red blood cells, white blood cells (WBCs): decreased levels
Drug-behaviors. Sun exposure: increased risk of phototoxicity
Patient monitoring
See Watch for signs and symptoms of toxicity, especially stomatitis and diarrhea. If these occur, stop drug and notify prescriber. Note that toxicity may take 1 to 3 weeks to develop.
• Monitor CBC, WBC and platelet counts, and kidney and liver function test results.
• Assess fluid intake and output.
• With long-term use, watch for serious rash on hands and feet. If it occurs, consult prescriber regarding need for pyridoxine.
• Assess for bleeding tendency.
• Monitor blood glucose level in patients at risk for hyperglycemia.
Patient teaching
See Emphasize importance of taking leucovorin as prescribed with high-dose therapy.
See Instruct patient to report signs and symptoms of toxicity, particularly stomatitis and diarrhea. Tell him that these may not occur for 1 to 3 weeks.
• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.
• Tell patient to avoid activities that can cause injury. Instruct him to use soft toothbrush and electric razor to avoid gum and skin injury.
• Advise patient to minimize GI upset by eating frequent, small servings of food and drinking adequate fluids.
• Tell patient that drug may cause reversible hair loss.
• Inform patient that he'll undergo regular blood testing during therapy.
See Advise female to inform prescriber immediately if she is pregnant. Caution her not to breastfeed.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and behaviors mentioned above.
fluor·o·u·ra·cil (FU),
(flōr'ō-yū'ră-sil),fluorouracil
(flo͝or′ō-yo͝or′ə-sĭl, flôr′-)fluorouracil
5-FU, Efudex® Oncology An antimetabolite that interferes with DNA synthesis, and deprives DNA of functional thymidine; 5-FU is used for bladder CA, for terminal CA and, topically, for actinic keratosis Side effects BM toxicity, mucosal inflammationflu·o·ro·u·ra·cil
(FU, FUra) (flōr'ō-yū'ră-sil)fluorouracil
A pyrimidine anticancer drug. The drug is on the WHO official list.Fluorouracil
flu·o·ro·u·ra·cil
(flōr'ō-yū'ră-sil)fluorouracil
enUK- noun
Words related to fluorouracil
noun an antimetabolite used to treat certain cancers
Related Words
- antimetabolite