Fluorouracil

Fluorouracil is indicated for the treatment of patients with:

• Adenocarcinoma of the Colon and Rectum
• Adenocarcinoma of the Breast
• Gastric Adenocarcinoma
• Pancreatic Adenocarcinoma Fluorouracil is a nucleoside metabolic inhibitor indicated for the treatment of patients with
• Adenocarcinoma of the Colon and Rectum ( 1 )
• Adenocarcinoma of the Breast ( 1 )
• Gastric Adenocarcinoma ( 1 )
• Pancreatic Adenocarcinoma ( 1 )

None. None ( 4 )

• Serious Adverse Reactions from Dihydropyrimidine Dehydrogenase (DPD) Deficiency : Patients with certain homozygous or compound heterozygous variants in the DPYD gene are at increased risk for acute early-onset toxicity and serious, including fatal, adverse reactions due to fluorouracil (e.g., mucositis, diarrhea, neutropenia, and neurotoxicity). Fluorouracil is not recommended for use in patients known to have certain homozygous or compound heterozygous DPYD variants that result in complete absence of DPD activity. Withhold or permanently discontinue based on clinical assessment. No fluorouracil dose has been proven safe in patients with complete absence of DPD activity. ( 5.1 )
• Cardiotoxicity : Fluorouracil can cause cardiotoxicity, including angina, myocardial infarction/ischemia, arrhythmia, and heart failure. Withhold fluorouracil for cardiac toxicity. ( 5.2 )
• Hyperammonemic Encephalopathy : Altered mental status, confusion, disorientation, coma, or ataxia with elevated serum ammonia level can occur within 72 hours of initiation of fluorouracil. Withhold fluorouracil and initiate ammonia-lowering therapy. ( 5.3 )
• Neurologic Toxicity : Fluorouracil can cause acute cerebellar syndrome, confusion, disorientation, ataxia, or visual disturbances. Withhold fluorouracil for neurologic toxicity. ( 5.4 )
• Diarrhea : Fluorouracil can cause severe diarrhea. Withhold fluorouracil for severe diarrhea until resolved. ( 5.5 )