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Efudix

Generic Name: Fluorouracil
Product Name: Efudix

Indication

Fluorouracil is used as part of a chemotherapy regime aimed at palliative treatment of malignant tumours of:- Breast (ranging from mild and early to late and inoperable)- Colon- Rectum- Stomach- PancreasFluorouracil usually aims to provide temporary relief in gastrointestinal cancers.Fluorouracil cream (Efudix) is used in the treatment of a number of skin cancers.

Action

Fluorouracil is an anticancer drug known as an antimetabolite. After entering cells and being activated, it interferes with the replication of rapidly dividing cells (including cancer cells) by preventing the conversion of folic acid to folinic acid, a building block for new DNA. Fluorouracil aims to reduce tumour size and prolong life for cancer sufferers.

Dose advice

Efudix cream- Apply a thin layer of cream over the affected area.- A dressing is generally not used for solar and senile keratoses.- Other conditions, such as keratosis palmaris, may require an occlusive dressing.- Duration of therapy is usually 3-4 weeks- The total area of skin being treated at one time should not exceed 500cm2; larger areas should be treated in sections.Fluorouracil Injection BPFluorouracil Injection BP can be administered via injection or infusion. Dosage is always determined according to body weight, using ideal weight only in patients who have gained weight due to oedema, ascites or other forms of fluid retention.Intravenous infusion- 15mg/kg to a maximum of 1g daily.- Should be given in 300-500ml glucose 6% over a period of 4 hours.- Continue infusions daily until signs of toxicity begin to appear (stomatitis, diarrhoea etc), when treatment should be discontinued.- Maintenance therapy can be started after the side effects have subsided.Intravenous injection- 12mg/kg daily for 3 days.- In the absence of toxic effects, give 6mg/kg on the 5th, 7th and 9th days.- Maintenance therapy can then be initiated in the continuing absence of toxic effects.- Otherwise, wait until toxic effects have subsided, then initiate maintenance therapy.Maintenance therapy- 5-10mg/kg by intravenous injection once a week.- Discontinue until toxic effects subside, in the rare occurrence that they appear during maintenance therapy.- Reduce dose accordingly when co-administering with other cytotoxic agents or radiotherapy.

Schedule

S4

Common side effects

Efudix cream: (side effects seen at site of application):- Pain.- Itching.- Change in skin pigmentation.- Burning. Use of Fluorouracil Injection is usually accompanied by adverse effects, as the window between effective dose and toxicity is narrow.The following effects have been observed:- Nausea and vomiting – occur often and symptomatic treatment is indicated.- Diarrhoea.- Proctitis.- Oesophagitis.- Stomatitis (sore, red, ulcerated oral cavity) – an indicator of toxicity.- Decreased blood cells – occurs commonly and may lead to fever, blood noses, infection, bruising, tiredness and weakness.- Hair loss (reversible).- Abdominal cramps.- Fatigue.Haematological – Leukocytes are inhibited more than platelets.Mucositis- depending on dosage schedule, the lining of the digestive tract can be damaged causing diarrhoea and mouth sores.

Uncommon side effects

Efudix cream (side effects seen at site of application):- Dermatitis.- Scarring.- Soreness.- Tenderness.Some less common reactions seen with Fluorouracil Injection include:- Allergic skin rashes.- Skin pigmentation.- Confusion.- Depression.- Emotional disorders.- Speech disturbances.- Staggering.- Seizures.- Loss of sex drive.

 

For further information talk to your doctor.

Dates

Posted On: 22 July, 2003
Modified On: 30 January, 2014


Created by: myVMC