Fluorouracil Injection BP

Generic Name: Fluorouracil
Product Name: Fluorouracil Injection BP

Indication

Fluorouracil is used as part of a chemotherapy regime aimed at palliative treatment of malignant tumours of the:

• Breast cancer (ranging from mild and early to late and inoperable)
• Colon
• Rectum
• Stomach
• Pancreas

Fluorouracil usually aims to provide temporary relief in gastrointestinal 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

Fluorouracil 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.

Schedule

S4

Common side effects

Use of Fluorouracil 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

Some less common reactions 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.