Adult Dosing
Carcinoma of the colon, rectum, breast, stomach and pancreas
- Various protocols; please consult your organization's protocol
- Initial dose
- 12 mg/kg IV daily x 4 days; Max: 800 mg/day
- If no toxicity observed: 6 mg/kg IV on 6th, 8th, 10th, 12th day
- Poor risk patients or inadequate nutritional state: 6 mg/kg IV x 3 days, Max: 400 mg/day
- If no toxicity observed: 3 mg/kg on 5th, 7th, 9th day
- Maintenance therapy
- If no toxicity repeat same dosage of first course every 30 days after the last day of the previous course of treatment
- Alt: 10-15 mg/kg/wk as single dose; Max: 1 g/wk (If toxicity is observed with the first course of therapy)
- Based on patient's reaction to the previous course of therapy give 9-45 courses of treatment during periods of 12-60 months
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
- Hospitalize the patient during the first course of therapy, and do not exceed the daily recommended dose of 800 mg [US Black Box Warning]
- Rarely, severe toxicity (eg, diarrhea, neurotoxicity, neutropenia, stomatitis) has been attributed to dihydropyrimidine dehydrogenase deficiency and despite lowering the dose of 5-fluorouracil toxicity recurred and progressed with worse morbidity
- Use with extreme caution in poor risk patients with a history of high-dose pelvic irradiation or previous use of alkylating agents, those who have a widespread involvement of bone marrow by metastatic tumors or those with impaired hepatic or renal function
- Fluorouracil can cause fetal harm when administered to a pregnant woman. Women of childbearing potential should be advised to avoid becoming pregnant. If the patient becomes pregnant while taking the drug or drug is given during pregnancy, the patient should be told of the potential hazard to the fetus
- Toxicity of fluorouracil will increase, if any therapy that adds to the stress of the patient, interferes with nutrition or depresses bone marrow function, is given along with fluorouracil therapy
- Fluorouracil is a highly toxic drug and can cause Severe hematological toxicity, gastrointestinal hemorrhage and even death, hence carefully supervise the patient throughout the therapy
- Discontinue the therapy promptly, if stomatitis or esophagopharyngitis, leukopenia (WBC under 3500) or a rapidly falling white blood count, intractable vomiting, diarrhea, frequent bowel movements or watery stools, gastrointestinal ulceration and bleeding, thrombocytopenia (platelets under 100,000), hemorrhage from any site occurs
- Palmar-plantar erythrodysesthesia syndrome or hand-foot syndrome characterized as a tingling sensation of hands and feet which progress over the next few days to pain, symmetrically swollen and erythematous palms and soles, tenderness of the distal phalanges has been reported with fluorouracil therapy. Discontinuation of therapy gradually resolves the symptoms over 5 to 7 days
- Monitor WBC with differential count before each injection
Cautions: Use cautiously in
- Renal impairment
- Hepatic impairment
- History of high-dose pelvic irradiation
- History of use of alkylating agents
- Poor nutritional status
Pregnancy Category:D
Breastfeeding: Safety unknown. It is not known whether fluorouracil is excreted in human milk. As fluorouracil inhibits DNA, RNA and protein synthesis, manufacturer recommends mothers should discontinue nursing while receiving this drug.
Pricing data from www.DrugStore.com in U.S.A.
- Fluorouracil 5 GM/100ML SOLN [Vial] (APP PHARMACEUTICAL)
50 100ml = $18.99
100 100ml = $29.97 - Fluorouracil 2 % SOLN [Bottle] (TARO)
10 % = $65.99
30 % = $179.97 - Fluorouracil 5 % SOLN [Bottle] (TARO)
10 % = $101.99
30 % = $283.89 - Fluorouracil 50 MG/ML SOLN [Vial] (APP PHARMACEUTICAL)
50 ml = $25.99
100 ml = $39.97 - Fluorouracil 5 % CREA [Tube] (TARO)
40 % = $249.98
120 % = $709.87
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
