Emergency treatment of fluorouracil or capecitabine overdose regardless of the presence of symptoms.
Vistogard
Emergency treatment of patients who exhibit early-onset, severe, or life-threatening cardiovascular or central nervous system toxicity, and/or early-onset, unusually severe adverse reactions within 96 hr following the end of fluorouracil or capecitabine administration.
Xuriden
Treatment of hereditary orotic aciduria.
Contraind./Precautions⬆⬇
Contraindicated in:
None.
Use Cautiously in:
OB: Pregnancy or lactation;
Pedi: Children <1 yr (safety and effectiveness not established for Vistogard) children <2 mo (safety and effectiveness not established for Xuriden).
PO (Adults ): 10 g every 6 hr for a total of 20 doses.
PO (Children ≥1 yr): 6.2 g/m2 body surface area (max = 10 g/dose) every 6 hr for total of 20 doses.
Xuriden
PO (Adults and Children ): 60 mg/kg once daily; if suboptimal response, may ↑ to 120 mg/kg once daily.
US Brand Names⬆⬇
Vistogard, Xuriden
Action⬆⬇
Vistogard
Converted into uridine which competitively inhibits cell damage and cell death caused by fluorouracil.
Xuriden
Provides uridine to patients who cannot synthesize adequate quantities of uridine due to a genetic defect in uridine nucleotide synthesis.
Therapeutic effects: Vistogard
Improved survival in patients experiencing fluorouracil- or capecitabine-induced toxicities.
Improvements in hematologic abnormalities and reduction in urinary orotic acid concentrations.
Classifications⬆⬇
Therapeutic Classification: antidotes
Pharmacologic Classification: pyrimidine analogs
Pharmacokinetics⬆⬇
Absorption: Well absorbed following oral administration.
Distribution: Crosses the blood-brain barrier.
Metabolism/Excretion: Undergoes catabolic metabolism in tissues; primarily excreted in urine.
Half-Life: 2–2.5 hr.
Time/Action Profile⬆⬇
(blood levels)
ROUTE
ONSET
PEAK
DURATION
PO
unknown
2–3 hr
unknown
Patient/Family Teaching⬆⬇
Instruct patient to take full course as directed, even if feeling well. Take missed doses as soon as remembered; take next dose at regularly scheduled time.
Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and consult health care professional before taking any new medications.
Advise female patients to notify health care professional if pregnancy is planned or suspected or if breastfeeding.