section name header

Pronunciation ⬇

flure-oh-YOOR-a-sill audio

Classifications ⬆ ⬇

Therapeutic Classification: antineoplastics

Pharmacologic Classification: antimetabolites

Indications ⬆ ⬇

High Alert

Action ⬆ ⬇

Therapeutic Effects:

Pharmacokinetics ⬆ ⬇

Absorption: Minimal absorption (5–10%) after topical application.

Distribution: Widely distributed; concentrates and persists in tumors.

Metabolism/Excretion: Metabolized by dihydropyrimidine dehydrogenase to a less toxic compound; inactive metabolites are excreted primarily in urine.

Half-life: 20 hr.

Time/Action Profile ⬆ ⬇

(IV = effects on blood counts, Top = dermatologic effects)

ROUTEONSETPEAKDURATION
IV1–9 days9–21 days (nadir)30 days
Top2–3 days2–6 wk1–2 mo

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects ⬆ ⬇

More likely to occur with systemic use than with topical use

CV: CARDIOTOXICITY.

Derm: alopecia, maculopapular rash, local inflammatory reactions (topical only), melanosis of nails, nail loss, palmar-plantar erythrodysesthesia, phototoxicity.

Endo: sterility.

GI: diarrhea, nausea, stomatitis, vomiting.

Hemat: anemia, leukopenia, thrombocytopenia.

Local: thrombophlebitis.

Neuro: acute cerebellar dysfunction.

Misc: fever.

Interactions ⬆ ⬇

Drug-Drug:

Route/Dosage ⬆ ⬇

see Calculator

Doses may vary greatly, depending on tumor, patient condition, and protocol used

Advanced Colorectal Cancer

Breast Cancer

Gastric Adenocarcinoma

Pancreatic Adenocarcinoma

Actinic (Solar) Keratoses

Superficial Basal Cell Carcinomas

Availability ⬆ ⬇

(Generic available)

Assessment ⬆ ⬇

Lab Test Considerations:

Implementation ⬆ ⬇

Patient/Family Teaching ⬆ ⬇

Evaluation/Desired Outcomes ⬆ ⬇

US Brand Names ⬆ ⬇

Carac, Efudex, Tolak

Code ⬆

NDC Code*