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*