Medicines & Supplements A to Z > Fluorouracil

Fluorouracil

Last updated on 14/07/2021.

Overview   |   Dosage   |    Side Effects   |   Precautions   |   Tips   |   Where To Buy  

GENERIC NAME: Fluorouracil

ALTERNATIVE NAME: 5-FU, FU

CHINESE NAME: 5-氟尿嘧啶, 氟尿嘧啶

BRAND NAME(S) IN HONG KONG: 5-FU 好復, Verrumal

DRUG CLASS: Antineoplastics

SUB CLASS: Antimetabolites

USED FOR: Treatment of colorectal cancer, Treatment of pancreatic cancer, Treatment of gastric cancer, Treatment of breast cancer, Actinic keratoses

AVAILABLE DOSAGE FORMS:
– 50 mg/ml, 250 mg/5ml (injections)
– 0.5% (topical solution)

What is Fluorouracil for?

Fluorouracil is an antimetabolite that resembles pyrimidine to suppress the synthesis of DNA and thus cell growth. Therefore, it can be used in the treatment of colorectal, pancreatic, gastric and breast cancer and actinic keratoses.

How to use it?

Fluorouracil is to be injected into the veins or combined with 10% Salicylic acid and used on skin. For the dose of the intravenous injection, your body surface area will be estimated by the physician to calculate the appropriate dose. Fluorouracil is usually accompanied by the use of Leucovorin to reduce side effects.

Breast cancer
Adult and elderly
CEF or FEC regimen: Inject 500 mg/m2 into the veins on days 1 and 8 every 28 days in combination with Cyclophosphamide and Epirubicin for 6 cycles
CMF regimen: Inject 600 mg/m2 into the veins on days 1 and 8 every 28 days in combination with Cyclophosphamide and Epirubicin for 6 cycles

Colorectal cancer
Adult and elderly
Inject 400 mg/m2 as intravenous bolus on day 1, followed by 2400-3000 mg/m2 over 46 hours as a continuous infusion every 2 weeks in combination with Leucovorin and a possible addition of either Oxaliplatin or Irinotecan.

Gastric cancer
Adult and elderly
Inject 200-1000 mg/m2 into the veins daily as a continuous infusion over 24 hours as part of a platinum-containing regimen. The duration and frequency of each cycle varies based on the dose and regimen.

Potentially curable pancreatic cancer
Adult and elderly
mFOLFIRINOX regimen: Inject 2400 mg/m2 into the veins as a continuous infusion over 46 hours every 14 days in combination with Leucovorin, Irinotecan, and Oxaliplatin for 24 weeks

Advanced or metastatic pancreatic cancer
Adult and elderly
FOLFIRINOX regimen: Inject 400 mg/m2 as intravenous bolus on day 1, followed by 2400 mg/m2 as a continuous infusion over 46 hours every 14 days in combination with Leucovorin, Irinotecan, and Oxaliplatin until disease progression or unacceptable toxicity occurs for a recommended 12 cycles.
OFF regimen: Inject 2000 mg/m2 into the veins daily as continuous infusion over 24 hours on days 1, 8, 15, and 22 every 6 weeks in combination with Oxaliplatin and Leucovorin until disease progression or unacceptable toxicity.

Hyperkeratotic actinic keratosis
Adult and elderly
Apply once daily until lesions have cleared or a maximum duration of 12 weeks.

What are the side effects of Fluorouracil?

Common side effects of Fluorouracil include, but not limited to, angina pectoris, cerebellar syndrome, hair loss, agranulocytosis, excessive tear and an increased risk of infection.

Who should not take Fluorouracil?

– People allergic to Fluorouracil or any component of the formulation.
– Debilitated patients
– People with poor nutritional state
– Patients with depressed bone marrow function following radiotherapy or therapy with other antineoplastic agents
– Patients with potentially serious infections

Pharmacist Tips:

For topical Fluorouracil:
– Treat at most 10 lesions at a time
– Keep the Fluorouracil solution out of reach from children
– Apply to the head with a brush applicator
– Allow the solution to dry on your skin and do not cover the applied area
– Before applying the solution again, remove the film from the last time
– Only apply the solution to the area with keratosis but not healthy skin or bleeding lesions

For intravenous Fluorouracil:
– Fluorouracil heavily suppresses bone marrow, slowing down the formation of blood cells. Signs like pale skin, lips and nail beds, fatigue and shortness of breath will be observed. This will increase the risk of infection. Report all signs of infection like fever, shortness of breath and sore throat to your physician as soon as possible.
– Leucovorin (Folinic acid) should be used together to reduce the side effects.
– A blood test should be carried out to check for DPD deficiency.
– Fluorouracil is often accompanied by Hand-foot syndrome. If redness, swelling, and pain on the palms of the hands or the soles of the feet, or even blisters appear, notify your physician as soon as possible.

Common dosing schedule:
Fluorouracil injections are prescribed in institutions by the physicians.

Topical Fluorouracil is to be applied daily, preferably after shower at night.

This schedule is for reference only, adjustments may be made according to individual needs. 

Some common medications Fluorouracil may interact with:
– Baricitinib
– QT-prolonging agents, e.g. Chlorpromazine, Haloperidol, Olanzapine
Warfarin
– Palifermin
– Tacrolimus
– Vaccines, e.g. BCG, Smallpox and Monkeypox, COVID-19

Fluorouracil may interact with many other medications. Please notify your doctor or pharmacist if you are taking the above medication, dosage adjustments might be needed.

Where to buy Fluorouracil in Hong Kong?

In Hong Kong, Fluorouracil is a prescription only medicine, and requires a prescription from a doctor to be purchased in a pharmacy. It can also be obtained from doctors. To find a pharmacy near you, refer to the list of pharmacies (“Authorized Sellers of Poisons”) from the Hong Kong Department of Health.

For more information about drug names and ingredients, you can visit Hong Kong’s Drug Office at https://www.drugoffice.gov.hk

Need more information?

For detailed information about the use of Fluorouracil in children, pregnancy and breastfeeding, and for questions about drug interactions, please check with your pharmacist or doctor.

Disclaimer: our goal is to provide you with the most relevant drug information and common dosage for Hong Kong. This information does not constitute medical advice. For specific treatment recommendations and advice, always discuss with your doctor or pharmacist, and follow the instructions included with your specific medicine.