Classifications: antineoplastic; antimetabolite, pyrimidine; Therapeutic: antineoplastic; antimetabolite
Pregnancy Category: D
500 mg powder for injection
Pyrimidine antagonist and cell-cycle specific. Catabolized to fluorouracil in the body; highly toxic because it blocks an
enzyme essential to normal DNA and RNA synthesis.
Proliferative cells of neoplasms are affected more than healthy tissue cells.
Palliative agent in management of selected patients with GI metastasis to liver.
Carcinoma of breast, ovary, cervix, urinary bladder, and prostate not responsive to other antimetabolites.
Existing or recent viral infections; pregnancy (category D); lactation.
Poor nutritional status, bone marrow depression, serious infections; high-risk patients: prior high-dose pelvic irradiation,
use of alkylating agents; impaired kidney or liver function.
Route & Dosage
Adult: Intraarterial 0.10.6 mg/kg/d by continuous intraarterial infusion
PREPARE: Direct: Reconstitute with 5 mL sterile distilled water for injection; further dilute with D5W or NS injection to a volume appropriate
for the infusion apparatus to be used.
ADMINISTER: Direct: It is administered by pump to overcome pressure in large arteries and to ensure a uniform rate. Examine infusion site frequently
for signs of extravasation. If this occurs, stop infusion and restart in another vessel.
INCOMPATIBILITIES Y-site: Allopurinol, cefepime.
- Keep reconstituted solutions, which are stable at 2°8° C (36°46° F), for no more than
- Store at 15°30° C (59°86° F) unless otherwise directed.
Adverse Effects (≥1%)CNS:
Vertigo, convulsions, depression
, hemiplegia. CV:
Myocardial ischemia, angina. GI: Nausea, vomiting, stomatitis, diarrhea
, cramps, anorexia, enteritis
, esophagopharyngitis. Hematologic: Leukopenia
, thrombocytopenia. Skin:
(usually reversible), erythema
or increased skin pigmentation (photosensitivity), dry skin, pruritic ulcerations, rash. Body as a Whole:
Hiccups, fever, epistaxis, decreased resistance to disease. Urogenital: Renal
may increase general floxuridine toxicity
; may increase or decrease serum
levels of phenytoin, fosphenytoin; hydroxyurea
can decrease conversion to active metabolite
Distributed to tumor, intestinal mucosa
, bone marrow
, liver, and CSF; probably crosses placenta. Metabolism:
Rapidly metabolized in liver to fluorouracil. Elimination:
15% excreted in urine, 6080% excreted through lungs as carbon dioxide. Half-Life:
Assessment & Drug Effects
- Discontinue therapy promptly with onset of any of the following: Stomatitis, esophagopharyngitis, intractable vomiting, diarrhea,
leukopenia (WBC <3500/mm3), or rapidly falling WBC count, thrombocytopenia (platelets 100,000/mm3), GI bleeding, hemorrhage from any site.
- Lab tests: Obtain baseline and periodic total and differential leukocyte counts, Hct, platelet count, serum uric acid creatinine,
and liver function tests.
Patient & Family Education
- Be aware that floxuridine sometimes causes temporary thinning of hair.