HEALTHY LIFESTYLE




Fluorouracil
Fluorouracil.JPG

Fluorouracil

CLINICAL USE

Antineoplastic agent

DOSE IN NORMAL RENAL FUNCTION

IV infusion

: 15 mg/kg/day to a total dose of 12–15 gIV bolus: 12 mg/kg/day for 3 days, then 6 mg/kg on alternate days or 15 mg/kg once a weekMaintenance: 5–15 mg/kg once a week Intra-arterial infusion: 5–7.5 mg/kg by continuous 24-hour infusionOral: 15 mg/kg weekly; maximum 1 g in a dayOr consult relevant local chemotherapy protocol

PHARMACOKINETICS

  • Molecular weight                           :130.1
  • %Protein binding                           :10
  • %Excreted unchanged in urine     : 15
  • Volume of distribution (L/kg)       :0.25–0.5
  • half-life – normal/ESRD (hrs)      :16 minutes/Unchanged

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50     : Dose as in normal renal function
  • 10 to 20     : Dose as in normal renal function
  • <10           : Dose as in normal renal function

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD                :Some removal likely. Dose as in normal renal function
  • HD                     :Dialysed. Dose as in normal renal function
  • HDF/high flux   :Dialysed. Dose as in normal renal function
  • CAV/VVHD      :Dialysed. Dose as in normal renal function

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs
  • Anticoagulants: possibly enhances effect of coumarins
  • Antipsychotics: avoid concomitant use with clozapine, increased risk of agranulocytosisMetronidazole and cimetidine inhibit metabolism (increased toxicity)Temoporfin: increased skin photosensitivity with topical fluorouracil

    ADMINISTRATION

    Reconstition

    Consult relevant local protocol

    Route

    IV infusion

    intermittent or continuous, IV injection, intra-arterial, oral, topical

    Rate of Administration

    30–60 minutes, 4 hours or as a continuous infusion over 24 hours or consult relevant local protocol

    Comments

    OTHER INFORMATION

    Use ideal body weight in patients showing obesity, ascites, and oedemaRoche recommends decreasing the initial dose by one-third to one-half in patients with impaired hepatic or renal functionDistributed throughout the body water, activated in target cells, most of dose (80%) is metabolised by the liver, 60–80% is excreted as respiratory CO2 and 2–3% by the biliary systemFollowing a single IV dose, approximately 15% is excreted unchanged in the urine.
  • other drugs