Description
Fluorouracil belongs to the group of medicines known as antimetabolites. It is used to treat cancer of the colon, rectum, breast, stomach, and pancreas. It may also be used to treat other kinds of cancer, as determined by your doctor.
Fluorouracil interferes with the growth of cancer cells, which are eventually destroyed. Since the growth of normal body cells may also be affected by fluorouracil, other effects will also occur. Some of these may be serious and must be reported to your doctor. Other effects, like hair loss, may not be serious but may cause concern. Some effects may not occur for months or years after the medicine is used.
Before you begin treatment with fluorouracil, you and your doctor should talk about the good this medicine will do as well as the risks of using it.
Fluorouracil is to be administered only by or under the immediate supervision of your doctor.
This product is available in the following dosage forms:
- Solution
Before Using
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:
Allergies
Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Pediatric
Although there is no specific information comparing use of fluorouracil in children with use in other age groups, it is not expected to cause different side effects or problems in children than it does in adults.
Geriatric
Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults. Although there is no specific information comparing use of fluorouracil in the elderly with use in other age groups, it is not expected to cause different side effects or problems in older people than it does in younger adults.
Breastfeeding
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
Drug Interactions
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Brivudine
- Measles Virus Vaccine, Live
- Mumps Virus Vaccine, Live
- Rotavirus Vaccine, Live
- Rubella Virus Vaccine, Live
- Tegafur
- Varicella Virus Vaccine, Live
- Zoster Vaccine, Live
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acenocoumarol
- Adenovirus Vaccine Type 4, Live
- Adenovirus Vaccine Type 7, Live
- Allopurinol
- Azanidazole
- Bacillus of Calmette and Guerin Vaccine, Live
- Benznidazole
- Cholera Vaccine, Live
- Cimetidine
- Dengue Tetravalent Vaccine, Live
- Ebola Zaire Vaccine, Live
- Fosphenytoin
- Influenza Virus Vaccine, Live
- Isoconazole
- Leucovorin
- Levoleucovorin
- Methotrexate
- Metronidazole
- Nimorazole
- Ornidazole
- Oxypurinol
- Phenindione
- Phenprocoumon
- Phenytoin
- Poliovirus Vaccine, Live
- Secnidazole
- Smallpox Monkeypox Vaccine, Live Non-Replicating
- Smallpox Vaccine
- Tamoxifen
- Tinidazole
- Typhoid Vaccine, Live
- Warfarin
- Yellow Fever Vaccine
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Levamisole
- Rolapitant
- Thiamine
Other Interactions
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.
Other Medical Problems
The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:
- Chickenpox (including recent exposure) or
- Herpes zoster (shingles)—Risk of severe disease affecting other parts of the body
- Infection—Fluorouracil can decrease your body's ability to fight infection
- Kidney disease or
- Liver disease—Effects of fluorouracil may be increased because of slower removal from the body
Proper Use
This medicine is sometimes given together with certain other medicines. If you are using a combination of medicines, it is important that you receive each one at the proper time. If you are taking some of these medicines by mouth, ask your health care professional to help you plan a way to remember to take them at the right times.
Fluorouracil often causes nausea and vomiting. However, it is very important that you continue to receive the medicine, even if your stomach is upset. Ask your health care professional for ways to lessen these effects.
Dosing
The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
Precautions
It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly and to check for unwanted effects.
While you are being treated with fluorouracil, and after you stop treatment with it, do not have any immunizations (vaccinations) without your doctor's approval. Fluorouracil may lower your body's resistance and there is a chance you might get the infection the immunization is meant to prevent. In addition, other persons living in your household should not take oral polio vaccine since there is a chance they could pass the polio virus on to you. Also, avoid persons who have taken oral polio vaccine within the last several months. Do not get close to them and do not stay in the same room with them for very long. If you cannot take these precautions, you should consider wearing a protective face mask that covers the nose and mouth.
Fluorouracil can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:
- If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.
- Check with your doctor immediately if you notice any unusual bleeding or bruising; black, tarry stools; blood in urine or stools; or pinpoint red spots on your skin.
- Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.
- Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.
- Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.
- Avoid contact sports or other situations where bruising or injury could occur.
Side Effects
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Also, because of the way these medicines act on the body, there is a chance that they might cause other unwanted effects that may not occur until months or years after the medicine is used. These delayed effects may include certain types of cancer, such as leukemia. Discuss these possible effects with your doctor.
Check with your doctor immediately if any of the following side effects occur:
More common
- Diarrhea
- heartburn
- sores in mouth and on lips
Less common
- Black, tarry stools
- cough or hoarseness, accompanied by fever or chills
- fever or chills
- lower back or side pain, accompanied by fever or chills
- nausea and vomiting (severe)
- painful or difficult urination, accompanied by fever or chills
- stomach cramps
Rare
- Blood in urine or stools
- pinpoint red spots on skin
- unusual bleeding or bruising
Check with your doctor as soon as possible if any of the following side effects occur:
Rare
- Chest pain
- cough
- shortness of breath
- tingling of hands and feet, followed by pain, redness, and swelling
- trouble with balance
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
- Loss of appetite
- nausea and vomiting
- skin rash and itching
- weakness
Less common
- Dry or cracked skin
This medicine often causes a temporary loss of hair. After treatment with fluorouracil has ended, normal hair growth should return.
After you stop using this medicine, it may still produce some side effects that need attention. During this period of time, check with your doctor immediately if you notice the following side effects:
- Black, tarry stools
- blood in urine or stools
- cough or hoarseness, accompanied by fever or chills
- fever or chills
- lower back or side pain, accompanied by fever or chills
- painful or difficult urination, accompanied by fever or chills
- pinpoint red spots on skin
- unusual bleeding or bruising
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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