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Terms Of Use

FLUOROURACIL

Brand Name(s) : Efudix
Warnings
Uses
Side Effects
Precautions
Interactions
Overdose

FLUOROURACIL WARNINGS

Fluorouracil cream should be used with caution when:

  • using any other medications that you apply to the areas being treated, including ones bought without a prescription.

It should not be used in:

Fluorouracil injection should be used with caution in:

  • the number of cells in your blood become too low (you will have blood tests to check this)
  • kidney problems
  • liver problems including jaundice (yellowing of the skin)
  • history of angina
  • history of heart disease
  • reduced activity/deficiency of the enzyme DPD (dihydropyrimidine dehydrogenase)

It should not be used in:

  • hypersensitivity (severe allergy) to fluorouracil or any of the ingredients of this medicine
  • patients weakened by long illness
  • bone marrow damaged by other treatments (including radiotherapy)
  • pregnancy or when trying for a baby
  • breastfeeding
  • non-malignant cancer

Also see list of precautions and interactions

STORAGE

Do not store above 25°C-30°C, depending on the formulation.

FLUOROURACIL USES

What is it used for?

  • Fluorouracil is used to interfere with the growth of abnormal (cancer) cells.
  • It is an antimetabolite anti-cancermedicine, sometimes known as cancer chemotherapy.
  • It is used to destroy cancer cells.
  • In general this drug is used as a cream to treat certain skin conditions caused by abnormal cell growth and as an injection to treat many common cancers.
  • Benefits of being on this drug can include destruction of cancerous cells and reducing the size of cancer growths and slowing the spread of cancers.

Listed below are the typical uses of fluorouracil.

  • The cream is used to treat certain skin conditions caused by abnormal cell growth including different types of keratoses (an overgrowth of the skin), keratocanthoma (a firm nodule on the skin), Bowen’s disease and some simple skin cancers.
  • The injection is used to treat many common cancers, particularly cancers of the large bowel (guts) and breast. It may be used in combination with other anti-cancer medicines or radiotherapy.

On occasion your doctor may prescribe this medicine to treat a condition not on the above list.

HOW TO USE/TAKE

How often do I take it?

  • Apply the cream thinly to the affected area usually once or twice daily, or as your doctor has advised you.
  • Your doctor or nurse will give you your injection. Your first course of treatment may be given daily or at weekly intervals. Further courses may be given according to your response to treatment. It will be given either into a vein or an artery. If it is given into a vein, it can either be given as a normal injection or a slow injection via a drip (infusion). If it is given into an artery, it will be given as an infusion.
  • Use this medication for the duration of prescription in order to get the most benefit from it.
  • Remember to use it at the same time each day - unless specifically told not to by your doctor.
  • You will normally need to use the cream for at least three to four weeks. At first your skin may appear to be worse, this is normal and you should continue to apply the cream as directed. If your skin becomes much worse, or if you are worried, consult your doctor. After stopping treatment you may find that your skin takes one to two months to heal completely.
  • It may take up to a few months before the full benefit of this drug takes effect.
  • Certain medical conditions may require different dosage instructions as directed by your doctor.

What dose?

  • Dosage is based on your age, gender, medical condition, response to therapy, and use of certain interacting medicines.

Do I need to avoid anything?

  • Fluorouracil injection may cause side effects such as feeling sick (nausea) and being sick (vomiting) which could interfere with driving or the use of heavy machinery.
  • When applying the cream, avoid any contact with the eyes or mouth. Wash your hands thoroughly after use.
  • Avoid direct sunlight as much as possible whilst using the cream and do not use a sunlamp or sunbed.
  • Consult your doctor or pharmacist for more details.

When can I stop?

  • It is important to continue taking this medication even if you feel well, unless your doctor tells you to stop.

FLUOROURACIL SIDE EFFECTS

Cream:

  • redness and discomfort in the affected skin and surrounding healthy skin,
  • skin allergy,
  • sores,
  • sensitivity to sunlight.

Injection:

  • Diarrhoea,
  • feeling or being sick,
  • hair loss (especially in women),
  • skin problems,
  • changes in your nails,
  • unsteady on your feet,
  • blood disorders,
  • fever,
  • quickening of your heart rate and breathlessness,
  • painful and/or watering eyes, changes in vision or sensitivity to light,
  • feeling confused,
  • painful inflammation and ulceration of the mucous membranes lining the digestive tract (the organs through which food and liquid pass in the body) and mouth,
  • tiredness,
  • reddening of the palms of the hands and/or the soles of the feet,
  • immune system weakened,
  • the vein where fluorouracil is administered may become painful or discoloured.

If any of these persist or you consider them severe then inform your doctor or pharmacist.

Tell your doctor immediately if you develop any of the following symptoms while taking fluorouracil injection:

  • Chest pains.
  • Bowel motions are bloodstained or black.
  • Mouth becomes sore or develops ulcers.
  • Severe allergic reaction - you may experience a sudden itchy rash (hives), swelling of the hands, feet, ankles, face, lips, mouth or throat (which may cause difficulty in swallowing or breathing), and you may feel you are going to faint.
  • Symptoms of leucoencephalopathy (disease of brain) - weakness, coordination problems in arms and legs; thinking/speech difficulties; vision/ memory problems; seizures; headaches.
  • All of these very serious side effects are rare.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction include: rash, itching/swelling (especially of the face/tongue/throat), dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

The Yellow Card Scheme allows you to report suspected side effects from any type of medicine (which includes vaccines, herbals and over the counter medicines) that you are taking. It is run by the medicines safety watchdog called the Medicines and Healthcare products Regulatory agency (MHRA). Please report any suspected side effect on the Yellow Card Scheme website.

FLUOROURACIL PRECAUTIONS

Before taking fluorouracil, tell your doctor or pharmacist if you are allergic to it; or to other antimetabolite anti-cancer medicine; or if you have any other allergies.

Fluorouracil cream should not be applied if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist in case of:

  • Pregnancy
  • breast feeding
  • allergies to fluorouracil or any of its ingredients including parabens
  • not recommended for use by children
  • over large areas of skin

Fluorouracil injection should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist in case of:

  • hypersensitivity (severe allergy) to fluorouracil or any of the ingredients of this medicine
  • patients weakened by long illness
  • bone marrow damaged by other treatments (including radiotherapy)
  • pregnancy or when trying for a baby
  • breastfeeding
  • non-malignant cancer

Before applying this medication (the cream), tell your doctor or pharmacist your medical history, especially any of the following:

  • use of any other medications that you apply to the areas being treated, including ones bought without a prescription.

Before using fluorouracil injection, tell your doctor or pharmacist your medical history, especially any of the following:

  • the number of cells in your blood become too low (you will have blood tests to check this)
  • kidney problems
  • liver problems including jaundice (yellowing of the skin)
  • history of angina
  • history of heart disease
  • reduced activity/deficiency of the enzyme DPD (dihydropyrimidine dehydrogenase)

Before having surgery, tell your doctor or dentist that you are taking this medication.

Does alcohol intake affect this drug?

  • Alcohol intake is not known to affect fluorouracil.

The elderly: fluorouracil can be used in the elderly.

Pregnancy and breastfeeding - please ensure you read the detailed information below

PREGNANCY

Fluorouracil is not safe to take if you are, or are planning to become, pregnant.

It is sensible to limit use of medication during pregnancy whenever possible. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.

If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.

BREAST FEEDING

Fluorouracil is not safe to take if you are breastfeeding.

It is sensible to limit use of medication during breastfeeding whenever possible. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.

If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.

FLUOROURACIL INTERACTIONS

Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with them first.

This drug should not be used with the following medications because very serious, possibly fatal interactions may occur: none known.

Before applying this medication (the cream), tell your doctor or pharmacist of all prescription and non-prescription/herbal products you may use, especially use of any other medications that you apply to the areas being treated.

Before using fluorouracil injection, tell your doctor or pharmacist of all prescription and non-prescription/herbal products you may use, especially of:

  • methotrexate (an anti-cancer medicine),
  • metronidazole (an antibiotic),
  • calcium leucovorin (also called calcium folinate - used to reduce the harmful effects of anti-cancer medicines),
  • allopurinol (used to treat gout),
  • cimetidine (used to treat stomach ulcers),
  • warfarin (used to treat blood clots),
  • sorivudine (an antiviral).

This information does not contain all possible interactions. Therefore, before using fluorouracil, tell your doctor or pharmacist of all the products you use.

FLUOROURACIL OVERDOSE

Taking or using too much fluorouracil may cause the following: feeling sick (nausea), being sick (vomiting), diarrhoea, ulceration and bleeding, blood disorders.

If you think you, or someone you care for, might have accidentally taken more than the recommended dose of fluorouracil or intentional overdose is suspected, contact your local hospital, GP or if in England call 111. In Scotland call NHS 24. In Wales, call NHS Direct Wales. In the case of medical emergencies, always dial 999.

MISSED DOSE

If you miss a dose, apply it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

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Source: Selected from data included with permission and copyrighted by Boots UK Limited or TicTac Communications Ltd. This copyrighted material is sourced from a licensed data provider and is not for distribution, except as may be authorised by the applicable terms of use.
CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgement of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse events, nor should it be construed to indicate that use of a particular medicine is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any medicine, changing any diet, or discontinuing any course of treatment.

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