Fluorouracil

Brand Names

Adrucil, 5-FU (There may be other names for this medication)

How is Fluorouracil Administered?

Your medicine will be given intravenously (IV), which means it will be delivered directly into a vein.

What is Fluorouracil Used For?

This drug is used to treat many types of cancers including cancers of the breast, stomach, pancreas, colon and rectum.

How Does it Work?

Cancer is a group of diseases in which abnormal cells reproduce without control. Your chemo schedule is based upon your cancer type, how fast the cancer cells multiply, and the time of the cells’ reproductive cycle when the medication is the most likely to be effective. This is why chemotherapy is typically given in cycles.
5-FU is in a class of drugs known as antimetabolites, drugs that interrupt the cell cycle. It is biologically similar to a nutrient that cancer cells need to grow. The cancer cells take in the 5-FU and it disrupts their growth.

The faster cells reproduce, the more likely it is that chemotherapy will damage and/or kill them. Since there are some types of cells in your body that naturally reproduce rapidly, these types of cells are likely to be damaged/destroyed by chemo. These normal cells will eventually grow back and be healthy. During treatment, however, you may experience side effects involving the cells that line the digestive tract (mouth, stomach, and intestines), the hair follicles, and bone marrow.

What Should I Tell My Doctor Before I Begin Receiving Fluorouracil?

Tell your doctor if you:

  • have ever had an allergic reaction to fluorouracil
  • have any infections or bone marrow, liver, or kidney problems
  • are pregnant or breast feeding
  • are taking aspirin, leucovorin, or vitamins

This drug may interact with other medications, increasing or decreasing their effectiveness or causing harmful side effects. Tell your doctor and pharmacist about any prescription or over-the- counter medications, vitamins, herbal or diet supplements that you are taking.

What Are Some Possible Side Effects I May Experience?

  • Bone marrow depression (increased risk of infection, fatigue, and/or bleeding)
  • Loss of appetite, nausea, vomiting, diarrhea, and/or weight loss
  • Mouth or throat sores, taste changes, metallic taste in mouth during infusion
  • Drying or darkening of the skin or nails, skin and eye sensitivity of skin to sunlight (photosensitivity and photophobia), acne, blistering skin
  • Watery eyes
  • Discoloration of the vein in which the medication is given
  • Thin or brittle hair, hair loss
  • Headache, weakness, or achiness
  • Tingling in the hands or feet
  • Hand -foot syndrome (Palmar-plantar erythrodysesthesia or PPE): rash, swelling, redness, pain and/or peeling of the skin on the palms of hands and soles of feet (usually mild – starts about 5-6 weeks after therapy begins)
  • Decreased fertility (both men and women); irregular menstruation and vaginal dryness or itching (women)

How Can I Manage These Side Effects?

  • To help avoid infections, stay away from crowds or people with colds, flu, or other infections. Talk to your doctor before you have any vaccinations. Wash your hands often.
  • To help prevent bleeding problems, be careful when handling sharp objects. Stay away from rough sports or other situations where you could be bruised or injured. Use an electric razor. Be careful when using a toothbrush or dental floss (your doctor may recommend other ways to clean your teeth and gums).
  • Mouth care is very important. To minimize mouth problems, rinse your mouth with a mixture of 1⁄2 tsp of baking soda in 8 oz of water after every meal and at bedtime. Brush your teeth and gums often with a soft toothbrush. (Soften it further by running it under warm water). Avoid smoking, alcohol, and mouthwashes that contain alcohol.
  • Ask your doctor about medication to help prevent/lessen nausea, vomiting and diarrhea.
  • Use sunscreen with SPF 15 or higher when you are outdoors, even for a short time. Wear wide-brimmed hats, long-sleeved shirts, and pants. Keep your neck, chest, and back covered.
  • If you develop a rash, do not put anything on it unless it is approved by your doctor.
  • Drink at least 2-3 quarts of fluid, especially water, every 24 hours, unless your doctor tells you to limit your fluids.

When Should I Call the Doctor?

Call your doctor immediately if you experience:

  • any sign of infection: fever of 100.5F (38C) or higher, chills, cough, sore throat, pain or burning upon urination; redness or tenderness along a vein, at an IV site, or at any other wound or skin irritation
  • any sign of an allergic reaction: itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing, dizziness, or palpitations
  • unusual bruising or bleeding: bleeding lasts more than10-15 minutes or that causes dizziness; black or bloody stools; vomit that is bloody or that looks like coffee grounds; blood in your urine or phlegm /mucus, unusually heavy menstrual bleeding, spontaneous bleeding from your gums or nose, or superficial bleeding into the skin that appears as a rash of pinpoint-sized reddish-purple spots (petechiae)
  • changes in vision or yellowing of the skin or eyes

Call your doctor as soon as possible if you have:

  • difficulty walking or changes in the way you walk or joint pain
  • persistent headache
  • painful mouth or throat that makes it difficult or eat or drink
  • diarrhea of three stools a day or diarrhea with weakness
  • nausea or vomiting not relieved by prescribed medication or that prevents you from eating or drinking

What Else Do I Need to Know About Fluorouracil?

  • Fluorouracil may interfere with the normal menstrual cycle (period) in women and stop sperm production in men. Do NOT, however, assume that you cannot get pregnant or that you cannot get someone else pregnant. Do not plan to have children while receiving chemotherapy or for a while after treatments. Use a reliable method of birth control to prevent pregnancy. Fluorouracil may harm the fetus.
  • Do not use aspirin or any product that has aspirin in it (such as some cold medicines) unless you have talked to your doctor first.
  • You may get drowsy or dizzy from 5FU. Avoid driving or engaging in tasks that require alertness until you know how you respond to this medication.
  • Discuss whether you can drink alcohol with your doctor.
  • If you would like more information about 5-FU, talk to your doctor.