Fluorouracil (5-FU) (Efudex)

Last updated 20.09.12

 

Index

 

Definition

-  Antimetabolite used as chemotherapy (systemic or topical)

 

Features

-  Pyrimidine analog

-  Topical (Efudex) OR IV

-  Topical

-   Applied w gloves or applicator (non-metallic)

-   Applied post wash, rinse & dry effecte area

-   DO NOT cover with dressing

 

Mechanism

-  Irreversible inhibition of thymidylate synthase blocking DNA replication

-  Rapidly dividing cells more sensitive

 

Indications

-  Systemic

-  Colorectal cancer

-  Pancreatic cancer

-  Topical

-  Solar keratosis

-  Superficial BCC

 

Precautions/Contraindications

-  Pts w dihydropyramidine dehydrogenase deficiency (DPD) have increased risk of systemic toxicity (even for topical)

-  Topical cream NOT applied to mucus membranes

 

Side Effects

-  Systemic

-  Myelosuppression

-  Mucositis

-  Dermatitis

-  Diarrhoea

-  Cardiac toxicity

-  Teratogenic

-  Topical

-  Photosensitivity

-  Pruritis

-  Rash

-  Dryness

-  Erosin

-  Hyperpigmentation

 

Dose

-  Topical (Efudex) 5% cream (40g)

-  Solar keratosis: BD to lesions for 2-4 weeks

-  Superficial BCC: BD to lesions for 3-6 weeks, up to 12 weeks

 

 

 

References

 

MIMS 2011