Dosing and uses of FUDR (floxuridine)
Adult dosage forms and strengths
powder for injection
- 500mg/vial
GI Adenocarcinoma with Metastasis to Liver, Gallbladder, Bile Ducts
0.1-0.6 mg/kg/d continuous arterial infusion
Monitor: CBC, LFTs
Gastric Cancer (Orphan)
Intraperitoneal treatment of gastric cancer
Orphan indication sponsor
- Franco Muggia, M.D.; 160 East 34th Street; New York, NY 10016
Pediatric dosage forms and strengths
Safety & efficacy not established
FUDR (floxuridine) adverse (side) effects
Frequency not defined
Nausea
Vomiting
Diarrhea
Mucositis
Enteritis
Stomatitis
Myelosuppression
Anemia
Leukopenia
Thrombocytopenia
Alopecia
Erythema
Photosensitivity
Warnings
Black box warnings
The drug should be administered under the supervision of an experienced cancer chemotherapy physician because of the possibility of severe toxic reactions
Patient should be hospitalized for initiation of the therapy because of the risk for severe toxic reactions
Contraindications
Hypersensitivity
Poor nutritional status
Myelosuppression (leukocyte count <5000/cu.mm or decreases rapidly, or Plts <100,000/cu.mm)
Cautions
Hepatic/renal impairment
Discontinue if leukocyte count falls to <3500/cu.mm or decr rapidly, or if Plt count falls to <100,000/cu.mm)
Discontinue immediately in MI occurs
Discontinue in case of stomatitis, esophagopharyngitis, leukopenia, thrombocytopenia, intractable vomiting, GI bleeding, hemorrhage, diarrhea
Pts who have received high-dose pelvic irradiation or alkylating agents
Avoid pregnancy
Pregnancy and lactation
Pregnancy category: d
Lactation: excretion in milk unknown; contraindicated
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of FUDR (floxuridine)
Half-Life: 16 min
Metabolism: liver
Metabolites: urea, fluorouracil, dihydrofluorouracil, expired CO2 metabolite
Excretion: urine
Mechanism of action
Metabolized to 5-FU; inhibits DNA synthesis during S phase by inhibition of thymidylate synthetase
Administration
IV Incompatibilities
Y-site: allopurinol, cefepime
IV Compatibilities
Additive: carboplatin, cisplatin, etoposide, fluorouracil, leucovorin
Y-site: amifostine, aztreonam, etoposide PO4, filgrastim, fludarabine, gemcitabine, granisetron, melphalan, ondansetron, paclitaxel, piperacillin-tazobactam, sargramostim, teniposide, thiotepa, vinorelbine
IV Preparation
Dilute with 5 mL SWI for a final concentration of 100 mg/mL
IV Administration
Dilute in D5W or Ns
Store reconstituted soln at 2-8°C if necessary & use within 2 wk
Use infusion pump, either external or implanted
Storage
Store intact vials at 15-30°C (59-86°F)
Reconstituted vials are stable for up to weeks under refrigeration at 2-8°C (36-46°F)
