Trade Names:FUDR- Powder for injection 500 mg- Solution for injection 100 mg/mL
The primary effect is to interfere with the synthesis of DNA and to a lesser extent inhibit the formation of RNA.
When given by rapid intra-arterial injection, floxuridine is rapidly catabolized to 5-fluorouracil. When given by continuous intra-arterial infusion, direct anabolism to floxuridine-monophosphate is enhanced. Floxuridine is metabolized in the liver.
The drug is excreted intact as urea, fluorouracil, alpha-fluoro-beta-ureidopropionic acid, dihydrofluorouracil, alpha-fluoro-beta-guanidopropionic acid, and alpha-fluoro-beta alanine in the urine. It also is expired as respiratory carbon dioxide.
Palliative management of GI adenocarcinoma metastatic to the liver administered by continuous regional intra-arterial infusion as long as cancer does not extend beyond area perfused by a single artery.
Tumors of the liver, gallbladder, bile ducts, or kidneys.
Patients in a poor nutritional state, those with depressed bone marrow function or those with potentially serious infections.
Implantable pump Using an implantable pump, administer 0.1 to 0.6 mg/kg/day for 1 to 6 wk, followed by a 14-day rest period between courses. Repeat cycles as long as response continues.Solid TumorsAdults
IV infusion 0.5 to 1 mg/kg/day for 6 to 15 days or until toxicity occurs.
Cimetidine may increase the bioavailability of floxuridine.
None well documented.
Arterial aneurysm; ischemia; thrombosis; embolism; fibromyositis.
Localized erythema; alopecia; rash.
Nausea and vomiting; diarrhea; enteritis; mucositis; duodenal ulcers; elevated LFTs; hepatic necrosis; hepatic abscesses; intra- and extrahepatic biliary sclerosis; acalculous cholecystitis.
Bone marrow suppression, nadir at 9 to 14 days; bleeding at the catheter site.
Fever and malaise; infection of the catheter site.
Hospitalization recommended for first course of therapy because of possibility of severe toxic reactions.
Category D .
Safety and efficacy not established.
Use with extreme caution in poor-risk patients who have had high-dose pelvic irradiation or previous use of alkylating agents, who have wide-spread involvement of bone marrow by metastatic tumors, or impaired hepatic or renal function.
According to product labeling, promptly discontinue floxuridine if any of the following occur: myocardial ischemia, mucositis or esophagopharyngitis, leukopenia with WBC less than 3,500/mm 3 , intractable vomiting, frequent diarrhea, GI ulcer or bleeding, thrombocytopenia with platelets less than 100,000/mm 3 , or hemorrhage from any site.
Local irritation or phlebitis may occur. Refer to your institution-specific protocol.
Nausea, vomiting, diarrhea, GI ulceration and bleeding, bone marrow depression (eg, thrombocytopenia, leukopenia, agranulocytosis).
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