5fu-Fluorouracil

Patient Education Quick Reference Guide

Diablo Valley Oncology/Hematology Medical Group

Phone Number: 925-677-5041

Uses For This Medication

  • Fluorouracil (5-FU) is used alone or together with other chemotherapy medications to treat adults with many different types of cancer including anal cancer, colon or rectal (colorectal) cancer, stomach cancer, pancreatic cancer, breast cancer, esophageal cancer, head and neck cancers, and cervical cancer.
  • This medication may also be given for other conditions as determined by your doctor.

How This Medication Works

5-FU is a chemotherapy medication that doesn’t allow cancer cells, also known as tumor cells, to divide and grow  normally, which leads to tumor cell death.

Benefits Of This Medication

5-FU, alone or together with other chemotherapy medications, may slow down the growth of the tumor, or cancer. In addition, for some cancers, 5-FU may lengthen how long a person lives.

Who Should Not Take This Medication

You should not take this medication if you:
  • Are allergic to 5-FU or any of its components
  • Have an infection
  • Have very low white blood cell, red blood cell, or platelet levels. Your doctor or healthcare provider will check your blood before starting 5-FU to make sure that it is safe to start this medication.
  • Lack the enzyme dihydropyrimidine dehydrogenase (DPD)

Precautions To Be Aware Of Before Taking This Medication

Blood related precautions

  • This medication may temporarily reduce the number of platelets in your blood. This can increase your risk of bleeding. Contact your doctor or healthcare provider if you notice unusual bleeding or bruising, have black or tar-like stools, see blood in your urine, or develop pinpoint red spots on your skin. If your platelet levels become too low, your doctor or healthcare provider may recommend that your treatment be delayed, that  you receive a platelet transfusion, and/or that you take medication to help increase the number of platelets in  your blood. To lower your chance of bleeding, do not use aspirin, aspirin-containing medications, or aspirin-like  medications (for example ibuprofen, naproxen). Use caution with sharp objects like razors and nail cutters, and avoid activities that can cause cuts, bumps, and bruises.
  • This medication may temporarily reduce the number of germ fighting white blood cells in your blood. This can increase your risk of infection. Contact your doctor or healthcare provider promptly if you develop any signs of an infection such as fever, painful urination, chills, or a sore throat that doesn’t go away. If your white blood cell levels become too low, your doctor or healthcare provider may recommend that your treatment be delayed  and/or you receive medication to increase the number of white cells in your blood. To lower your risk of infection, stay away from crowds and people with colds or other illnesses, wash your hands with soap and water well and often, and brush and floss your teeth daily.
  • This medication may temporarily lower the number of red cells in your blood. This can increase your risk of  anemia. If your red blood cell level becomes low, you may feel tired and weak. If your red blood cell level  becomes too low, your doctor or healthcare provider may recommend that your treatment be delayed, that you  receive a red blood cell transfusion, and/or you receive a medication to help increase the red cells in your blood.

Gastrointestinal Related Precautions

  • This medication may cause nausea, vomiting, and/or diarrhea which can lead to dehydration. Eat small frequent meals, bland foods (for example bananas, rice, apples, toast), and drink plenty of water and fluids. Contact your doctor or healthcare provider if you have moderate to severe nausea, vomiting, or diarrhea. These side effects can be treated with medications.
  • This medication may cause redness or sores in your mouth, throat or on your lips. Talk with your doctor or healthcare provider about proper mouth and throat care (for example brushing and flossing). Avoid foods and drinks that may irritate your mouth such as citrus fruits and juices, tobacco, and spicy foods. Using a salt and baking soda mouthwash (1 teaspoon salt & 1 teaspoon baking soda dissolved in 1 quart of water) four times a day may be soothing.
  • Rarely, this medication may cause bleeding of the stomach. Let your doctor or healthcare provider know if you vomit blood or pass black tarry stools.

Miscellaneous Precautions

  • If you lack the enzyme dihydropyrimidine dehydrogenase (DPD), you may be more likely to have serious side effects from this medication, including swelling and sores in the mouth, diarrhea, low white blood cell levels, or nerve damage which can cause problems with the normal activity of the nervous system (symptoms include limb weakness or numbness, loss of memory and/or vision, confusion, headache, behavior problems, sexual dysfunction).
  • Rarely, when given as continuous infusion, this medication can cause hand-and-foot syndrome. This condition can cause the hands or soles of the feet to tingle, become numb, painful, swollen or red. Contact your doctor or healthcare provider if you experience new symptoms, if your symptoms become painful or worsen, or if you are unable to perform routine daily activities as a result of this condition. If you do develop this condition, you should try to protect your feet and hands. Prevent injuring them and avoid prolonged heat (for example taking hot baths) or pressure (for example wearing tight-fitting shoes). In addition, rubbing petroleum jelly (Vaseline or a similar type cream or ointment) on your hands and feet at bedtime and covering them with cotton gloves  and/or socks may be helpful.
  • Do not receive any immunizations (vaccinations) while on this medication without your doctor or healthcare provider’s approval. This medication can increase your risk of infection. For certain immunizations, you may develop the infection that the immunization is intended to prevent.

Patient Specific Precautions

  • It is not known if this medication is safe and effective in children. Pregnancy and Breastfeeding Precautions
  • This medication may cause fetal harm. When taking this medication, you should use effective birth control to prevent pregnancy. Tell your doctor or healthcare provider right away if you or your spouse/partner becomes pregnant.
  • It is not known whether this medication is found or excreted in breast milk. Since many medications are excreted in breast milk and because this medication can cause serious harmful reactions in infants, breastfeeding should be avoided.
  • Many anti-cancer therapies can cause sterility. Notify your doctor or healthcare provider if you want to have children in the future.

Medication and Food Interactions

Before using this medication, tell your doctor or healthcare provider of all prescription or over-the-counter products you are taking, including dietary supplements or vitamins, herbal medicines and homeopathic remedies. Do not start or stop any medication without your doctor or healthcare provider’s approval. Possible interactions can occur with 5-FU and the following medications:
  • Amphotericin B
  • Antithyroid agents
  • Azathioprine
  • Cimetidine
  • Chloramphenicol (Chloromycetin®)
  • Colchicine
  • Flucytosine (Ancobon®)
  • Ganciclovir
  • Interferon
  • Leucovorin
  • Metronidazole
  • Methotrexate
  • Phenytoin
  • Thiazide diuretics, Hydrochlorothiazide
  • Warfarin (Coumadin®) (specifically when continuous infusion 5-FU is given)
  • Zidovudine (Retrovir®)
NOTE: This list may not include all medications that can have interactions with arsenic trioxide.

Side Effects

  • All medications can cause side effects. However, not all patients will experience these side effects. In addition, other side effects not listed can also occur in some patients. You should call your doctor or healthcare provider if you have any questions or concerns while you are on this medication.
  • You should contact your doctor or healthcare provider if you experience any side effect(s) which don’t go away, worsen, are serious in nature, or are worrisome to you.
  • Side effects can occur when 5-FU is given alone or together with other chemotherapy medications. The side effects listed below are those reported in patients who were treated with 5-FU alone.

More Common Side Effects

  • Low platelet, red blood cell, and/or white blood cell levels (see Precautions To Be Aware Of Before Taking This Medication)
  • Nausea, vomiting, diarrhea, loss of appetite, sores in mouth or on lips (see Precautions To Be Aware Of Before Taking This Medication)
  • Hair loss or thinning
  • Dry and/or itchy skin with a rash
  • Darkening of the skin over the vein

Less Common Side Effects

  • Brittle nails, oversensitivity of the skin to sunlight, darkening of skin and nail beds
  • Headache, weakness, muscle aches

Rare Side Effects

This is not a complete list of the rare side effects reported with 5-FU. For a complete list, please talk with your doctor or healthcare provider about reviewing a copy of the package insert.
  • Allergic reactions
  • Heart attack and angina (specifically when continuous infusion 5-FU is given)
  • Difficulty walking
  • Darkening and stiffening of vein used for giving the drug
  • Irritation of eyes, increased tearing of eyes, blurred vision, photophobia (sensitivity to light)
  • Nose bleeds
  • Confusion, disorientation, euphoria
  • Stomach ulcers and/or bleeding (see Precautions To Be Aware Of Before Taking This Medication)
  • Hand-and-foot syndrome (see Precautions To Be Aware Of Before Taking This Medication)
  • Loss of fingernails and toenails

How To Take This Medication

  • This medication is usually given by injection into a vein (IV) by a healthcare professional. This medication can be given in different doses depending on your weight, your type of condition and whether 5-FU is being given with other chemotherapy medications.
  • Antiemetics, which are medications to help prevent and control nausea and vomiting, may be given prior to fluorouracil either by mouth (orally) or by injection into a vein (IV).
  • In the unlikely event of an overdose of this medication contact your doctor, your local poison control center at 1-800-222-1222, or emergency services immediately.

Proper Storage

  • It is unlikely that you will need to store this medication. However, in the event that you do, the unopened containers should be stored at controlled room temperature.
  • Keep this medication out of the reach of children or pets.
  • Ask your doctor or healthcare provider how to dispose of any medication that you no longer use.