Class: Pyrimidine antimetabolite
- 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.
Indications and Usage
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.
Dosage and AdministrationHepatic Artery Infusion
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 Tumors
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.
Laboratory Test Interactions
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.
Special Risk Patients
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).
- Contraceptive measures are recommended for men and women during therapy.
- Notify health care provider if chills, nausea, vomiting, unusual bleeding or bruising, yellowing of skin or eyes, abdominal pain, flank or joint pain, or swelling of feet or legs occurs.
- Notify health care provider if the following become pronounced: diarrhea, fever, weakness
- Drink plenty of liquids while taking this drug.
- Inform patients of expected toxic effects, particularly oral manifestations.
- Alert patient to the possibility of alopecia as a result of therapy, and inform patient that alopecia is usually a transient effect.
Copyright © 2009 Wolters Kluwer Health.
More about floxuridine
- Other brands: FUDR