Fluorouracil Injection

50 mg/mL, 20 mL vial, 10 count (NDC 16729-0276-67)

50 mg/mL, 50 mL vial, 1 count (NDC 16729-0276-11)

50 mg/mL, 100 mL vial, 1 count (NDC 16729-0276-38)

 

Fluorouracil injection, Fresenius Kabi

50 mg/mL, 10 mL vial, 10 count (NDC 63323-0117-10)

50 mg/mL, 20 mL vial, 10 count (NDC 63323-0117-20)

50 mg/mL, 50 mL vial, 1 count (NDC 63323-0117-51)

50 mg/mL, 100 mL vial, 1 count (NDC 63323-0117-61)

 

Fluorouracil injection, Teva
50 mg/mL, 10 mL vial, 10 count (NDC 00703-3015-13)
50 mg/mL, 50 mL vial, 5 count (NDC 00703-3018-12)

50 mg/mL, 100 mL vial, 5 count (NDC 00703-3019-12)

Estimated Resupply Dates

All marketed presentations are available.

Implications for Patient Care

• Fluorouracil is an antimetabolite antineoplastic agent. Fluorouracil is labeled for the palliative management of breast, colon, rectal, pancreatic, and stomach cancers.^4,5,6
• Fluorouracil is used off-label for a variety of neoplastic diseases including ovarian, cervical, bladder, hepatic, prostate, endometrial, esophageal, head and neck, penile, and thymic cancers. It is also used off-label for the treatment of renal cell carcinoma and carcinoid tumors.^4,5,6
• Refer to national guidelines such as those from the National Comprehensive Cancer Network or American Society of Clinical Oncology for additional information regarding therapeutic use.

Safety

• Chemotherapy agents, such as fluorouracil, pose additional safety risks both for patients and for healthcare workers handling these agents.^4,5,6
• Use additional caution when processing orders for chemotherapy drugs, especially when switching between chemotherapy agents or when processing orders for chemotherapy agents with which staff may be unfamiliar (eg, those not normally prescribed at a specific institution).^4,5,6
  

Alternative Agents & Management

• The choice of an alternative agent must be patient-specific and based on renal function, liver function, and the neoplasm type and location. No single agent can be substituted for fluorouracil.4,5,6
• Consider evaluating the health-care system's total supply of fluorouracil before beginning patients on combination chemotherapy regimens containing fluorouracil. If adequate supplies are not available, select an alternative regimen.
• Consult a Hematology/Oncology specialist for patient- and neoplasm-specific recommendations.
• Refer to the ASHP Guidelines on Managing Drug Product Shortages for more guidance on developing a multidisciplinary plan when the supply must be allocated.

Related Shortages

• Aldesleukin Injection — Resolved
• Asparaginase Erwinia chrysanthemi — Current
• Asparaginase Injection — No Longer Available
• Bendamustine Injection — Resolved
• Bleomycin Sulfate Injection — Current
• Busulfan — Resolved
• Capecitabine Tablets — Resolved
• Carbidopa and Levodopa Extended-Release Tablets — Resolved
• Carboplatin Solution for Injection — Current
• Carmustine Injection — Resolved
• Cisplatin Injection — Current
• Cyclophosphamide Injection — Resolved
• Cyclophosphamide Tablets — No Longer Available
• Cytarabine Injection — Resolved
• Dacarbazine Injection — Resolved
• Dactinomycin Injection — Resolved
• Daunorubicin Hydrochloride Injection — Resolved
• Denileukin Diftitox Injection — No Longer Available — No Commercially Available Preparations
• Doxorubicin Injection — Current
• Doxorubicin Liposomal Injection — Resolved
• Etoposide Injection — Current
• Fludarabine Injection — Resolved
• Gemtuzumab Ozogamicin Injection — No Longer Available
• Idarubicin Hydrochloride Injection — Resolved
• Interferon Alpha-2b, Intron A — Resolved
• Irinotecan Injection — Resolved
• Leuprolide Acetate 14-Day Kit — Current
• Lomustine Capsules — Resolved
• Mercaptopurine Tablets — Resolved
• Methotrexate Injection — Resolved
• Methotrexate Tablets — Resolved
• Mitomycin Injection — Resolved
• Mitoxantrone Hydrochloride Injection — Current
• Paclitaxel Injection — Resolved
• Peginterferon alfa-2b Injection — Resolved
• Pentostatin Injection — Resolved
• Streptozocin For Injection — Resolved
• Tamoxifen Tablets — Resolved
• Thiotepa for Injection — Current
• Tretinoin Oral Capsules — Resolved
• Vinblastine Injection — Resolved — No Commercially Available Preparations
• Vincristine Injection — Resolved

References

1. Accord (personal communications). January 28, February 25, March 4, 14, 22, and 28, April 6, May 3 and 16, June 2, July 19, and October 11, 2016.
2. Fresenius Kabi (personal communications). January 28, February 25, March 4, 14, 22, and 28, April 6, May 3, 16, and 23, July 15, August 1, 3, 11, and 26, and October 17, 2016.
3. Teva (personal communications) January 28, February 25, March 4, 14, 22, and 28, April 6, May 3 and 16, July 14, and October 21, 2016.
4. Antineoplastic agents. In: McEvoy GK, ed. AHFS 2015 Drug Information. Bethesda, MD: American Society of Health-Systems Pharmacists; 2015: 839-1281.
5. Drug Facts and Comparisons Online. St. Louis, MO: Wolters Kluwer Health Inc. March 2015.
6. Lexi-Drugs Online. Lexi-Comp, Inc.; 2015.

Updated

Updated October 21, 2016 by Michelle Wheeler, PharmD, Drug Information Specialist. Created January 28, 2016 by Jane Chandramouli, PharmD, Drug Information Specialist. Copyright 2016, Drug Information Service, University of Utah, Salt Lake City, UT.