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"What is it used for?  Breast cancer. Bowel (colorectal) cancer.  Stomach cancer. Cancer of the oesophagus or gullet.  How does it work?  Fluorouracil is a type of chemotherapy medicine used to treat cancer known as a cytotoxic antimetabolite. It is sometimes also known as FU or 5FU. Cancers form when cells within the body multiply abnormally and uncontrollably. These cells spread, destroying nearby tissues. Fluorouracil works by stopping the cancer cells from multiplying. It does this by being incorporated into the cells&amp;#039; genetic material, DNA and RNA. Both DNA and RNA are needed for cells to grow, repair themselves and multiply. Fluorouracil causes problems with the production of DNA and RNA in the cancer cells and this causes the cancer cells to grow in an unbalanced way, resulting in the death of the cells. Unfortunately, fluorouracil can also affect normal, healthy cells, particularly those that multiply quickly, such as blood cells. The most important side effect is on the bone marrow where blood cells are made. Fluorouracil can decrease the production of blood cells, leaving people susceptible to infection. Regular blood tests are therefore needed to monitor the levels of blood cells. In most chemotherapy regimens, doses are administered in courses at various intervals. The intervals between doses allow normal cells to recover from the adverse effects of the anticancer medicines. However, during this period, cancer cells will also recover and start to replicate again. Successful treatment depends on the administration of the next course of therapy before the cancer has regrown to its previous size and the net effect is to decrease the amount of cancer with each successive course. How is this treatment given?  This treatment is given either as an injection into a vein, or as a drip (infusion) into a vein or artery.  Treatment with fluorouracil is given in several cycles of treatment.  The length of your treatment and the number of cycles you have will depend on the type of cancer you&amp;#039;re being treated for, what other medicines are being used, how well the cancer responds and how well your body tolerates the treatment.   Warning!  This medicine can decrease the number of healthy blood cells in your blood. A low white blood cell count can increase your susceptibility to infections; a low red blood cell count causes anaemia and a low platelet count can cause problems with blood clotting. For this reason, you will need regular blood tests to monitor your blood cells during treatment with this medicine. Tell your doctor immediately if you experience any of the following symptoms during your treatment, as they may indicate problems with your blood cells: unexplained bruising or bleeding, purple spots, black or tarry stools, sore mouth or throat, mouth ulcers, high temperature (fever) or other signs of infection, or suddenly feeling tired, breathless, or generally unwell. People having treatment with this medicine will also need regular blood tests to monitor their liver function. Symptoms that may suggest a liver problem include persistent nausea and vomiting, abdominal pain, or the development of jaundice (a yellow colouring to the skin and the whites of the eyes). Tell your doctor if you experience any of these symptoms.  This medicine can make your skin more sensitive to sunlight. For this reason you should avoid exposing your skin to sunlight or sunlamps while having treatment with this medicine. If exposure to sunlight cannot be avoided, use protective measures such as sun-creams and protective clothing such as hats and long sleeves. Your doctor can prescribe you a high factor sun-cream.  This medicine may be harmful to an unborn baby, and for this reason you should use effective contraception to avoid getting pregnant or fathering a child during treatment. You should continue to use contraception to prevent pregnancy for at least six months after stopping this medicine; discuss this with your doctor. Women should consult their doctor immediately if they get pregnant during treatment.  Your ability to get pregnant or father a child may be affected by this medicine. If you are a woman your periods may stop. It is important to discuss fertility with your doctor before starting treatment.   Use with caution in  Decreased kidney function. Decreased liver function. Jaundice. People with history of heart disease.  People with reduced activity or deficiency of an enzyme in the body called dihydropyrimidine dehydrogenase (DPD).  Not to be used in  People who are very weak and debilitated. People with severely decreased production of blood cells by the bone marrow (myelosuppression), resulting in very low levels of white blood cells or platelets in the blood (for example due to radiotherapy or previous courses of chemotherapy).  People with serious infections.  People who are taking medicines known as antiviral nucleosides, such as brivudine or sorivudine, used for the treatment of shingles and chickenpox.  Pregnancy. Breastfeeding. Children.  This medicine should not be used if you are allergic to any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately. Pregnancy and breastfeeding Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.  This medicine may be harmful to a developing baby. It should not be used in pregnancy, unless considered essential by your doctor due to life-threatening disease.  Women who could get pregnant should use effective contraception to prevent pregnancy, and men should use effective contraception to prevent fathering a child, both during treatment, and for at least six months after treatment is finished. Seek further medical advice from your doctor.  It is not known if this medicine passes into breast milk. Mothers who need treatment with this medicine should not breastfeed. Seek medical advice from your doctor.   Side effects Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect. Very common (affect more than 1 in 10 people)  Decrease in the number of healthy white blood cells, red blood cells or platelets in the blood (leukopenia and neutropenia, anaemia and thrombocytopenia) - see warning section above.  Increased risk of infection. Diarrhoea.  Feeling or being sick. You will be given medicines to help with this. Loss of appetite. Sore mouth or mouth ulcers. Hair loss (alopecia). Nosebleeds. Feeling generally weak and tired. Delayed wound healing. Painful redness, swelling, blistering or ulceration of the palms and soles (hand-foot syndrome or palmar-plantar erythrodysesthesia). This is most likely in people having high doses and continuous infusion of the medicine. If you are affected it can be helpful to keep your hands and feet cool and to avoid tight-fitting clothing, such as socks, shoes and gloves.  Increased level of uric acid in the blood.  Common (affect between 1 in 10 and 1 in 100 people)  Chest pain. Tell your doctor if you experience this.  Uncommon (affect between 1 in 100 and 1 in 1000 people)  Headache. Dizziness. Sleepiness. Skin reactions, such as rash, hives, redness, dryness or darkening of the skin. Increased sensitivity of the skin to sunlight (see warning section above). Changes in the nails. Parkinson&amp;#039;s like symptoms, such as tremor, twitching or rigidity of muscles. Watery eyes. Visual disturbances, such as blurred or double vision. Inflammation of the optic nerve, eyes or eyelids (optic neuritis, conjunctivitis, blepharitis). Dehydration. Ulceration or bleeding in the gut. Irregular heart beats.  Heart attack. Low blood pressure. Liver problems.  Rare (affect between 1 in 1000 and 1 in 10,000 people)  Confusion. Blood clot in a blood vessel (thromboembolism). Cold and painful hands or feet (Raynaud&amp;#039;s syndrome).  The side effects listed above may not include all of the side effects reported by the medicine&amp;#039;s manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist. How can this medicine affect other medicines? It is important to tell your doctor or pharmacist what medicines you or your child are already taking, including those bought without a prescription and herbal medicines, before treatment with this medicine is started. Similarly, check with your doctor or pharmacist before taking any new medicines during treatment with this one, to make sure that the combination is safe.  Vaccines may be less effective in people receiving chemotherapy. This is because chemotherapy medicines reduce the activity of the immune system and can prevent the body forming adequate antibodies. Live vaccines should be postponed until at least six months after finishing chemotherapy because they may cause infection. Live vaccines include the following: oral polio; rubella; measles, mumps and rubella (MMR); BCG; chickenpox; yellow fever and oral typhoid vaccines.   Fluorouracil is broken down in the body by an enzyme called dihydropyrimidine dehydrogenase (DPD). The action of DPD is inhibited by medicines known as antiviral nucleosides, such as brivudine and sorivudine. These medicines may increase the risk of side effects from fluorouracil and should not be used in people treated with fluorouracil, or within four weeks of treatment with fluorouracil. Fluorouracil may increase the amount of the anticonvulsant medicine phenytoin in the blood and could therefore increase the chance of its side effects. If you are taking phenytoin while having fluorouracil treatment your doctor may need to do some extra monitoring. Fluorouracil may enhance the anti-blood-clotting effect of the anticoagulant warfarin. Your doctor may need to monitor your blood clotting time (INR) more frequently if you are taking warfarin while having fluorouracil treatment. The following medicines may affect the amount of fluorouracil in the blood:  allopurinol cimetidine interferon alfa leucovorin methotrexate metronidazole.  There may be an increased risk of side effects if this medicine is used in combination with other medicines which can also suppress bone marrow function and affect blood cell counts, for example other chemotherapy medicines, or the antipsychotic clozapine. Other medicines containing the same active ingredient Efudix cream contains fluorouracil and is applied to the skin to treat skin cancer and pre-cancerous skin lesions. Last updated 25.10.2012 "^^<http://www.w3.org/2001/XMLSchema#string>
<http://www.netdoctor.co.uk/medicines/cancer/a6751/fluorouracil/>