Fluorouracil (Fluorouracil) - Drug Interactions, Contraindications, Overdosage, etc

DRUG INTERACTIONS

Drug Interactions

Leucovorin calcium may enhance the toxicity of fluorouracil.

Also see WARNINGS section.

OVERDOSAGE

The possibility of overdosage with fluorouracil is unlikely in view of the mode of administration. Nevertheless, the anticipated manifestations would be nausea, vomiting, diarrhea, gastrointestinal ulceration and bleeding, bone marrow depression (including thrombocytopenia, leukopenia and agranulocytosis). No specific antidotal therapy exists. Patients who have been exposed to an overdose of fluorouracil should be monitored hematologically for at least four weeks. Should abnormalities appear, appropriate therapy should be utilized.

The acute intravenous toxicity of fluorouracil is as follows:

Species	LD50 (mg/kg ± S.E.)
Mouse	340 ± 17
Rat	165 ± 26
Rabbit	27 ± 5.1
Dog	31.5 ± 3.8

CONTRAINDICATIONS

Fluorouracil Injection, USP therapy is contraindicated for patients in a poor nutritional state, those with depressed bone marrow function, those with potentially serious infections or those with a known hypersensitivity to Fluorouracil Injection.

REFERENCES

1. Recommendations for the Safe Handling of Parenteral Antineoplastic Drugs. Washington, DC, U.S. Government Printing Office (NIH Publication No. 83-2621).
2. AMA Council Report. Guidelines for Handling Parenteral Antineoplastics. JAMA Mar 15, 1985; 253:1590–1592.
3. National Study Commission on Cytotoxic Exposure: Recommendations for Handling Cytotoxic Agents. Available from Louis P. Jeffrey, ScD, Director of Pharmacy Services, Rhode Island Hospital, 593 Eddy Street, Providence, Rhode Island 02902.
4. Clinical Oncological Society of Australia: Guidelines and Recommendations for Safe Handling of Antineoplastic Agents. Med J Aust. Apr 30, 1983; 1:426–428.
5. Jones RB, Frank R, Mass T: Safe Handling of Chemotherapeutic Agents: A Report from the Mount Sinai Medical Center. Sept–Oct 1983; 33:258–263.
6. American Society of Hospital Pharmacists Technical Assistance Bulletin on Handling Cytotoxic Drugs in Hospitals. Am J Pharm. Jan 1985; 42: 131–137.
7. OSHA Work-Practice Guidelines for Personnel Dealing with Cytotoxic (Antineoplastic) Drugs. Am J Hosp Pharm. 1986; 43:1193–1204.