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Floxuridine

(flox-yoor-uh-deen)

Trade/other name(s): Fdur, fluorodeoxyuridine, deoxyfluorouridine

Why would this drug be used?

Floxuridine is used to treat some cancers that have spread to the liver. It is also being studied for treating other types of cancer.

How does this drug work?

Floxuridine is part of the general group of chemotherapy drugs known as anti-metabolites. Once in the body, this drug breaks down into several different compounds that fight cancer. One of these compounds is 5-fluorouracil, a well-known chemotherapy medicine. Floxuridine and the other compounds prevent cells from making DNA and RNA by interfering with the making of DNA and RNA. This stops the cells from growing and leads to their death.

Before taking this medicine

Tell your doctor…

  • If you are allergic to anything, including medicines, dyes, additives, or foods.
  • If you have any medical conditions such as kidney disease, liver disease (including hepatitis), heart disease, congestive heart failure, diabetes, gout, or infections. These conditions may require that your medicine dose, regimen, or timing be changed.
  • If you are pregnant, trying to get pregnant, or if there is any chance of pregnancy. This drug may cause birth defects if either the male or female is taking it at the time of conception or during pregnancy. Check with your doctor about what kinds of birth control can be used with this medicine.
  • If you are breast-feeding. It is not known whether this drug passes into breast milk. If it does, it could harm the baby.
  • If you think you might want to have children in the future. Some drugs can cause sterility. Talk with your doctor about the possible risk with this drug and the options that may preserve your ability to have children.
  • If you have ever been treated for cancer with chemotherapy or high doses of radiation to the pelvis. Your doctor will want to watch you more carefully for problems while you are taking floxuridine.
  • About any other prescription or over-the-counter medicines you are taking, including vitamins and herbs. In fact, keeping a written list of each of these medicines (including the doses of each and when you take them) with you in case of emergency may help prevent complications if you get sick.

Interactions with other drugs

Any drugs or supplements that interfere with blood clotting can raise the risk of bleeding during treatment with floxuridine. These include:

  • vitamin E
  • non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), and many others
  • warfarin (Coumadin)
  • ticlopidine (Ticlid)
  • clopidogrel (Plavix)

Note that many cold, flu, fever, and headache remedies contain aspirin or ibuprofen. Ask your pharmacist if you aren't sure what's in the medicines you take.

Check with your doctor, nurse, or pharmacist about other medicines, vitamins, herbs, and supplements, and whether alcohol can cause problems with this medicine.

Interactions with foods

No serious interactions with food are known at this time. Check with your doctor, nurse, or pharmacist about whether any foods may be a problem.

Tell all the doctors, dentists, nurses, and pharmacists you visit that you are taking this drug.

How is this drug taken or given?

Floxuridine is given by a special pump through an artery that goes directly into the liver. It is typically given as a continuous infusion for 14 to 21 days, and the first course is usually given while you are in the hospital. The dose depends on your size.

Sometimes floxuridine is given as an injection into a vein by a specially trained doctor or nurse as part of a clinical trial or research study. You will likely also get a medicine to cut down on stomach acid to prevent ulcers. Other researchers are studying floxuridine to see if it works when it's put in the space in the belly, around the intestines (called intra-peritoneal).

Precautions

Call your doctor right away if you notice mouth sores, difficulty swallowing, vomiting, diarrhea, chest pain, stomach pain, trouble walking, or bleeding from anywhere in the body.

Floxuridine is pumped into an artery that feeds directly into the liver. Your doctor or nurse should explain the problems that can happen when a drug is given through an artery and what you should do if they occur.

Do not get any immunizations (vaccines), either during or after treatment with this drug, without your doctor's OK. Floxuridine may affect your immune system. This could make vaccinations ineffective, or could even lead to serious infections if you get a live virus vaccine during or soon after treatment. Try to avoid contact with people who have recently received a live virus vaccine, such as the oral polio vaccine or smallpox vaccine.

Your doctor will likely test your blood throughout your treatment, looking for possible effects of the drug on blood counts (described below) or on other body organs. Based on the test results, you may be given medicines to help treat any effects. Your doctor may also need to reduce or delay your next dose of this drug, or even stop it altogether. Keep all your appointments for lab tests and doctor visits.

This drug can lower your white blood cell count, especially in the weeks after the drug is given. This can increase your chance of getting an infection. Be sure to let your doctor or nurse know right away if you have any signs of infection, such as fever (100.5° or higher), chills, pain when passing urine, a new cough, or bringing up sputum.

This drug may lower your platelet count in the weeks after it is given, which can increase your risk of bleeding. Speak with your doctor before taking any drugs or supplements that might affect your body's ability to stop bleeding, such as aspirin or aspirin-containing medicines, warfarin (Coumadin), or vitamin E. Tell your doctor right away if you have unusual bruising, or bleeding such as nosebleeds, bleeding gums when you brush your teeth, or black, tarry stools.

Avoid pregnancy during treatment and for some months afterward. This drug may harm a growing fetus. Talk with your doctor about this.

Possible side effects

You will probably not have most of the following side effects, but if you have any talk to your doctor or nurse. They can help you understand the side effects and cope with them.

Common

  • loss of appetite
  • diarrhea*
  • numbness or tingling in hands and/or feet

Less common

  • stomach cramping and pain*
  • sores in mouth or on lips*
  • bleeding at catheter site (where the tube goes into your artery)
  • infection around the catheter (the tube that goes into your artery)
  • catheter blockage
  • hair loss or thinning, including face and body hair (grows back when drug is stopped)

Rare

  • nausea
  • vomiting*
  • sore throat
  • difficulty swallowing*
  • rash
  • itching
  • seizures
  • depression
  • hiccups
  • blurred vision
  • chest pain*
  • low white blood cell count with increased risk of infection*
  • low platelet count with increased risk of bleeding*
  • low red blood cell count (anemia) with weakness, fatigue
  • trouble walking*

*See "Precautions" section for more detailed information.

There are some other side effects not listed above that can also occur in some patients. Tell your doctor or nurse if you develop these or any other problems.

FDA approval

Yes – first approved before 1984 (FDA cannot verify dates of drugs approved before 1984).

Disclaimer: This information does not cover all possible uses, actions, precautions, side effects, or interactions. It is not intended as medical advice, and should not be relied upon as a substitute for talking with your doctor, who is familiar with your medical needs.


Last Medical Review: 02/05/2010
Last Revised: 02/05/2010