Concurrent use with other bone marrow depressants agents or irriadiation may result in additive advers effect.

Aminoglycosides delay absorption.

Simultaneous live viral vaccination may produce generalised and life threatening infection,killed virus are ineffective.

Methotrexate folinic acid pretreatment may potentiates 5 urofluracil.

Drug/Lab test reaction:

Elevation of alkaline phosphatase, serum transminase, serum bilirubin, and lactic dehydrogenase may occur. Leucovorin calcium may enhance the toxicity of fluorouracil

Palliative treatment of carcinoma of colon, rectum, breast., stomach and pancreas.

Thrombocytopenia and neutropenia. Leucopenia, stomatitis, G.I.urceration, Bleeding and severe diarrhoea (stop treatment). Nausea, vomiting, Rashes, hyper-pigmentation, alopecia, Central neurotoxicity, Mycardial ischaema. Infiltration during I.V. injection may cause severe Irritation and tissue damage. Elevated serum bilirubin levels.

Patients in poor nutritional state,those with depressed bone marrow function or those with potentially serious infection pregnancy.

Special precautions:

All patients must be hospitalised during first course of treatment,regular monitoring of blood counts.

Indications:

Palliative treatment of carcinoma of colon, rectum, breast., stomach and pancreas.

Dosage:

Individualise dosage. Administer IV, avoid extravasation Initial dosage- 12mg/kg IV nce daily for 4 days. Do not exceed 800mg/day.

1. Transient alopecia, may occur with fluorouracil; alert patient to this possibility.

2. Contrceptive measures are recommended for men and women during therapy.

3. Notify doctor 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

4. May cause diarrhea, fever, and weakness. Notify if these become pronounced.

5. Drink plenty of water. while taking the drug.

6. Allergies- Tell your doctor if you have ever had any unusual or allergic reactions to fluorouracil or related medicines. Also tell your doctor if your are allergic to any other substances such as foods, preservatives or dyes.

7. Pregnancy- there is a chance that this medicine can cause birth defects ifeither the male or female is receiving it at the time of conception or taken during pregnancy. Tell your doctor if you are pregnant or hoping to become pregnant

8.Breast feeding- not recommended

9.Children- not expected to cause different side effects or problems in children

10. Elderly- not shown to cause different problems in elderly people than in younger adults.

11. Tell your doctor if you are taking any of the following- Amphotericin B or Antithyroid agents or Azthioprine or Chloramphenicol or Colchicine or Flucytosine or Ganciclovir or Interferon or Plicamycin or Zidovudine or if you have ever been treated with radiation or cancer medicines - fluorocil may increase the effects of these medicines or radiation on the blood.

11. Other medical problems- presence of other medical problems may affect the use of this medicine- Chickenpox or Herpes zoster - risk of severe disease affectring other parts of thebody Infection- fluorouracil can decrease your bodys ability to fight infection Kidney disease or Liver disease - efects of fluorocil may be increased because of slower removal from the body.

12. Missed dose- If you miss a dose of this medicine take it as soon as possible. However if it is almost time for your next dose go back to your regular dosing schedule. Do not double dose

Pharmacology:

Metabolism of fluorouracil in the anabolic pathway blocks the methlation reaction of deoxyuridylic acid to thymidylic acid. Fluorouracil interfere with the synthesis of deoxyribonucleic acid(DNA) and to a lesser extent inhibits the formation of ribonucleic acid(RNA).

Pharmacokinetics:

Fluorouracil diffuse rapidly across the blood- brain barrier and distributes into CSF and brain tissues.

Metabolism may be reduced.

Pregnancy:

Do not use during pregnancy

Lactation:

Not known whether fluorouracil is excreted in breast milk. Do not nurse while using it.