May increase warfarin effects.

May reduce response to vaccines possibility of generalized infection with live vaccines

Action may be modified by Allopurinol

Leucovorin Ca may enhance toxicity of fluorouracil

Palliatice treatment of breast carcinoma, of the colon, rectum

breast, stomach or pancreas

Leucopenia, thrombocytopaenia, stomatitis, GI ulceration, bleeand ding and diarrhoea haemorrhage, from any site(stop treatment)

Nausea, vomiting, rashes, hyperpigmentation, alopecia, 

Topical- Local  Inflammatory and photosensitivity reactions,

Dermatitis and erythema multiforme( rare)

Central neurotoxicity, myocardial ischaemia

Contraindications-

Topical application to mucous membrane, exposure to sunlight, hypersensitivity. Depressed bone marrow function, poor nutrional status, potentialy serious infections

Pregnancy and lactation

Special Instructions-

Regular monitoring f bloos counts, History of heart disease , hepatic  or renal insufficiency,weak or malnourished patients, patients who with history of high dose pelvic radiation or use of alkylating agents. Patients with widespread metastases to the bone marrow

Indication-

Palliatice treatment of breast carcinoma, of the colon, rectum

breast, stomach or pancreas 

Dosage-

Oral- 15mg/kg (max 1g dailly) may be given once weekly for maintenance

Maximum dose - 1g/week

Intravenous- Adult- 5-7.5mg/kg daily continous infusion (regional perfusion)