Floxuridine

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Floxuridine

Definition

Floxuridine is an anti-cancer drug that is injected directly into the artery that carries blood to the liver or the abdominal cavity. The brand names of floxuridine are Fluorodeoxyuridine, FUDR, and Floxuridine For Injection USP. The generic name product may be available in the United States.

Purpose

Floxuridine is used to treat gastrointestinal cancers that have metastasized, or spread, to the liver. These cancers include rectal cancer and Stage IV colon cancer . Floxuridine also has been used to treat cancerous gastrointestinal tumors; however the response rate is poor and usually the drug is used only to relieve symptoms.

Description

Floxuridine is approved by the United States Food and Drug Administration.

Floxuridine is a type of medicine called an antimetabolite because it interferes with the metabolism and growth of cells. Floxuridine prevents the production of DNA in cells. The cells cannot reproduce and eventually they die.

Floxuridine sometimes is used in conjunction with the drugs fluorouracil (5-FU), cisplatin , and/or leucovorin . Leucovorin increases the activity of floxuridine. In general, floxuridine is more effective than other chemotherapies against liver metastases, but its use does not improve overall survival rates. Ongoing studies are comparing floxuridine with other chemotherapies. The drug may be used in conjunction with surgery. Its use in conjunction with radiation therapy is being evaluated.

Recommended dosage

Floxuridine is injected directly into the liver. This is called hepatic intra-arterial infusion, or hepatic arterial infusion . A special pump delivers the drug through an implanted infusion port or catheter into an artery that goes to the liver. Injection of floxuridine into a vein is being evaluated. Floxuridine also may be injected into the abdominal cavity (intraperitoneal therapy). The dosage of floxuridine depends on a number of factors including body weight, type of cancer, and any other medicines that are being used.

Precautions

Floxuridine may lower the number of white blood cells and, therefore, reduce the body's ability to fight infection. Immunizations (vaccinations) should be avoided during or after treatment with floxuridine because of the risk of infection. It also is important to avoid contact with individuals who have recently taken an oral polio vaccine. Treatment with floxuridine may cause chicken pox or shingles (Herpes zoster ) to become very severe and spread to other parts of the body.

Kidney or liver diseases may increase the effects of floxuridine, since the drug may be removed from the body at a slower rate. Floxuridine also may put an individual at an increased risk for hepatitis.

Floxuridine can cause birth defects in animals. Therefore this drug should not be taken by pregnant women or by either the man or the woman at the time of conception. Women usually are advised against breast-feeding while receiving this drug.

Side effects

Since floxuridine may affect the growth of normal cells as well as cancer cells, side effects may occur during or after drug treatment. Some effects may occur months or even years after the drug is administered. Floxuridine increases the risk of later developing certain types of cancer, such as leukemia.

The more common side effects of floxuridine include:

diarrhea
loss of appetite (anorexia )
sores in the mouth or on the lips
stomach pain or cramps
numbness or tingling in the hands and feet

Less common side effects of floxuridine include:

nausea and vomiting
black, tar-like stools
heartburn
redness or scaling of the hands or feet
sore, swollen tongue
skin rash or itching
temporary thinning of hair (alopecia )
bleeding at the site of the catheter
infection from the catheter
closing off of the catheter

Other, rare side effects of floxuridine include:

blood in urine or stools
hiccups
hoarseness or coughing
fever or chills
sore throat
difficulty swallowing
blurred vision
lower back or side pain
painful or difficult urination
small red skin spots
difficulty walking
bleeding or bruising
yellow eyes or skin
seizures
depression

In addition to lowering the white blood cell count, increasing the risk of infection, floxuridine may reduce the level of blood platelets that are necessary for normal blood clotting. This can increase the risk of bleeding. The drug also may lead to abnormalities in liver function. Intraperitoneal floxuridine therapy has been associated with the development of fibrous masses in the abdomen.