Fluorouracil for Injection

What is this fluorouracil?

Fluorouracil is a medicine that interferes with the growth of cancer cells. It is used to treat different types of cancer.

You may hear fluorouracil called 5-fluorouracil or 5-FU, or by its brand name, Adrucil. Fluorouracil comes in injection form.

Before giving fluorouracil to your child

Tell the doctor if your child has ever reacted badly to fluorouracil or to any other medication, food, preservative or coloring agent.

Talk with the doctor or pharmacist if your child has any of the following conditions. Precautions may need to be taken with this medicine if your child has:

• an infection or recent exposure to infection (for example chickenpox)
• liver or kidney problems
• dihydrodipyrimidine deficiency (DPD)
• had a major surgery recently
• low blood counts

How will your child get fluorouracil?

Fluorouracil is a clear liquid that a nurse will give by a needle into your child's vein (intravenously or IV). Your child will get this medicine in the hospital clinic or on a nursing unit.

What are the possible side effects of fluorouracil?

Your child may have some of these side effects while they take fluorouracil. Check with your child's doctor if your child continues to have any of these side effects and they do not go away, or they bother your child:

• loss of appetite
• nausea (upset stomach) and vomiting (throwing up)
• mild skin rash and itching
• feeling weak
• change in colour of the skin or nails

Call your child's doctor during office hours if child has any of these side effects:

• tingling of hands and feet, followed by pain, redness, and swelling (called hand-foot syndrome)
• pain when holding objects with hands
• trouble with balance, walking, or standing
• diarrhea (loose stools)
• mouth or lip sores

Most of the following side effects are not common, but they may be a sign of a serious problem. Call your child's doctor right away or take your child to Emergency if your child has any of these side effects:

• fever or chills
• cough, sore throat, or hoarseness
• painful or difficult urination
• lower back or side pain
• severe nausea (upset stomach) and vomiting (throwing up)
• severe stomach pain
• blood in urine or stools
• black, tarry stools
• vomiting material that looks like coffee grounds
• pinpoint red spots on skin
• severe skin rash or peeling
• unusual bleeding or bruising
• shortness of breath or trouble breathing
• chest pain
• uneven heartbeat
• eye irritation or change in vision

What safety measures should you take when your child is using fluorouracil?

Your child may have stomach upset (nausea) with fluorouracil. There are medicines which can be given to help to prevent stomach upset and throwing up caused by fluorouracil.

Your child may lose their hair. It will grow back once your child is no longer receiving fluorouracil. Its color and texture may change. Use a gentle shampoo and a soft brush.

Fluorouracil may cause sores in the mouth. Rinse your child's mouth with a mouthwash made from baking soda to help keep it clean. Your nurse or pharmacist can review this with you. Avoid store-bought mouthwash, as it may sting and cause dry mouth.

While your child is receiving fluorouracil, and for several months afterwards, they will be more sensitive to the sun. The skin will burn more easily than normal. To prevent sunburn, your child should wear sunscreen and protective clothing when outdoors.

Fluorouracil can lower the number of white blood cells in the blood temporarily, which increases your child's chances of getting an infection. Your child can take the following precautions to prevent infections, especially when the blood count is low:

• Avoid people with infections, such as a cold or the flu.
• Avoid places that are very crowded with large groups of people.
• Be careful when brushing or flossing your child's teeth. Your doctor, nurse or dentist may suggest different ways to clean your child's mouth and teeth.
• You and your child should not touch your child's eyes or inside the nose without washing hands first.
• Your child's nurse will review with you what to do in case of fever.

Your child should not receive any immunizations (vaccines) without your child's doctor's approval. Your child and anyone else in your household should not get oral polio vaccine while your child is being treated for cancer. Tell your child's doctor if anyone in your household has recently received oral polio vaccine. Your child should avoid contact with anyone who has recently received this vaccine. Other live vaccines that your child should not get include measles, mumps, and rubella (MMR) vaccine and chickenpox vaccine.

Fluorouracil can lower the number of platelets in the blood, which increases your child's risk of bleeding. You can take the following precautions:

• Be careful not to cut your child when using a razor, fingernail scissors, or toenail clippers.
• Be careful when shaving or waxing.
• Your child should avoid contact sports where bruising or injury could occur.
• Your child should not receive a permanent tattoo or any kind of body piercing.
• Before your child has surgery, including dental surgery, inform the doctor or dentist that your child is taking fluorouracil.

There is a chance that fluorouracil may cause birth defects if it is taken at the time of conception or if it is taken during pregnancy. If your child is sexually active, it is best that they use some kind of birth control while receiving fluorouracil. Tell the doctor right away if your child may be pregnant.

Check with your child's doctor or pharmacist before giving your child any other medicines (prescription, non-prescription, herbal, or natural products).

What other important information should you know about fluorouracil?

• Keep a list of all medications your child is on and show the list to the doctor or pharmacist.
• Tell your child's doctor or dentist that your child is getting fluorouracil before your child has any kind of operation, even on teeth, or an emergency treatment.
  

Keep fluorouracil out of your child’s sight and reach and locked up in a safe place. If your child takes too much fluorouracil, call your local Poison Information Centre at one of these numbers. These calls are free. 

• Call 1-844 POISON-X, or 1-844-764-7669, from anywhere in Canada except Quebec.
• Call 1-800-463-5060 if you live in Quebec.