Chemocare.com
Care During Chemotherapy and Beyond
(flure-oh-YOOR-a-sil)
Trade names: CaracTM, Efudex®, Fluoroplex®
Other names: 5-fluorouracil, 5-FU
Chemocare.com uses generic names in all descriptions of drugs. Carac is the trade
name for fluorouracil cream. 5-FU cream and efudex and fluoroplex are other names
for fluorouracil cream. In some cases, health care professionals may use the trade
name carac or other names 5-FU cream or efudex or fluoroplex when referring to the
generic drug name fluorouracil cream.
Drug type: Fluorouracil is an anti-cancer ("antineoplastic"
or "cytotoxic") chemotherapy drug. This medication is classified as an "antimetabolite."
(For more detail, see "How this drug works" section below).
What Fluorouracil Cream Is Used For:
- Basal cell cancer of the skin.
- Actinic keratoses (a pre-cancerous skin condition).
Note: If a drug has been approved for one use, physicians
may elect to use this same drug for other problems if they believe it may be helpful.
How Fluorouracil Cream Is Given:
- As a topical cream or solution, a thin coating is applied to the affected skin lesions,
treatment may continue over several weeks.
- Use non-metal applicator or fingertips to apply cream.
- Use care when applying cream or solution around the eyes, nose, and mouth.
- Wash your hands immediately after applying this medication.
- The amount of fluorouracil (cream) that you will receive depends on many factors,
such as the type of cancer or condition being treated. Your doctor will determine
your dose and schedule.
Side Effects:
Important things to remember about the side effects of fluorouracil (cream):
- Most people do not experience all of the side effects listed.
- Side effects are often predictable in terms of their onset and duration.
- Side effects are almost always reversible and will go away after treatment is complete.
- There are many options to help minimize or prevent side effects.
- There is no relationship between the presence or severity of side effects and the
effectiveness of the medication.
The following side effects are common (occurring in greater than 30%) for
patients taking flurouracil(cream):
- Pain, itching, burning, irritation, inflammation, dryness, swelling, tenderness
at the site of application. This will heal once the treatment is complete.
These side effects are less common side effects (occurring in about 10-29%)
of patients receiving flurouracil(cream):
- Discoloration of the skin or scarring
- Increased sensitivity to sunlight
Not all side effects are listed above. Some that are rare (occurring in less than
10% of patients) are not listed here. However, you should always inform your
health care provider if you experience any unusual symptoms.
When to contact your doctor or health care provider:
Always inform your health care provider if you experience any unusual symptoms.
Precautions:
- Before starting fluorouracil (cream) treatment, make sure you tell your doctor about
any other medications you are taking (including prescription, over-the-counter,
vitamins, herbal remedies, etc).
- Do not take aspirin, products containing aspirin unless your doctor specifically
permits this.
- Inform your health care professional if you are pregnant or may be pregnant prior
to starting this treatment. Pregnancy category X fluorouracil (cream) may cause
fetal harm when given to a pregnant woman. This drug must not be given to
a pregnant woman or a woman who intends to become pregnant. If a woman becomes
pregnant while taking fluorouracil (cream), the medication must be stopped immediately
and the woman given appropriate counseling).
- For both men and women: Do not conceive a child (get pregnant) while taking fluorouracil (cream).
Barrier methods of contraception, such as condoms, are recommended. Discuss with
your doctor when you may safely become pregnant or conceive a child after therapy.
- Do not breast feed while taking this medication.
Self-Care Tips:
- Use non-metal applicator or fingertips to apply cream.
- Use care when applying cream or solution around the eyes, nose, and mouth.
- Wash your hands immediately after applying this medication.
- Avoid sun exposure. Wear SPF 15 (or higher) sunblock and protective clothing.
- If you experience symptoms or side effects, be sure to discuss them with your health
care team. They can prescribe medications and/or offer other suggestions that
are effective in managing such problems.
Monitoring and Testing:
You will be checked regularly by your doctor while you are taking fluorouracil (cream),
to monitor side effects and check your response to therapy.
How Fluorouracil Cream Works:
Cancerous tumors are characterized by cell division, which is no longer controlled
as it is in normal tissue. "Normal" cells stop dividing when they come
into contact with like cells, a mechanism known as contact inhibition. Cancerous
cells lose this ability. Cancer cells no longer have the normal checks and
balances in place that control and limit cell division. The process of cell
division, whether normal or cancerous cells, is through the cell cycle. The
cell cycle goes from the resting phase, through active growing phases, and then
to mitosis (division).
The ability of chemotherapy to kill cancer cells depends on its ability to halt
cell division. Usually, the drugs work by damaging the RNA or DNA that tells
the cell how to copy itself in division. If the cells are unable to divide,
they die. The faster the cells are dividing, the more likely it is that chemotherapy
will kill the cells, causing the tumor to shrink. They also induce cell suicide
(self-death or apoptosis).
Chemotherapy drugs that affect cells only when they are dividing are called cell-cycle
specific. Chemotherapy drugs that affect cells when they are at rest are called
cell-cycle non-specific. The scheduling of chemotherapy is set based on the
type of cells, rate at which they divide, and the time at which a given drug is
likely to be effective. This is why chemotherapy is typically given in cycles.
Unfortunately, chemotherapy does not know the difference between the cancerous cells
and the normal cells. Chemotherapy will kill all cells that are rapidly dividing.
The "normal" cells will grow back and be healthy but in the meantime, side effects
occur. The "normal" cells most commonly affected by chemotherapy are the blood
cells, the cells in the mouth, stomach and bowel, and the hair follicles; resulting
in low blood counts, mouth sores, nausea, diarrhea, and/or hair loss. Different
drugs may affect different parts of the body.
Fluorouracil belongs to the category of chemotherapy called antimetabolites.
Antimetabolites are very similar to normal substances within the cell. When
the cells incorporate these substances into the cellular metabolism, they are unable
to divide. Antimetabolites are cell-cycle specific. They attack cells
at very specific phases in the cycle. Antimetabolites are classified according
to the substances with which they interfere.
- Folic acid antagonist: Methotrexate
- Pyrimidine antagonist: 5-Fluorouracil, Foxuridine, Cytarabine,
Capecitabine, and Gemcitabine
- Purine antagonist: 6-Mercaptopurine and 6-Thioguanine
- Adenosine deaminase inhibitor: Cladribine, Fludarabine and Pentostatin
Note: We strongly encourage you to talk with your health
care professional about your specific medical condition and treatments. The information
contained in this website is meant to be helpful and educational, but is not a substitute
for medical advice.
Chemocare.com is designed to provide the latest information about chemotherapy to patients and their families, caregivers and friends. For information about the 4th Angel Mentoring Program visit www.4thangel.org