Dosing & Uses
Dosage Forms & Strengths
powder for injection
- 500mg/vial
GI Adenocarcinoma with Metastasis to Liver, Gallbladder, Bile Ducts
0.1-0.6 mg/kg/d continuous arterial infusion
Monitor: CBC, LFTs
Gastric Cancer (Orphan)
Intraperitoneal treatment of gastric cancer
Orphan indication sponsor
- Franco Muggia, M.D.; 160 East 34th Street; New York, NY 10016
Safety & efficacy not established
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (18)
- adenovirus types 4 and 7 live, oral
floxuridine decreases effects of adenovirus types 4 and 7 live, oral by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Immunosuppressives may diminish therapeutic effects of vaccines and increase risk of adverse effects (increased risk of infection). Live-attenuated vaccines should be avoided for at least 3mo after cessation of immunosuppressive therapy.
- axicabtagene ciloleucel
floxuridine, axicabtagene ciloleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.
- brexucabtagene autoleucel
floxuridine, brexucabtagene autoleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.
- ciltacabtagene autoleucel
floxuridine, ciltacabtagene autoleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.
- deferiprone
deferiprone, floxuridine. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid use of deferiprone with other drugs known to be associated with neutropenia or agranulocytosis; if an alternative is not possible, monitor absolute neutrophil count more frequently.
- etrasimod
etrasimod, floxuridine. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Risk of additive immune system effects with etrasimod has not been studied in combination with antineoplastic, immune-modulating, or noncorticosteroid immunosuppressive therapies. Avoid coadministration during and in the weeks following administration of etrasimod. .
- fexinidazole
fexinidazole and floxuridine both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels or prolong QT interval.
- idecabtagene vicleucel
floxuridine, idecabtagene vicleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.
- influenza virus vaccine quadrivalent, adjuvanted
floxuridine decreases effects of influenza virus vaccine quadrivalent, adjuvanted by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Immunosuppressive drugs may reduce the immune response to influenza vaccine.
- influenza virus vaccine trivalent, adjuvanted
floxuridine decreases effects of influenza virus vaccine trivalent, adjuvanted by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Immunosuppressive drugs may reduce the immune response to influenza vaccine.
- lefamulin
lefamulin and floxuridine both increase QTc interval. Avoid or Use Alternate Drug.
- lisocabtagene maraleucel
floxuridine, lisocabtagene maraleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.
- palifermin
palifermin increases toxicity of floxuridine by Other (see comment). Avoid or Use Alternate Drug. Comment: Palifermin should not be administered within 24 hrbefore, during infusion of, or within 24 hr after administration of antineoplastic agents. Coadministration of palifermin within 24 hr of chemotherapy resulted in increased severity and duration of oral mucositis.
- pexidartinib
floxuridine and pexidartinib both increase Other (see comment). Avoid or Use Alternate Drug. Pexidartinib can cause hepatotoxicity. Avoid coadministration of pexidartinib with other products know to cause hepatoxicity.
- pretomanid
floxuridine, pretomanid. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Pretomanid regimen associated with hepatotoxicity. Avoid alcohol and hepatotoxic agents, including herbal supplements and drugs other than bedaquiline and linezolid.
- ropeginterferon alfa 2b
ropeginterferon alfa 2b, floxuridine. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
- tisagenlecleucel
floxuridine, tisagenlecleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.
- tofacitinib
floxuridine, tofacitinib. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.
Monitor Closely (38)
- amiodarone
floxuridine and amiodarone both increase QTc interval. Use Caution/Monitor.
- arsenic trioxide
floxuridine and arsenic trioxide both increase QTc interval. Use Caution/Monitor.
- bedaquiline
floxuridine and bedaquiline both increase QTc interval. Use Caution/Monitor.
- belatacept
belatacept and floxuridine both increase immunosuppressive effects; risk of infection. Use Caution/Monitor.
- chlorpromazine
floxuridine and chlorpromazine both increase QTc interval. Use Caution/Monitor.
- cholera vaccine
floxuridine decreases effects of cholera vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Immunosuppressive therapies, including irradiation, antimetabolites, alkylating agents, cytotoxic drugs and corticosteroids (used in greater than physiologic doses), may reduce the immune response to cholera vaccine.
- dengue vaccine
floxuridine decreases effects of dengue vaccine by immunosuppressive effects; risk of infection. Use Caution/Monitor. Immunosuppressive therapies (eg, irradiation, antimetabolites, alkylating agents, cytotoxic drugs, corticosteroids [greater than physiologic doses]) may reduce immune response to dengue vaccine.
- denosumab
floxuridine, denosumab. Other (see comment). Use Caution/Monitor. Comment: Caution should be taken in patients on concomitant immunosuppressants or with impaired immune systems because of increased risk for serious infections.
- disopyramide
floxuridine and disopyramide both increase QTc interval. Use Caution/Monitor.
- dofetilide
floxuridine and dofetilide both increase QTc interval. Use Caution/Monitor.
- dronedarone
floxuridine and dronedarone both increase QTc interval. Use Caution/Monitor.
- ethotoin
floxuridine increases levels of ethotoin by unknown mechanism. Use Caution/Monitor. Based on case reports.
- fingolimod
floxuridine increases effects of fingolimod by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Concomitant therapy is expected to increase the risk of immunosuppression. Use caution when switching patients from long-acting therapies with immune effects. .
- fosphenytoin
floxuridine increases levels of fosphenytoin by unknown mechanism. Use Caution/Monitor. Based on case reports.
- fostemsavir
floxuridine and fostemsavir both increase QTc interval. Use Caution/Monitor. QTc prolongation reported with higher than recommended doses of fostemsavir.
- ibutilide
floxuridine and ibutilide both increase QTc interval. Use Caution/Monitor.
- influenza A (H5N1) vaccine
floxuridine decreases effects of influenza A (H5N1) vaccine by Mechanism: pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce immune response to H5N1 vaccine.
- influenza virus vaccine (H5N1), adjuvanted
floxuridine decreases effects of influenza virus vaccine (H5N1), adjuvanted by Mechanism: pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce immune response to H5N1 vaccine.
- ivosidenib
floxuridine and ivosidenib both increase QTc interval. Use Caution/Monitor.
- lenvatinib
floxuridine and lenvatinib both increase QTc interval. Use Caution/Monitor.
- meningococcal group B vaccine
floxuridine decreases effects of meningococcal group B vaccine by pharmacodynamic antagonism. Use Caution/Monitor. Individuals with altered immunocompetence may have reduced immune responses to the vaccine.
- methadone
floxuridine and methadone both increase QTc interval. Use Caution/Monitor.
- mobocertinib
floxuridine and mobocertinib both increase QTc interval. Use Caution/Monitor.
- ofatumumab SC
ofatumumab SC, floxuridine. Either increases effects of the other by immunosuppressive effects; risk of infection. Use Caution/Monitor. Consider the risk of additive immune system effects when coadministering immunosuppressive therapies with coadministration. When switching from therapies with immune effects, take into account the duration and mechanism of action of these therapies when initiating ofatumumab SC.
- olaparib
floxuridine and olaparib both increase pharmacodynamic synergism. Use Caution/Monitor. Coadministration with other other myelosuppressive anticancer agents, including DNA damaging agents, may potentiate and prolongate the myelosuppressive toxicity.
- osilodrostat
osilodrostat and floxuridine both increase QTc interval. Use Caution/Monitor.
- phenytoin
floxuridine increases levels of phenytoin by unknown mechanism. Use Caution/Monitor. Based on case reports.
- procainamide
floxuridine and procainamide both increase QTc interval. Use Caution/Monitor.
- quinidine
floxuridine and quinidine both increase QTc interval. Use Caution/Monitor.
- quinine
floxuridine and quinine both increase QTc interval. Use Caution/Monitor.
- selpercatinib
floxuridine and selpercatinib both increase QTc interval. Use Caution/Monitor.
- siponimod
siponimod and floxuridine both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Caution if coadministered because of additive immunosuppressive effects during such therapy and in the weeks following administration. When switching from drugs with prolonged immune effects, consider the half-life and mode of action of these drugs to avoid unintended additive immunosuppressive effects.
- sipuleucel-T
floxuridine decreases effects of sipuleucel-T by pharmacodynamic antagonism. Modify Therapy/Monitor Closely.
- sotalol
floxuridine and sotalol both increase QTc interval. Use Caution/Monitor.
- ublituximab
ublituximab and floxuridine both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered
- valoctocogene roxaparvovec
floxuridine and valoctocogene roxaparvovec both increase Other (see comment). Use Caution/Monitor. Medications that may cause hepatotoxicity when combined with valoctogene roxaparvovec may potentiate the risk of elevated liver enzymes. Closely monitor these medications and consider alternative medications in case of potential drug interactions.
- vandetanib
floxuridine and vandetanib both increase QTc interval. Use Caution/Monitor.
- ziprasidone
floxuridine and ziprasidone both increase QTc interval. Use Caution/Monitor.
Minor (4)
- maitake
maitake increases effects of floxuridine by pharmacodynamic synergism. Minor/Significance Unknown. Maitake mushroom has anti-tumor effects (animal/in vitro research).
- taurine
floxuridine decreases levels of taurine by unspecified interaction mechanism. Minor/Significance Unknown.
- vitamin A
vitamin A, floxuridine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin A enhance the efficacy, and reduce toxicity, of antineoplastic drugs.
- vitamin E
vitamin E, floxuridine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin E enhance the efficacy, and reduce toxicity, of antineoplastic drugs.
Adverse Effects
Frequency Not Defined
Nausea
Vomiting
Diarrhea
Mucositis
Enteritis
Stomatitis
Myelosuppression
Anemia
Leukopenia
Thrombocytopenia
Alopecia
Erythema
Photosensitivity
Warnings
Black Box Warnings
The drug should be administered under the supervision of an experienced cancer chemotherapy physician because of the possibility of severe toxic reactions
Patient should be hospitalized for initiation of the therapy because of the risk for severe toxic reactions
Contraindications
Hypersensitivity
Poor nutritional status
Myelosuppression (leukocyte count <5000/cu.mm or decreases rapidly, or Plts <100,000/cu.mm)
Cautions
Hepatic/renal impairment
Discontinue if leukocyte count falls to <3500/cu.mm or decr rapidly, or if Plt count falls to <100,000/cu.mm)
Discontinue immediately in MI occurs
Discontinue in case of stomatitis, esophagopharyngitis, leukopenia, thrombocytopenia, intractable vomiting, GI bleeding, hemorrhage, diarrhea
Pts who have received high-dose pelvic irradiation or alkylating agents
Avoid pregnancy
Pregnancy & Lactation
Pregnancy Category: D
Lactation: excretion in milk unknown; contraindicated
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Half-Life: 16 min
Metabolism: liver
Metabolites: urea, fluorouracil, dihydrofluorouracil, expired CO2 metabolite
Excretion: urine
Mechanism of Action
Metabolized to 5-FU; inhibits DNA synthesis during S phase by inhibition of thymidylate synthetase
Administration
IV Incompatibilities
Y-site: allopurinol, cefepime
IV Compatibilities
Additive: carboplatin, cisplatin, etoposide, fluorouracil, leucovorin
Y-site: amifostine, aztreonam, etoposide PO4, filgrastim, fludarabine, gemcitabine, granisetron, melphalan, ondansetron, paclitaxel, piperacillin-tazobactam, sargramostim, teniposide, thiotepa, vinorelbine
IV Preparation
Dilute with 5 mL SWI for a final concentration of 100 mg/mL
IV Administration
Dilute in D5W or NS
Store reconstituted soln at 2-8°C if necessary & use within 2 wk
Use infusion pump, either external or implanted
Storage
Store intact vials at 15-30°C (59-86°F)
Reconstituted vials are stable for up to weeks under refrigeration at 2-8°C (36-46°F)
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| floxuridine injection - | 0.5 gram vial |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
floxuridine injection
FLOXURIDINE - INJECTION
(flox-YOUR-eh-deen)
COMMON BRAND NAME(S): FUDR
USES: Floxuridine is used to treat certain types of stomach/intestinal cancer that have spread to the liver. It is a chemotherapy drug that is used to slow or stop cancer cell growth.
HOW TO USE: This medication is given by injection into an artery using a continuous infusion pump. It is given through a catheter placed inside the artery that supplies blood to the tumor. This method directs the medication to the tumor so that it can have a stronger effect on the tumor with less risk of serious side effects in the rest of the body. When starting the first course of treatment with this medication, you should be in a hospital where you can be monitored for possible serious side effects.This medication will be prepared and mixed for you by a health care professional. The dosage is based on your medical condition, weight, and response to treatment.This medication should be used as long as you continue to benefit from the treatment. When serious side effects appear, your doctor will stop treatment with this medication. After the side effects have lessened, treatment will resume.
SIDE EFFECTS: Nausea, vomiting, mild diarrhea, loss of appetite, tiredness, redness at the injection site, or dry skin may occur. Nausea and vomiting can be severe. In some cases, your doctor may prescribe medication to prevent or relieve nausea and vomiting. Eating several small meals or limiting activity may help lessen some of these effects. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Temporary hair loss may occur. Normal hair growth should return after treatment has ended.People using this medication may have serious side effects. However, you have been prescribed this drug because your doctor has judged that the benefit to you is greater than the risk of side effects. Careful monitoring by your doctor may decrease your risk.This medication can lower the body's ability to fight an infection. Tell your doctor promptly if you develop any signs of an infection such as fever or chills.Tell your doctor right away if you have any serious side effects, including: vomiting/diarrhea that is severe or doesn't stop, mouth sores, sore throat, painful/difficult swallowing, easy or unusual bruising/bleeding, black stools, blood/mucus in the stools, vomit that looks like coffee grounds, cramps/pain in the stomach/abdomen, yellowing eyes/skin, dark urine, weakness, weight loss, skin problems (such as peeling/darkening of the skin), muscle/joint pain.Get medical help right away if you have any very serious side effects, including: chest/jaw/left arm pain, warmth/swelling/pain/leaking at the injection site, pain/swelling/redness/weakness of the arms or legs, calf pain/swelling that is warm to the touch, shortness of breath, coughing up blood, sudden vision changes, weakness on one side of the body, severe clumsiness/trouble walking, trouble speaking, confusion, severe headache.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Before using floxuridine, tell your doctor or pharmacist if you are allergic to it; or to fluorouracil; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: poor nutrition, decreased bone marrow function/blood cell disorders (such as anemia, leukopenia, thrombocytopenia), a serious infection, liver problems, kidney problems, past high-dose radiation treatment of the pelvis.Tell your health care professional that you are using floxuridine before having any immunizations/vaccinations. Avoid contact with people who have recently received live vaccines (such as flu vaccine inhaled through the nose).Floxuridine can make you more likely to get infections or may make current infections worse. Stay away from anyone who has an infection that may easily spread (such as chickenpox, COVID-19, measles, flu). Talk to your doctor if you have been exposed to an infection or for more details.To lower the chance of getting cut, bruised, or injured, use caution with sharp objects like safety razors and nail cutters, and avoid activities such as contact sports.This medication may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Tell your doctor right away if you get sunburned or have skin blisters/redness.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Tell your doctor if you are pregnant or plan to become pregnant. You should not become pregnant while using floxuridine. Floxuridine may harm an unborn baby. Ask about reliable forms of birth control while using this medication. If you become pregnant, talk to your doctor right away about the risks and benefits of this medication.It is unknown if this drug passes into breast milk. Because of the possible risk to the infant, breastfeeding is not recommended while using this drug. Consult your doctor before breastfeeding.
DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: drugs that may decrease bone marrow function (such as azathioprine, trimethoprim/sulfamethoxazole), past or present use of alkylating-type cancer drugs (such as cyclophosphamide, melphalan).Floxuridine is very similar to fluorouracil. Do not use medications containing fluorouracil while using floxuridine.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.
NOTES: Lab and/or medical tests (such as complete blood counts) should be done while you are using this medication. Keep all medical and lab appointments. Consult your doctor for more details.
MISSED DOSE: The drug is given continuously as an infusion. If your infusion is interrupted, contact your doctor or pharmacist right away.
STORAGE: Consult the product instructions and your pharmacist for storage details. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
MEDICAL ALERT: Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507 (Canada).
Information last revised October 2023. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
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