Generic name: 5-fluorouracil , 5-FU

Brand name: Efudex

Action Classification: antineoplastic or cytotoxic
Mechanism of Action: Inhibits DNA and RNA synthesis by preventing thymidine production
(cell-cycle Sphase– specific). Therapeutic Effects: Death of rapidly replicating
cells, particularly malignant ones.
Dose and Route:Topical (Efudex): ADULTS, ELDERLY: Apply twice a day for 2–4 wks.
Basal Cell Carcinoma Topical (Efudex 5%): ADULTS, ELDERLY: Apply twice a day
for 3–6 wks up to 10–12 wks.

Indication: Efudex is recommended for the topical treatment of multiple actinic or solar

keratoses. In the 5% strength it is also useful in the treatment of superficial basal cell
carcinomas when conventional methods are impractical, such as with multiple lesions
or difficult treatment sites.

Contraindication/s: Myelosuppression, poor nutritional status, potentially seri- ous

infections. Cautions: History of high-dose pelvic irradiation, hepatic/re- nal
impairment, palmar- plantar erythro- dysesthia syndrome (hand and foot
syndrome), previous use of alkylating agents.
Side effects: Occasional: Erythema, skin ulceration, pruritus, hyperpigmenta- tion,
dermatitis, insomnia, stomatitis, irritability, photosensitivity, excessive lac- rimation,
blurred vision.

Adverse effects: Earliest sign of toxicity (4–8 days after beginning therapy) is stomatitis (dry
mouth, burning sensation, mucosal erythema, ulceration at inner margin of lips). Most
common dermatologic toxicity is pruritic rash (generally on extremities, less
frequently on trunk). Leukopenia (WBC less than 3500/mm3) generally oc- curs
within 9–14 days after drug adminis- tration but may occur as late as 25th day.
Thrombocytopenia (platelets less than 100,000/mm3) occasionally occurs within 7–
17 days after administration. Pancyto- penia, agranulocytosis occur rarely.

Drug Interactions: DRUG: Bone marrow depressants may increase risk of

myelosuppression. Live virus vaccines may potentiate virus replication, increase vaccine
 beside effects, and decrease patients’ antibody response to vaccine. Topical: may cause
eosinophilia, leukocytosis, thrombocytopenia, and toxic granulation.

Nursing responsibilities:
1. Assess the history of hypersensitivity reaction
2. Advise patient to rinse mouth with clear water after eating and drinking and to avoid
flossing
3.Caution patient to use sunscreen and protective clothing
4. Re- port signs/symptoms of infection, un- usual bruising/bleeding, visual changes,
nausea, vomiting, diarrhea, chest pain, palpitations.

5. Avoid sunlight, artificial light sources; wear protective clothing, sunglasses,

sunscreen.

6. Apply only to affected area.

7. Do not use occlusive coverings.

8.Be careful near eyes, nose, mouth.

9. Wash hands thoroughly after application.

10.Treated areas may be unsightly for several weeks after therapy.