Citation

Launay M, Pourroy B, Ciccolini J. Pharmacien Hospitalier et Clinicien 2018; 53(4): 354-358.

Copyright

(Copyright © 2018)

DOI

10.1016/j.phclin.2018.04.004

PMID

unavailable

Abstract

For the last 60 years, 5-Fluoro-Uracil (5-FU) ranks among the most widely prescribed anticancer agents worldwide. Standard dosing with 5-FU usually claims 15-40% of severe toxicities, mostly digestive or hematologic disorders. A total of 0.5-3% of toxic deaths are regularly reported. DPD deficiency is often at the origin of the most severe side-effects. Capecitabine is an oral prodrug with the same safety profile. It was involved in suicide attempt or accidental administration to children. Uridine triacetate (Vistogard®) is indicated for the emergency treatment of adult and pediatric patients following an overdose of 5-FU or capecitabine regardless of the presence of symptoms, or who exhibit early onset, severe or life-threatening toxicity and/or early onset, unusually severe adverse reactions. Treatment must be given within 96 hours following the end of 5-FU or capecitabine administration. Survival of patients with 5-FU overdose is improved from 16 to 96%. In France, Vistogard® can be obtained using Temporary Use Authorisation and 12 patients have been administered with uridine triacetate between 2013 and 2015. Hospital pharmacist plays a key role in rescuing patients with 5-FU overdose because the antidote should be administered in the 96 hours following the end of the administration and the treatment shipping and delivery in France takes an average 36 hours. © 2018 Elsevier Masson SAS

Language: en

Keywords

adult; human; child; Review; Antidote; suicide attempt; disease severity; drug overdose; prescription; drug safety; emergency treatment; cancer survival; fluorouracil; capecitabine; 5-Fluorouracil; dihydropyrimidine dehydrogenase deficiency; DPD deficiency; Fluoropyrimidine; hospital pharmacist; pediatric patient; uridine triacetate; Uridine triacetate; Vistogard