R-FU 25 mg/ml (IV Injection or Infusion)

Indications

• Carcinoma of the colon or rectum
• Carcinoma of the stomach and exocrine pancreas
• Carcinoma of the liver
• Carcinoma of the breast
• Carcinoma of the bladder
• Carcinoma of the lung
• Epithelial ovarian carcinoma
• Cervical carcinoma

Pharmacology

• Metabolic conversion to active form
• Inhibition of thymidylate kinase
• Formation of stable complex with folate cofactor
• Incorporation into RNA
• Limited effect on proliferative cells
• Cell cycle effects

Dosage & Administration

• Intravenous delivery
• Rapid bolus injection
• Slow infusion
• Palliative management dosing
• Dosage for poor risk patients
• Maintenance therapy scheduling
• Pediatric dosing
• Intra-arterial infusion
• Combination with radiation
• Combination with other anticancer drugs

Interaction

• Pre-treatment with cimetidine

Contraindications

• Severe debilitation
• Bone marrow suppression
• Pregnancy
• Breastfeeding
• Non-malignant illnesses

Side Effects

• Cardiac effects
• Hematological effects
• Neurological effects
• Allergic reaction
• Hand-foot syndrome
• Vomiting and diarrhea
• Mild to moderate nausea
• Rash and itching
• Temporary hair loss
• Conjunctivitis
• Hematological toxicity

Pregnancy & Lactation

• Teratogenic risk
• Contraindicated throughout pregnancy
• Inhibition of DNA, RNA, and protein synthesis
• Excretion in human milk
• Nursing prohibition

Precautions & Warnings

• Highly toxic with narrow safety margin
• Therapeutic response linkage to toxicity
• Dose limitations
• Prompt discontinuation upon toxicity signs
• Careful supervision
• Leucopenia
• Thrombocytopenia
• Stomatitis
• Severe diarrhea
• Gastro-intestinal ulceration and bleeding

Use in Special Populations

• Neonates
• Children
• The elderly

Overdose Effects

• Deliberate overdose cases
• Excessive toxicity
• No specific antidote
• Supportive care treatment

Reconstitution

• Specialized handling
• Room reservation for reconstitution
• Required equipment
• Skin contact precautions
• Mucous membranes contact precautions
• Pregnant women warning
• Contaminated waste disposal

Storage Conditions

• Storage temperature
• Original carton storage
• Protection from light

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