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Cancer Treatment Centers of America

Fluorouracil (Efudex®, Adrucil®)


Brand Name (injection): Adrucil®

Brand Name (topical): Efudex®

Fluorouracil is used to treat a type of skin cancer known as superficial basal cell carcinoma. It is also used in the treatment of breast cancer, colorectal cancer, gastric adenocarcinoma, pancreatic cancer, and squamous cell carcinoma of the head and neck. Less commonly, fluorouracil, also known as 5-FU, may be used to treat ovarian, cervical and bladder cancers.

Fluorouracil belongs to a class of drugs known as antimetabolites, and resembles a normal cell nutrient that cancer cells need to grow. Because of this resemblance, cancer cells “ingest” fluorouracil, which then interferes with their growth.

For the treatment of basal cell carcinoma, and also benign skin lesions called actinic keratosis, this medication comes as a solution and a cream that is applied directly to the skin. Usually, the cream is applied to the affected areas twice daily. It’s best to try to apply the cream at the same times each day. Treatment often takes 3 to 6 weeks, but can take as long as 10 to 12 weeks.

Redness or irritation around a skin lesion is a sign that the drug is working. Do not cover the area with a bandage or other dressing. Follow the directions provided with your prescription, making sure to not apply the cream more or less often than recommended by your doctor. Fluorouracil should be applied with a nonmetal applicator or your finger. Wear gloves when applying, if you can. If not, be sure to wash your hands well immediately afterwards.

For non-skin cancers, fluorouracil is given as an injection, usually as part of multi-drug combination therapy. The exact dose and duration of the treatment depends on what other drugs are being given, the type of cancer being treated, and other factors. Your doctor will recommend the dose and schedule that is best for you.

Fluorouracil side effects

To prevent problematic interactions between fluorouracil and other drugs, be sure to tell your doctor if you are allergic to any medications, and what other medications and supplements you are currently taking. You should also inform your doctor if you have or ever had a liver tumor, liver disease, or kidney disease, if you are pregnant or planning to become pregnant, or if you are breastfeeding. Fluorouracil may make your skin sensitive to sunlight, so reducing sun exposure is recommended.

Possible side effects from fluorouracil cream may include:

  • Burning, crusting, redness, discoloration, irritation, pain, itching, rash, or soreness at the site of the application

Possible side effects from fluorouracil injection may include:

  • Diarrhea
  • Nausea and vomiting
  • Mouth sores
  • Poor appetite
  • Water eyes, sensitivity to light
  • Taste changes, metallic taste in mouth during infusion
  • Discoloration along vein through which drug is given
  • Low blood counts (decreased amounts of red and white blood cells and platelets)

Some of fluorouracil’s side effects can be serious. Call your doctor immediately if you experience any of these symptoms:

  • Severe stomach pain
  • Bloody diarrhea
  • Vomiting
  • Fever
  • Chills
  • Severe red skin rash
  • Chest pain
  • Rapid heartbeat

Please note that this is not a comprehensive list. Patients may experience additional effects not mentioned above.

At Cancer Treatment Centers of America (CTCA), your team of cancer experts will explain each of the side effects of fluorouracil with you in detail, as well as the side effects and expectations of all other medications planned as part of your individualized treatment plan.

Fluorouracil for cancer treatment

Fluorouracil is approved by the FDA for the treatment of the following:

  • Actinic keratosis*
  • Basal cell carcinoma that is superficial and cannot be removed by surgery*
  • Breast cancer
  • Colorectal cancer that is advanced or has recurred, or has not improved after treatment with other chemotherapy
  • Gastric adenocarcinoma (includes anal, esophageal, pancreatic and stomach cancers)
  • Pancreatic cancer
  • Squamous cell carcinoma of the head and neck that is locally advanced and cannot be removed by surgery
  • Stomach cancer

Fluorouracil, also known as 5-FU, may be used alone or in combination with other drugs.

* Fluorouracil is given as a topical cream for these conditions. For other cancers, fluorouracil is given as an intravenous injection.

At CTCA, our integrative approach to cancer treatment works to fight your disease on all fronts and ensures that you remain at the center of everything we do. We encourage participation from both you and your family to make certain you are comfortable with all decisions made regarding your treatment.

The information provided here is for educational purposes only. In no way should it be considered as offering medical advice. Cancer Treatment Centers of America assumes no responsibility for how this material is used. Please check with a physician if you suspect you are ill. Also note that while Cancer Treatment Centers of America frequently updates its contents, medical information changes rapidly. Therefore, some information may be out of date.