Efudex

What is Efudex (fluorouracil topical)?

Fluorouracil interferes with the growth of skin cells. Fluorouracil works by causing the death of cells which are growing fastest, such as abnormal skin cells.

Fluorouracil topical (for the skin) is used to treat scaly overgrowths of skin (actinic or solar keratoses). Fluorouracil topical may also be used in the treatment of superficial basal cell carcinoma.

Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first.

Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use.

Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

—–How to Work Efudex :—–

Cancerous tumors are characterized by cell division, which is no longer controlled as it is in normal tissue.   “Normal” cells stop dividing when they come into contact with like cells, a mechanism known as contact inhibition.  Cancerous cells lose this ability.  Cancer cells no longer have the normal checks and balances in place that control and limit cell division.  The process of cell division, whether normal or cancerous cells, is through the cell cycle.  The cell cycle goes from the resting phase, through active growing phases, and then to mitosis (division).

The ability of chemotherapy to kill cancer cells depends on its ability to halt cell division.  Usually, the drugs work by damaging the RNA or DNA that tells the cell how to copy itself in division.  If the cells are unable to divide, they die.  The faster the cells are dividing, the more likely it is that chemotherapy will kill the cells, causing the tumor to shrink.  They also induce cell suicide (self-death or apoptosis).

Chemotherapy drugs that affect cells only when they are dividing are called cell-cycle specific.  Chemotherapy drugs that affect cells when they are at rest are called cell-cycle non-specific.  The scheduling of chemotherapy is set based on the type of cells, rate at which they divide, and the time at which a given drug is likely to be effective.  This is why chemotherapy is typically given in cycles.

Unfortunately, chemotherapy does not know the difference between the cancerous cells and the normal cells.  Chemotherapy will kill all cells that are rapidly dividing.  The “normal” cells will grow back and be healthy but in the meantime, side effects occur.  The “normal” cells most commonly affected by chemotherapy are the blood cells, the cells in the mouth, stomach and bowel, and the hair follicles; resulting in low blood counts, mouth sores, nausea, diarrhea, and/or hair loss.  Different drugs may affect different parts of the body.

Efudex belongs to the category of chemotherapy called antimetabolites.  Antimetabolites are very similar to normal substances within the cell.  When the cells incorporate these substances into the cellular metabolism, they are unable to divide.  Antimetabolites are cell-cycle specific.  They attack cells at very specific phases in the cycle.  Antimetabolites are classified according to the substances with which they interfere.

Folic acid antagonist: Methotrexate

Pyrimidine antagonist: 5-Fluorouracil, Foxuridine, Cytarabine, Capecitabine, and Gemcitabine

Purine antagonist: 6-Mercaptopurine and 6-Thioguanine

Adenosine deaminase inhibitor: Cladribine, Fludarabine and Pentostatin

Note:  We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.

Use

  • you are allergic to any ingredient in Efudex Cream
  • you are pregnant or may become pregnant
  • you have the metabolic disorder dihydropyrimidine dehydrogenase (DPD) enzyme deficiency
  • Contact your doctor or health care provider right away if any of these apply to you.
  • Use Efudex Cream as directed by your doctor. Check the label on the medicine for exact dosing instructions.
  • Use a nonmetallic applicator or wear rubber gloves while applying Efudex Cream.
  • Gently wash the area where you will apply Efudex Cream. Rinse well, pat dry with a towel, and wait 10 minutes before applying Efudex Cream.
  • Wash your hands immediately after applying Efudex Cream, unless they are part of the treated area.
  • Do not bandage or cover the treated area, unless directed to do so by your doctor.

Efudex Cream is for external use only. Do not get it in your eyes, nose, mouth, or genital area. If you get it in your eyes, rinse with a generous amount of cool water right away and contact your doctor.

If you miss a dose of Efudex Cream, use it as soon as possible. If it is almost time for your next dose, skip the missed dose. Go back to your regular dosing schedule. Do not use 2 doses at once.

Ask your health care provider any questions you may have about how to use Efudex Cream.

Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Do not take by mouth. Topical medicine is for use only on the skin.

 

Clean the area where you will apply fluorouracil topical. Rinse well and dry the area with a towel and wait ten minutes before applying the medication.

Wash your hands before and immediately after applying this medicine, unless it is being used to treat a hand condition.

Apply fluorouracil topical to the affected area with the finger tips or a non-metal applicator, smoothing it gently onto the affected skin. Use enough to cover the entire area with a thin film.

Caregivers who apply this medicine should wear rubber gloves.

Do not use fluorouracil topical on skin that is irritated, peeling, or infected or on open wounds. Wait until these conditions have fully healed before using fluorouracil topical.

Do not cover the treated skin area unless your doctor tells you to.

A moisturizer or sun screen may be applied 2 hours after fluorouracil topical has been applied.

Store at room temperature away from moisture and heat. Do not freeze. Keep the medicine container tightly closed when not in use.

—–Side Effects—–

Skin irritation, burning, redness, dryness, pain, swelling, tenderness, or changes in skin color may occur at the site of application. Eye irritation (e.g., stinging, watering), trouble sleeping, irritability, temporary hair loss, or abnormal taste in the mouth may also occur.

If any of these effects persist or worsen, contact your doctor or pharmacist promptly.

 

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if any of these rare but very serious side effects occur: stomach/abdominal pain, bloody diarrhea, vomiting, signs of infection (e.g., fever, chills, persistent sore throat), easy bruising/bleeding, mouth sores.

—-Major Side Effects—-

You should check with your doctor immediately if any of these side effects occur when taking fluorouracil topical:

  • Redness and swelling of normal skin
  • Minor Side Effects

Some of the side effects that can occur with fluorouracil topical may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

More common:

Burning feeling where medicine is applied

  • increased sensitivity of skin to sunlight
  • itching
  • oozing
  • skin rash
  • soreness or tenderness of skin
  • Less common or rare:
  • Darkening of skin
  • scaling

 

Important things to remember about Efudex side effects:

  • Most people do not experience all of the Efudex side effects listed.
  • Efudex side effects are often predictable in terms of their onset and duration.
  • Efudex side effects are almost always reversible and will go away after treatment is complete.
  • There are many options to help minimize or prevent Efudex side effects.
  • There is no relationship between the presence or severity of Efudex side effects and the effectiveness of the medication.
  • The following Efudex side effects are common (occurring in greater than 30%) for patients taking Efudex:

 

Pain, itching, burning, irritation, inflammation, dryness, swelling, tenderness at the site of application.  This will heal once the treatment is complete.

These Efudex side effects are less common side effects (occurring in about 10-29%) of patients receiving Efudex:

Discoloration of the skin or scarring

Increased sensitivity to sunlight

Not all side effects are listed above. Some that are rare (occurring in less than 10% of patients) are not listed here.  However, you should always inform your health care provider if you experience any unusual symptoms.

—-Efudex Precautions—–

Before starting Efudex treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc).

Do not take aspirin, products containing aspirin unless your doctor specifically permits this.

Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment.  Pregnancy category X Efudex may cause fetal harm when given to a pregnant woman.  Efudex must not be given to a pregnant woman or a woman who intends to become pregnant.  If a woman becomes pregnant while taking Efudex, the medication must be stopped immediately and the woman given appropriate counseling).

For both men and women: Do not conceive a child (get pregnant) while taking Efudex. Barrier methods of contraception, such as condoms, are recommended. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.

Do not breast feed while taking Efudex.

Before using fluorouracil, tell your doctor or pharmacist if you are allergic to it; or to flucytosine; or to capecitabine; or if you have any other allergies. This product may contain inactive ingredients (such as peanut oil found in some brands), which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: a certain enzyme deficiency (dihydropyrimidine dehydrogenase – DPD).

Before using this medication, tell your doctor or pharmacist your medical history, especially of: red/irritated/infected/open sores on skin.

This medication may make you more sensitive to the sun. Avoid prolonged sun exposure, tanning booths, and sunlamps. Use a sunscreen and wear protective.

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