Stable. Light sensitive. Combustible. Incompatible with strong oxidizing agents, strong bases.- 2.11 StorageTemp
- 2-8°C
3. Use and Manufacturing
- 3.1 General Description
- White to nearly white crystalline powder; practically odorless. Used as an anti neoplastic drug, chemosterilant for insects.
- 3.2 Potential Exposure
- This material is used as an antineo plastic drug for cancer treatment and as a chemosterilantfor insects.
- 3.3 Shipping
- UN2811 Toxic solids, organic, n.o.s., HazardClass: 6.1; Labels: 6.1-Poisonous materials, Technical NameRequired.
- 3.4 Usage
- 1. It is used for biochemical studies and antitumor drugs. 2. It is the anti tumor drug, also used for synthesis of flucytosine. 5-fluorouracil can be used in the study of rice in the biochemical studies, ear differentiation, genetic metabolic measurement, plant growth development research.3. It is used for the digestive system cancer, head and neck cancer, gynecological cancer, lung cancer, liver cancer, treatment of bladder cancer and skin cancer.4. Antimetabolite antitumor drugs.5. Anti tumor drugs. There is a certain effect on a variety of tumors such as digestive tract cancer, breast cancer, ovarian cancer, chorionic epithelial cancer, cervical cancer, hepatocellular carcinoma, bladder cancer, skin cancer (topical), leukoplakia (topical) etc. Adverse reactions mainly are bone marrow transplantation, digestive tract reaction, serious person can have diarrhea, local injection site phlebitis, a few of which have nervous system reactions such as cerebellar degeneration and ataxia. The course of medication should strictly check the blood.
4. Safety and Handling
- 4.1 Symbol
- GHS06
- 4.1 Hazard Codes
- Xn
- 4.1 Signal Word
- Danger
- 4.1 Risk Statements
- R20/21/22
- 4.1 Safety Statements
- S36-S36/37
- 4.1 Exposure Standards and Regulations
- The Approved Drug Products with Therapeutic Equivalence Evaluations List identifies currently marketed prescription drug products, incl fluorouracil, approved on the basis of safety and effectiveness by FDA under sections 505 of the Federal Food, Drug, and Cosmetic Act.
- 4.2 Packing Group
- III
- 4.2 Octanol/Water Partition Coefficient
- log Kow = -0.89
- 4.3 Fire Hazard
- Emits very toxic fumes of flourides and nitrogen oxides when heated to decomposition. Avoid decomposing heat.
- 4.4 Other Preventative Measures
- /PRECAUTIONS FOR ANTINEOPLASTIC AGENTS:/ Accidental contamination of the health-care environment, resulting in exposure of personnel, patients, visitors, and family members to hazardous substances, is prevented by maintaining the physical integrity and security of packages of hazardous drugs. 1. Access to all areas where hazardous drugs are stored is limited to specified authorized staff. 2. A method should be present for identifying to personnel those drugs that require special precautions (eg, cytotoxics). One way to accomplish this is to apply appropriate warning labels to all hazardous drug containers, shelves, and bins where the drug products are stored. ... 3. A method of identifying, for patients and family members, those drugs that require special precautions in the home should be in place. This may be accomplished in the health-care setting, by providing specific labeling for discharge medications, along with written instructions. 4. Methods for identifying shipping cartons of hazardous drugs should be required from manufacturers and distributors of these drugs. 5. Written procedures for handling damaged packages of hazardous drugs should be maintained. Personnel involved in shipping and receiving hazardous drugs should be trained in these procedures, including the proper use of protective garments and equipment. Damaged shipping cartons of hazardous drugs should be received and opened in an isolated area (eg, in a laboratory fume hood, if available, not in a vertical laminar airflow biological safety cabinet used for preparing sterile products). /Antineoplastic agents/
/PRECAUTIONS FOR ANTINEOPLASTIC AGENTS:/ Facilities (eg, shelves, carts, counters, and trays) for storing hazardous drugs are designed to prevent breakage and to limit contamination in the event of leakage. Bins, shelves with barriers at the front, or other design features that reduce the chance of drug containers falling to the floor should be used. Hazardous drugs requiring refrigeration should be stored separately from nonhazardous drugs in individual bins designed to prevent breakage and to contain leakage. /Antineoplastic agents/
/PRECAUTIONS FOR ANTINEOPLASTIC AGENTS:/ Until the reproductive risks (or lack thereof) associated with handling hazardous drugs within a safety program have been substantiated, staff who are pregnant or breast-feeding should be allowed to avoid contact with these drugs. Policies should be in effect that provide these individuals with alternative tasks or responsibilities if they so desire. /Antineoplastic agents/
/PRECAUTIONS FOR ANTINEOPLASTIC AGENTS:/ The pharmacy should provide access to information on toxicity, treatment of acute exposure (if available), chemical inactivators, solubility and stability of hazardous drugs (including investigational agents) used in the workplace. /Antineoplastic agents/
/PRECAUTIONS FOR ANTINEOPLASTIC AGENTS:/ Appropriate engineering controls should be in place to protect the drug product from microbial contamination and to protect personnel and the environment from the potential hazards of the product. These engineering controls should be maintained according to applicable regulations and standards. /Antineoplastic agents/
/PRECAUTIONS FOR ANTINEOPLASTIC AGENTS:/ Biological safety cabinets should be cleaned and disinfected regularly to ensure a proper environment for preparation of sterile products. For routine cleanups of surfaces between decontaminations, water should be used (for injection or irrigation) with or without a small amount of cleaner. If the contamination is soluble only in alcohol, then 70% isopropyl or ethyl alcohol may be used in addition to the cleaner. In general, alcohol is not a good cleaner, only a disinfectant, and its use in a biohazard cabinet should be limited. The biohazard cabinet should be disinfected with 70% alcohol before any aseptic manipulation is begun. The excessive use of alcohol should be avoided in biohazard cabinets where air is recirculated ... because alcohol vapors may build up in the cabinet. A lint-free, plastic-backed disposable liner may be used in the biological safety cabinet to facilitate spill cleanup. ... If used, the liner should be changed frequently ... /or/ whenever it is overtly contaminated. /Antineoplastic agents/
/PRECAUTIONS FOR ANTINEOPLASTIC AGENTS:/ The biological safety cabinets should be decontaminated on a regular basis (ideally at least weekly) and whenever there is a spill or the biological safety cabinet is moved or serviced, including for certification. ... Currently, no single reagent will deactivate all known hazardous drugs; therefore, decontamination of a biological safety cabinet used for such drugs is limited to removal of contamination from a nondisposable surface (the cabinet) to a disposable surface (eg, gauze or towels) by use of a good cleaning agent that removes chemicals from stainless steel. The cleaning agent selected should have a pH approximating that of soap and be appropriate for stainless steel. Cleaners containing chemicals such as quaternary ammonium compounds should be used with caution, because they may be hazardous to humans and their vapors may build up in any biological safety cabinet where air is recirculated. Similar caution should be used with any pressurized aerosol cleaner; spraying a pressurized aerosol into a biological safety cabinet may disrupt the protective containment airflow, damage the high efficiency particulate air filter, and cause an accumulation of the propellant within a biological safety cabinet where air is recirculated, resulting in a fire and explosion hazard. During decontamination, the operator should wear a disposable closed front gown, disposable latex gloves covered by disposable utility gloves, safety glasses or goggles, a hair covering, and a disposable respirator, because the glass shield of the biological safety cabinet occasionally must be lifted. The blower must be left on, and only heavy toweling or gauze should be used in the biological safety cabinet to prevent it from being "sucked" up the plenum and into the high efficiency particulate air filter. Decontamination should be done from top to bottom (areas of lesser contamination to greater) by applying the cleaner, scrubbing, and rinsing thoroughly with distilled or deionized water. /Antineoplastic agents/
/PRECAUTIONS FOR ANTINEOPLASTIC AGENTS:/ The high efficiency particulate air filters /or other exhaust scrubbing system/ of the biohazard cabinet must be replaced whenever they restrict required airflow velocity or if they are overtly contaminated (eg, by a breach in technique that causes hazardous drug to be introduced onto the clean side of the supply high efficiency particulate air filter). Personnel and environmental protection must be maintained during replacement of a contaminated high efficiency particulate air filter. Because replacement of a high efficiency particulate air filter generally requires breaking the integrity of the containment aspect of the cabinet, this procedure may release contamination from the filter into the pharmacy or intravenous preparation area if carried out in an inappropriate manner. Before replacement of a high efficiency particulate air filter contaminated with hazardous drugs, the biological safety cabinet service agent should be consulted for a mutually acceptable procedure for replacing and subsequently disposing of a contaminated high efficiency particulate air filter. One procedure would include moving the biological safety cabinet to a secluded area or using plastic barriers to segregate the contaminated area. Protective clothing and equipment must be used by the servicer. The biological safety cabinet should be decontaminated before filter replacement. /Antineoplastic agents/
/PRECAUTIONS FOR ANTINEOPLASTIC AGENTS:/ During removal of gloves, ... avoid touching the inside of the glove or the skin with the contaminated glove fingers. ... The worker should wear a protective disposable gown made of lint free, low-permeability fabric with a solid front, long sleeves, and tight-fitting elastic or knit cuffs when preparing hazardous drugs. Washable garments are immediately penetrated by liquids and therefore provide little, if any protection. /Antineoplastic agents/
/PRECAUTIONS FOR ANTINEOPLASTIC AGENTS:/ When double gloving, one glove should be placed under the gown cuff and one over. The glove-gown interface should be such that no skin on the arm or wrist is exposed. Gloves and gowns should not be worn outside the immediate preparation area. /Antineoplastic agents/
/PRECAUTIONS FOR ANTINEOPLASTIC AGENTS:/ Eyewash fountains should be available in areas where hazardous drugs are routinely handled. /Antineoplastic agents/
/PRECAUTIONS FOR ANTINEOPLASTIC AGENTS:/ Although noninjectable dosage forms of hazardous drugs contain varying proportions of drug to nondrug (nonhazardous) components, there is potential for personnel exposure and environmental contamination with the hazardous components. Procedures should be developed to avoid the release of aerosolized powder or liquid into the environment during manipulation of these drugs. Drugs designated as hazardous should be labeled or otherwise identified as such to prevent their improper handling. Tablet and capsule forms of these drugs should not be placed in automated counting machines, which subject them to stress and may introduce powdered contaminants into the work area. During routine handling of hazardous drugs and contaminated equipment, workers should wear one pair of gloves of good quality and thickness. The counting and pouring of hazardous drugs should be done carefully, and clean equipment dedicated for use with these drugs should be used. ... When hazardous drug tablets in unit-of-use packaging are being crushed, the package should be placed in a small sealable plastic bag and crushed with a spoon or pestle; caution should be used not to break the plastic bag. Disposal of unused or unusable oral or topical dosage forms of hazardous drugs should be performed in the same manner as for hazardous injectable dosage forms and waste. ... Hazardous drug work areas should have a sink (preferably with an eyewash fountain) and appropriate first aid equipment to treat accidental skin or eye contact according to the protocol. /Antineoplastic agents/
/PRECAUTIONS FOR ANTINEOPLASTIC AGENTS:/ A distinctive warning label with an appropriate CAUTION statement should be attached to all hazardous drug materials, consistent with state laws and regulations. This would include, for example, syringes, IV containers, containers of unit-dose tablets and liquids, prescription vials and bottles, waste containers, and patient specimens that contain hazardous drugs. /Antineoplastic agents/
/PRECAUTIONS FOR ANTINEOPLASTIC AGENTS:/ Supplies of disposable gloves and gowns, safety glasses, disposable plastic-backed absorbent liners, gauze pads, hazardous waste disposal bags, hazardous drug warning labels, and puncture-resistant containers for disposal of needles and ampuls should be conveniently located for all areas where hazardous drugs are handled. Assembling a "hazardous drug preparation and administration kit" is one way to furnish nursing and medical personnel with the materials needed to reduce the risk of preparing and administering a hazardous drug. /Antineoplastic agents/
/PRECAUTIONS FOR ANTINEOPLASTIC AGENTS:/ Prospective temporary and permanent employees who may be required to work with hazardous drugs should be so notified and should receive adequate information about the policies and procedures pertaining to their use. This notification should be documented during the interview process and retained as part of the employment record for all employees. /Antineoplastic agents/
/PRECAUTIONS FOR ANTINEOPLASTIC AGENTS:/ All personnel involved with the transportation, preparation, administration, and disposal of cytotoxic and hazardous substances should continually be updated on new or revised information on safe handling of cytotoxic and hazardous substances. Policies and procedures should be updated accordingly. /Antineoplastic agents/
/PRECAUTIONS FOR ANTINEOPLASTIC AGENTS:/ The work area should be designed to provide easy access to those items necessary to prepare, label, and transport final products; contain all related waste; and avoid inadvertent contamination of the work area. /Antineoplastic agents/
/PRECAUTIONS FOR ANTINEOPLASTIC AGENTS:/ Each health-care setting should have an established first aid protocol for treating cases of direct contact with hazardous drugs, many of which are irritating or caustic and can cause tissue destruction. Medical care providers in each setting should be contacted for input into this protocol. The protocol should include immediate treatment measures and should specify the type and location of medical follow-up and work-injury reporting. Copies of the protocol, highlighting emergency measures, should be posted wherever hazardous drugs are routinely handled. /Antineoplastic agents/
/PRECAUTIONS FOR ANTINEOPLASTIC AGENTS:/ Only individuals trained to administer hazardous drugs should be allowed to perform this function. Training programs should contain information on the therapeutic and adverse effects of these drugs and the potential, long term health risk to personnel handling these drugs. Each individual's knowledge and technique should be evaluated before administration of these drugs. This should be done by written examination and direct observation of the individual's performance. /Antineoplastic agents/
- 4.5 Hazard Class
- 6.1
- 4.5 Hazard Declaration
- H301-H412
- 4.5 Cleanup Methods
- /PRECAUTIONS FOR ANTINEOPLASTIC AGENTS:/ Spill kits containing all materials needed to clean up spills of hazardous drugs should be assembled or purchased. These kits should be readily available in all areas where hazardous drugs are routinely handled. If hazardous drugs are being prepared or administered in a nonroutine area (home setting or unusual patient-care area), a spill kit should be obtained by the drug handler. The kit should include two pairs of disposable gloves (one outer pair of utility gloves and one inner latex pair); low-permeability, disposable protective garments (coveralls or gown and shoe covers); safety glasses or splash goggles; respirator; absorbent, plastic-backed sheets or spill pads; disposable toweling; at least 2 sealable thick plastic hazardous waste disposal bags (prelabeled with an appropriate warning label); a disposable scoop for collecting glass fragments; and a puncture-resistant container for glass fragments. All individuals who routinely handle hazardous drugs must be trained in proper spill management and cleanup procedures. Spills and breakages must be cleaned up immediately according to the following procedures. If the spill is not located in a confined space, the spill area should be identified and other people should be prevented from approaching and spreading the contamination. Wearing protective apparel from the spill kit, workers should remove any broken glass fragments and place them in the puncture-resistant container. Liquids should be absorbed with a spill pad; powder should be removed with damp disposable gauze pads or soft toweling. The hazardous material should be completely removed and the area rinsed with water and then cleaned with detergent. The spill cleanup should proceed progressively from areas of lesser to greater contamination. The detergent should be thoroughly rinsed and removed. All contaminated materials should be placed in the disposal bags provided and sealed and transported to a designated containment receptacle. Spills occurring in the biohazard cabinet should be cleaned up immediately; a spill kit should be used if the volume exceeds 150 ml or the contents of one drug vial or ampule. If there is broken glass, utility gloves should be worn to remove it and place it in the puncture-resistant container located in the biohazard cabinet. The biological safety cabinet, including the drain spillage trough, should be thoroughly cleaned. If the spill is not easily and thoroughly contained, the biological safety cabinet should be decontaminated after cleanup. If the spill contaminates the high efficiency particulate air filter, use of the biological safety cabinet should be suspended until the cabinet has been decontaminated and the high efficiency particulate air filter replaced. /Antineoplastic agents/
/PRECAUTIONS FOR ANTINEOPLASTIC AGENTS:/ If hazardous drugs are routinely prepared or administered in carpeted areas, special equipment is necessary to remove the spill. Absorbent powder should be substituted for pads or sheets and left in place on the spill for the time recommended by the manufacturer. The powder should then be picked up with a small vacuum unit reserved for hazardous drug cleanup. The carpet should then be cleaned according to usual procedures. The vacuum bag should be removed and discarded or cleaned, and the exterior of the vacuum cleaner should be washed with detergent and rinsed before being covered and stored. The contaminated powder should be discarded into a sealable plastic bag and segregated with other contaminated waste materials. Alternatively, inexpensive wet or dry vacuum units may be purchased for this express use and used with appropriate cleaners. All such units are contaminated, once used, and must be cleaned, stored, and ultimately discarded /properly/ ... The circumstances and handling of spills should be documented. Health-care personnel exposed during spill management should also complete an incident report or exposure form. /Antineoplastic agents/
/PRECAUTIONS FOR ANTINEOPLASTIC AGENTS:/ Spill kits containing all materials needed to clean up spills of hazardous drugs should be assembled or purchased. These kits should be readily available in all areas where hazardous drugs are routinely handled. If hazardous drugs are being prepared or administered in a nonroutine area (home setting or unusual patient-care area), a spill kit should be obtained by the drug handler. The kit should include two pairs of disposable gloves (one outer pair of utility gloves and one inner latex pair); low-permeability, disposable protective garments (coveralls or gown and shoe covers); safety glasses or splash goggles; respirator; absorbent, plastic-backed sheets or spill pads; disposable toweling; at least 2 sealable thick plastic hazardous waste disposal bags (prelabeled with an appropriate warning label); a disposable scoop for collecting glass fragments; and a puncture-resistant container for glass fragments. All individuals who routinely handle hazardous drugs must be trained in proper spill management and cleanup procedures. Spills and breakages must be cleaned up immediately according to the following procedures. If the spill is not located in a confined space, the spill area should be identified and other people should be prevented from approaching and spreading the contamination. Wearing protective apparel from the spill kit, workers should remove any broken glass fragments and place them in the puncture-resistant container. Liquids should be absorbed with a spill pad; powder should be removed with damp disposable gauze pads or soft toweling. The hazardous material should be completely removed and the area rinsed with water and then cleaned with detergent. The spill cleanup should proceed progressively from areas of lesser to greater contamination. The detergent should be thoroughly rinsed and removed. All contaminated materials should be placed in the disposal bags provided and sealed and transported to a designated containment receptacle. Spills occurring in the biohazard cabinet should be cleaned up immediately; a spill kit should be used if the volume exceeds 150 ml or the contents of one drug vial or ampule. If there is broken glass, utility gloves should be worn to remove it and place it in the puncture-resistant container located in the biohazard cabinet. The biological safety cabinet, including the drain spillage trough, should be thoroughly cleaned. If the spill is not easily and thoroughly contained, the biological safety cabinet should be decontaminated after cleanup. If the spill contaminates the high efficiency particulate air filter, use of the biological safety cabinet should be suspended until the cabinet has been decontaminated and the high efficiency particulate air filter replaced. /Antineoplastic agents/
/PRECAUTIONS FOR ANTINEOPLASTIC AGENTS:/ If hazardous drugs are routinely prepared or administered in carpeted areas, special equipment is necessary to remove the spill. Absorbent powder should be substituted for pads or sheets and left in place on the spill for the time recommended by the manufacturer. The powder should then be picked up with a small vacuum unit reserved for hazardous drug cleanup. The carpet should then be cleaned according to usual procedures. The vacuum bag should be removed and discarded or cleaned, and the exterior of the vacuum cleaner should be washed with detergent and rinsed before being covered and stored. The contaminated powder should be discarded into a sealable plastic bag and segregated with other contaminated waste materials. Alternatively, inexpensive wet or dry vacuum units may be purchased for this express use and used with appropriate cleaners. All such units are contaminated, once used, and must be cleaned, stored, and ultimately discarded /properly/ ... The circumstances and handling of spills should be documented. Health-care personnel exposed during spill management should also complete an incident report or exposure form. /Antineoplastic agents/
- 4.6 DisposalMethods
- SRP: At the time of review, criteria for land treatment or burial (sanitary landfill) disposal practices are subject to significant revision. Prior to implementing land disposal of waste residue (including waste sludge), consult with environmental regulatory agencies for guidance on acceptable disposal practices.
/PRECAUTIONS FOR ANTINEOPLASTIC AGENTS:/ All contaminated disposables should be contained in sealable bags for transfer to larger waste containers. /Antineoplastic agents/
/PRECAUTIONS FOR ANTINEOPLASTIC AGENTS:/ All bottles must be discarded as contaminated waste after decontamination of the biohazard cabinet. All protective apparel (gown, gloves, goggles, and respirator) should be discarded as contaminated waste. /Antineoplastic agents/
/PRECAUTIONS FOR ANTINEOPLASTIC AGENTS:/ The contaminated filters must be removed, bagged in thick plastic and prepared for disposal in a hazardous waste dump site or incinerator licensed by the Environmental Protection Agency (EPA). /Antineoplastic agents/
/PRECAUTIONS FOR ANTINEOPLASTIC AGENTS:/ The gown should be removed and placed in a sealable container before removal of the inner gloves. The inner gloves should be removed last and placed in the container with the gown. /Antineoplastic agents/
/PRECAUTIONS FOR ANTINEOPLASTIC AGENTS:/ Hazardous drug waste should be placed in specially marked (specifically labeled CAUTION: HAZARDOUS CHEMICAL WASTE) thick plastic bags or leakproof containers. These receptacles should be kept in all areas where the drugs are commonly used. All and only hazardous drug waste should be placed in them. Receptacles used for glass fragments, needles, and syringes should be puncture resistant. Hazardous drug waste should not be mixed with any other waste. Waste containers should be handled with uncontaminated gloves. ... Gloves, gowns, drug vials, etc, should be sealed in specially labeled (CAUTION: HAZARDOUS CHEMICAL WASTE) thick plastic bags or leakproof containers. ... All hazardous waste collected from drug preparation and patient-care areas should be held in a secure place in labeled, leakproof drums or cartons (as required by state or local regulation or disposal contractor) until disposal. This waste should be disposed of as hazardous or toxic waste in an EPA-permitted state-licensed hazardous waste incinerator. Transport to an offsite incinerator should be done by a contractor licensed to handle and transport hazardous waste. ... If access to an appropriately licensed incinerator is not available, transport to and burial in an EPA-licensed hazardous waste dump site is an acceptable alternative. While there are concerns that destruction of carcinogens by incineration may be incomplete, newer technologies and stringent licensing criteria have improved this disposal method. ... Chemical deactivation of hazardous drugs should be undertaken only by individuals who are thoroughly familiar with the chemicals and the procedures required to complete such a task. The IARC recently published a monograph describing methods for chemical destruction of some cytotoxic (antineoplastic) drugs in the laboratory setting. The chemicals and equipment described, however, are not generally found in the clinical setting, and many of the deactivating chemicals are toxic and hazardous. Most procedures require the use of a chemical fume hood. The procedures are generally difficult, and the deactivation is not always complete. Serious consideration should be given to the negative aspects of chemical deactivation before one commits to such a course of action. /Antineoplastic agents/
/PRECAUTIONS FOR ANTINEOPLASTIC AGENTS:/ Regulatory agencies such as the EPA and state solid and hazardous waste agencies and local air and water quality control boards must be consulted regarding the classification and appropriate disposal of drugs that are defined as hazardous or toxic chemicals. EPA categorizes several of the antineoplastic agents as toxic wastes, while many states are more stringent and include as carcinogens certain cytotoxic drugs and hormonal preparations. EPA also allows exemptions from toxic waste regulations for small quantity generators, whereas certain states do not. It is critical to research these regulations when disposal procedures are being established. /Antineoplastic agents/
/PRECAUTIONS FOR ANTINEOPLASTIC AGENTS:/ If the biological safety cabinets is equipped with a drainpipe and valve, it may be used to collect rinse water. The collection vessel used must fit well around the drain valve and not allow splashing. Gauze may be used around the connection to prevent aerosol from escaping. The collection vessel must have a tight fitting cover, and all rinse water (gauze, if used) must be disposed of as contaminated waste. /Antineoplastic agents/
- 4.7 RIDADR
- UN 2811 6.1/PG 3
- 4.7 Fire Fighting Procedures
- Use dry chemical, carbon dioxide, or alcohol or polymer foam extinguishers. Poisonous gases, including nitrogen oxides, hydrogen fluoride, and carbon monoxide, are produced in fire. If material or contaminated runoff enters waterways, notify downstream users of potentially contaminated waters. Notify local health and fire officials and pollution control agencies. From a secure, explosion-proof location, use water spray to cool exposed containers. If cooling streams are ineffective (venting sound increases in volume and pitch, tank discolors, or shows any signs of deforming), withdraw immediately to a secure position. If employees are expected to fight fires, they must be trained and equipped in OSHA 1910.156.
- 4.8 Safety Profile
- Poison by ingestion, intraperitoneal, subcutaneous, and intravenous routes. Moderately toxic by parented and rectal routes. Experimental teratogenic and reproductive effects. Human systemic effects: EKG changes, bone marrow changes, cardiac, pulmonary, and gastrointestinal effects. Human mutation data reported. A human skin irritant. Questionable carcinogen. When heated to decomposition it emits very toxic fumes of Fand NOx.
- 4.9 Caution Statement
- P273-P301 + P310
- 4.9 Formulations/Preparations
- Parenteral Injection, for iv use, 50 mg/mL, Adrucil, Adria; Fluorouracil Injection, Goldline, Lyphomed, Roche, Smith & Nepheq solopak; 50 mg/ml (2.5 g) pharmacy bulk package, Adrucil, Adria; Fluorouracil Injection, Lyphomed; 50 mg/mL (5 g) pharmacy bulk package, Fluorouracil Injection, Lyphomed, Smith & Nephew SoloPak.
Topical Cream, 1%, Fluoroplex (with benzyl alcohol), Herbert; 5%, Efudex (with parabens and propylene glycol), Roche Derm; Solution, 1%, Fluoroplex (with propylene glycol), Herbert; 2%, Efudex (with parabens and propylene glycol), Roche Derm; 5%, Efudex (with parabens and propylene glycol), Roche Derm.
Efudex Solution is available in 10-mL drop dispensers containing either 2% (NDC 0187-3202-10) or 5% (NDC 0187-3203-10) fluorouracil on a weight/weight basis compounded with propylene glycol, tris (hydroxymethyl) aminomethane, hydroxypropyl cellulose, parabens (methyl and propyl) and disodium edetate. Efudex Cream is available in 40-gm tubes containing 5% fluorouracil (NDC 0187-3204-47) in a vanishing cream base consisting of white petrolatum, stearyl alcohol, propylene glycol, polysorbate 60 and parabens (methyl and propyl). /Efudex Solutions/
- 4.10 Incompatibilities
- Incompatible with oxidizers (chlorates,nitrates, peroxides, permanganates, perchlorates, chlorine,bromine, fluorine, etc.); contact may cause fires or explo sions. Keep away from alkaline materials, strong bases,strong acids, oxoacids, epoxides, methotrexrate sodium,sources of heat. 5-Fluorouracil Preparation Products And Raw materials Preparation Products
- 4.11 WGK Germany
- 3
- 4.11 RTECS
- YR0350000
- 4.11 Protective Equipment and Clothing
- /PRECAUTIONS FOR ANTINEOPLASTIC AGENTS:/ Protective apparel: Disposable closed-front gown or coveralls, disposable utility gloves over disposable latex gloves, NIOSH-approved air-purifying half-mask respirator equipped with a high efficiency filter, and eye protection should be worn. /Antineoplastic agents/
/PRECAUTIONS FOR ANTINEOPLASTIC AGENTS:/ Class 100 clean-air work stations, both horizontal and vertical airflow (with no containment characteristics), are inappropriate engineering controls for handling hazardous drugs because they provide no personnel protection and permit environmental contamination. Although there are no engineering controls designed specifically for the safe handling of hazardous chemicals as sterile products, Class II contained vertical-flow biological safety cabinets (biohazard cabinets) have been adopted for this use. Biohazard cabinetry is, however, designed for the handling of infectious agents, not hazardous chemicals. ... Based on design, ease of use, and cost considerations, Class II contained-vertical-flow biohazard cabinetry is currently recommended for use in preparing sterile doses of hazardous drugs. Class II cabinetry design and performance specifications are defined in NSF Standard 49. Biological safety cabinets selected for use with hazardous drugs should meet NSF Standard 49 specifications to ensure the maximum protection from these engineering controls. /Antineoplastic agents/
/PRECAUTIONS FOR ANTINEOPLASTIC AGENTS:/ Workers should wear powder free, disposable surgical latex gloves of good quality when preparing hazardous drugs. Selection criteria for gloves should include thickness (especially at the fingertips where stress is the greatest), fit, length, and tactile sensation. ... The practice of double gloving is supported by research that indicates that many glove materials vary in drug permeability even within lots; therefore, double gloving is recommended. ... In general, surgical latex gloves fit better, have appropriate elasticity for double gloving and maintaining the integrity of the glove-gown interface, and have sufficient tactile sensation (even during double gloving) for stringent aseptic procedures. ... Powdered gloves should be avoided. /Antineoplastic agents/
/PRECAUTIONS FOR ANTINEOPLASTIC AGENTS:/ Workers who are not protected by the containment environment of a biohazard cabinet should use respiratory protection when handling hazardous drugs. Respiratory protection should be an adjunct to and not a substitute for engineering controls. Surgical masks of all types provide no respiratory protection against powdered or liquid aerosols of hazardous drugs. In situations where workers may be exposed to potential eye contact with hazardous drugs, an appropriate plastic face shield or splash goggles should be worn. /Antineoplastic agents/
/PRECAUTIONS FOR ANTINEOPLASTIC AGENTS:/ During compounding of hazardous drugs (eg, crushing, dissolving, and preparing an ointment), workers should wear low permeability gowns and double gloves. Compounding should take place in a protective area such as a disposable glove box. If compounding must be done in the open, an area away from drafts and traffic must be selected, and the worker should use appropriate respiratory protection. /Antineoplastic agents/
- 4.12 Reactivities and Incompatibilities
- Oxidizers, strong bases, heat.
- 4.13 Safety
-
Hazard Codes:?Xn,Xi ;T;C
Risk Statements: 20/21/22?
R20/21/22: Harmful by inhalation, in contact with skin and if swallowed.
Safety Statements: 36/37/39-22?
S36/37/39: Wear suitable protective clothing, gloves and eye/face protection.?
S22: Do not breathe dust.
RIDADR: UN 2811 6.1/PG 3
WGK Germany: 3
RTECS: YR0350000
F: 10-23
Hazard Note: Irritant/Highly Toxic
TSCA: T
HazardClass: 6.1
PackingGroup: III
HS Code: 29335995
- 4.14 Sensitive
- Air Sensitive
- 4.15 Specification
-
?Fluorouracil , its cas register number is 51-21-8. It also can be called?2,4(1H,3H)-Pyrimidinedione, 5-fluoro- ; 2,4-Dioxo-5-fluoropyrimidine ; 5-FU ; 5-Faracil ; 5-Fluor-2,4(1H,3H)-pyrimidindion ; 5-Fluor-2,4-dihydroxypyrimidin .It is a?white to nearly white crystalline powder and?insoluble in water.
- 4.16 Toxicity
-
| Organism |
Test Type |
Route |
Reported Dose (Normalized Dose) |
Effect |
Source |
| dog |
LD50 |
oral |
30mg/kg (30mg/kg) |
GASTROINTESTINAL: NAUSEA OR VOMITING |
Oyo Yakuri. Pharmacometrics. Vol. 16, Pg. 303, 1978. |
| guinea pig |
LD50 |
intravenous |
25mg/kg (25mg/kg) |
VASCULAR: BP ELEVATION NOT CHARACTERIZED IN AUTONOMIC SECTION |
Japanese Journal of Pharmacology. Vol. 30, Pg. 871, 1980. |
| hamster |
LD10 |
parenteral |
140mg/kg (140mg/kg) |
? |
Journal of Surgical Oncology. Vol. 15, Pg. 355, 1980. |
| human |
TDLo |
intravenous |
6mg/kg/3D (6mg/kg) |
CARDIAC: EKG CHANGES NOT DIAGNOSTIC OF ABOVE
CARDIAC: OTHER CHANGES
LUNGS, THORAX, OR RESPIRATION: OTHER CHANGES |
British Medical Journal. Vol. 1, Pg. 547, 1978. |
| human |
TDLo |
oral |
450mg/kg/30D (450mg/kg) |
GASTROINTESTINAL: OTHER CHANGES
BLOOD: CHANGES IN BONE MARROW NOT INCLUDED ABOVE |
Cancer Vol. 39, Pg. 1936, 1977. |
| man |
TDLo |
intravenous |
39mg/kg/1D-I (39mg/kg) |
CARDIAC: CHANGES IN CORONARY ARTERIES |
American Heart Journal. Vol. 114, Pg. 433, 1987. |
| man |
TDLo |
intravenous |
122mg/kg/9W-I (122mg/kg) |
SKIN AND APPENDAGES (SKIN): "DERMATITIS, OTHER: AFTER SYSTEMIC EXPOSURE" |
Australian and New Zealand Journal of Medicine. Vol. 22, Pg. 385, 1992. |
| mouse |
LD50 |
intracrebral |
41600ug/kg (41.6mg/kg) |
PERIPHERAL NERVE AND SENSATION: SENSORY CHANGE INVOLVING PERIPHERAL NERVE
SENSE ORGANS AND SPECIAL SENSES: PTOSIS: EYE
SENSE ORGANS AND SPECIAL SENSES: OTHER: EYE |
Chemotherapy Vol. 15, Pg. 519, 1967. |
| mouse |
LD50 |
intraperitoneal |
100mg/kg (100mg/kg) |
? |
Eksperimental'naya i Klinicheskaya Farmakoterapiya. Vol. 7, Pg. 100, 1977. |
| mouse |
LD50 |
intravenous |
81mg/kg (81mg/kg) |
? |
Iyakuhin Kenkyu. Study of Medical Supplies. Vol. 4, Pg. 90, 1973. |
| mouse |
LD50 |
oral |
115mg/kg (115mg/kg) |
? |
Journal of Medicinal Chemistry. Vol. 21, Pg. 738, 1978. |
| mouse |
LD50 |
subcutaneous |
169mg/kg (169mg/kg) |
? |
Iyakuhin Kenkyu. Study of Medical Supplies. Vol. 4, Pg. 90, 1973. |
| mouse |
LD50 |
unreported |
171mg/kg (171mg/kg) |
? |
Cancer Research. Vol. 46, Pg. 2703, 1986. |
| mouse |
LDLo |
intratracheal |
200mg/kg (200mg/kg) |
? |
Toxicology Letters. Vol. 30, Pg. 63, 1986. |
| rabbit |
LD50 |
oral |
18900ug/kg (18.9mg/kg) |
BEHAVIORAL: MUSCLE WEAKNESS
GASTROINTESTINAL: "HYPERMOTILITY, DIARRHEA" |
Kiso to Rinsho. Clinical Report. Vol. 8, Pg. 2603, 1974. |
| rabbit |
LDLo |
intravenous |
15mg/kg (15mg/kg) |
VASCULAR: BP ELEVATION NOT CHARACTERIZED IN AUTONOMIC SECTION |
Japanese Journal of Pharmacology. Vol. 30, Pg. 871, 1980. |
| rat |
LD50 |
intramuscular |
240mg/kg (240mg/kg) |
? |
K'at'ollik Taehak Uihakpu Nonmunjip. Journal of Catholic Medical College. Vol. 38, Pg. 481, 1985. |
| rat |
LD50 |
intraperitoneal |
70mg/kg (70mg/kg) |
GASTROINTESTINAL: "HYPERMOTILITY, DIARRHEA"
GASTROINTESTINAL: NAUSEA OR VOMITING |
Oyo Yakuri. Pharmacometrics. Vol. 5, Pg. 569, 1971. |
| rat |
LD50 |
intravenous |
245mg/kg (245mg/kg) |
GASTROINTESTINAL: "HYPERMOTILITY, DIARRHEA"
GASTROINTESTINAL: NAUSEA OR VOMITING |
Oyo Yakuri. Pharmacometrics. Vol. 5, Pg. 569, 1971. |
| rat |
LD50 |
oral |
230mg/kg (230mg/kg) |
? |
Iyakuhin Kenkyu. Study of Medical Supplies. Vol. 4, Pg. 90, 1973. |
| rat |
LD50 |
parenteral |
500mg/kg (500mg/kg) |
? |
Recent Results in Cancer Research. Vol. 52, Pg. 76, 1975. |
| rat |
LD50 |
rectal |
884mg/kg (884mg/kg) |
GASTROINTESTINAL: "HYPERMOTILITY, DIARRHEA"
GASTROINTESTINAL: OTHER CHANGES |
Kiso to Rinsho. Clinical Report. Vol. 12, Pg. 1309, 1978. |
| rat |
LD50 |
subcutaneous |
217mg/kg (217mg/kg) |
? |
Iyakuhin Kenkyu. Study of Medical Supplies. Vol. 4, Pg. 90, 1973. |
| women |
TDLo |
intravenous |
27mg/kg/4D-C (27mg/kg) |
CARDIAC: OTHER CHANGES |
British Medical Journal. Vol. 294, Pg. 125, 1987. |
| women |
TDLo |
intravenous |
150mg/kg/17W- (150mg/kg) |
BLOOD: OTHER HEMOLYSIS WITH OR WITHOUT ANEMIA |
British Journal of Haematology. Vol. 65, Pg. 357, 1987. |
5. MSDS
2.Hazard identification 2.1 Classification of the substance or mixture Acute toxicity - Oral, Category 3 Acute toxicity - Dermal, Category 4 Skin irritation, Category 2 Eye irritation, Category 2 Specific target organ toxicity \u2013 single exposure, Category 3 Germ cell mutagenicity, Category 1B Reproductive toxicity, Category 1B 2.2 GHS label elements, including precautionary statements | Pictogram(s) |   | | Signal word | Danger | | Hazard statement(s) | H301 Toxic if swallowed H312 Harmful in contact with skin H315 Causes skin irritation H319 Causes serious eye irritation H335 May cause respiratory irritation H340 May cause genetic defects H360 May damage fertility or the unborn child | | Precautionary statement(s) | | | Prevention | P264 Wash ... thoroughly after handling. P270 Do not eat, drink or smoke when using this product. P280 Wear protective gloves/protective clothing/eye protection/face protection. P261 Avoid breathing dust/fume/gas/mist/vapours/spray. P271 Use only outdoors or in a well-ventilated area. P201 Obtain special instructions before use. P202 Do not handle until all safety precautions have been read and understood. | | Response | P301+P310 IF SWALLOWED: Immediately call a POISON CENTER/doctor/\u2026 P321 Specific treatment (see ... on this label). P330 Rinse mouth. P302+P352 IF ON SKIN: Wash with plenty of water/... P312 Call a POISON CENTER/doctor/\u2026if you feel unwell. P362+P364 Take off contaminated clothing and wash it before reuse. P332+P313 If skin irritation occurs: Get medical advice/attention. P305+P351+P338 IF IN EYES: Rinse cautiously with water for several minutes. Remove contact lenses, if present and easy to do. Continue rinsing. P337+P313 If eye irritation persists: Get medical advice/attention. P304+P340 IF INHALED: Remove person to fresh air and keep comfortable for breathing. P308+P313 IF exposed or concerned: Get medical advice/ attention. | | Storage | P405 Store locked up. P403+P233 Store in a well-ventilated place. Keep container tightly closed. | | Disposal | P501 Dispose of contents/container to ... | 2.3 Other hazards which do not result in classification none
7. Synthesis Route
51-21-8Total: 43 Synthesis Route
9. Other Information
- 9.0 Merck
- 14,4181
- 9.1 BRN
- 127172
- 9.2 Antimetabolite
- 5-fluorouracil is short for fluorouracil, and is pyrimidine antimetabolites, 5-fluorouracil as fluorouracil for pyrimidine antimetabolites, is currently clinically commonly used a chemotherapy drug, having effect on proliferation, can prevent the thymine formation, inhibition of DNA biosynthesis, thereby inhibiting the growth of cancer cells. Clinically, it is used to treat gastrointestinal tumors, such as stomach cancer, colon cancer, liver cancer and so on. In breast cancer, ovarian cancer, lung cancer, bladder cancer, cervical cancer, pancreatic cancer and so on are also effective. The Swiss production of skin cancer treatment ointment containing 5% of the goods, mainly used for actinic keratoses and senile keratosis, precancerous dermatitis, single and multiple shallow table basal cell carcinoma, radioactive skin lesion of carcinoma and superficial basal cell carcinoma.
5-fluorouracil first changes for 5-Fluoro 2 deoxy urea pyrimidine nucleotides in vivo and inhibition of thymidylate synthase, blocking the transformation of urea pyrimidine deoxyribonucleotide thymidine, which affects DNA biosynthesis. At the same time, it can be incorporation into RNA by blocking urea ethyl pyridine and whey acid was incorporated into the RNA to direct inhibition of RNA synthesis.
This medicine is mainly in the liver metabolism, most of the decomposed into carbon dioxide discharged from breathing, rarely excreted from urine. After oral, absorption is different; vein after administration, concentrations in plasma quickly drop in two hours; static note within 30 minutes can arrive in cerebrospinal fluid (CSF) and maintain for 3 hours; continuous intravenous infusion toxicity is lighter than intravenous injection; vein to the drug's effect is compared with oral high. Toxicity of 5-fluorouracil on the proliferation is greater than non proliferating cells, but no obvious cell cycle specificity. Resistance to 5-FU can increase essential activity of enzyme missing or thymidylate synthetase activity.
- 9.3 Pharmacokinetics
- Due to the instability of the absorption of 5-fluorouracil, the conventional the oral (in Europe can be obtained from oral preparation). General intravenous administration, We can also take transarterial Administration in order to directly reach the tumor (e.g. liver metastasis through hepatic artery) and injected directly into the body cavity infiltration liquid (such as ovarian cancer). Intravenous injection plasma half-life is 7.5~10 minutes, after 3 hours the drug in the plasma has not check did not change. Intracellular drug levels are last much longer.
Fluorouracil in the liver is used for metabolism; 60~80% in 8~12 hours as a respiratory carbon dioxide discharge and 15% in 6 hours technical unchanged from the urine discharge. The drug can enter into the exudate and cerebrospinal fluid (CSF). It has existed determination method for plasma fluorouracil.
- 9.4 Indications
- It is clinical for breast cancer, digestive tract cancer, ovarian cancer and primary bronchogenic lung adenocarcinoma adjuvant chemotherapy and palliative care; is also in the treatment of malignant hydatidiform mole, choriocarcinoma, serous cancer of effusion in bladder cancer and head and neck malignant tumor and liver cancer chemotherapy drugs.
Dermatological topical containing 5% 5-fluorouracil ointment is used in the treatment of actinic keratosis, actinic cheilitis, Bowen's disease, erythroplasia of Queyrat, Bowenoid papulosis, condyloma acuminatum, vitiligo, lichen amyloidosis, disseminated superficial porokeratosis, warts, flat warts, psoriasis, color of dry skin disease, superficial basal cell epithelioma table etc.; intralesional injection in the treatment of keratoacanthoma keloid.
- 9.5 Drug interaction
- Before using this drug, first it is used methotrexate, 5-fluorouracil nucleotide formation is increased by increasing the content of intracellular phosphoribosyl pyrophosphate. Allopurinol can change the role of fluorouracil. Its metabolites, oxypurinol, can inhibit orotate phosphoribosyl transferase and thus reduce the toxicity and may improve the therapeutic index. Increase in thymidine and other nucleoside combination of fluorouracil and RNA and thymidine by dihydropyrimidine dehydrogenase can delay fluorouracil decomposition. However, the drug combination did not significantly improve the clinical effect so far.
- 9.6 Adverse reactions and precautions
- The main toxic effect of fluorouracil is involving the gastrointestinal tract and blood cell generation system. Anorexia, nausea and vomiting were common. Stomatitis, pharyngo esophageal inflammation and diarrhea are withdrawal indication, otherwise there will be serious oropharyngeal and intestinal ulcers. Intravenous administration of gastrointestinal toxicity is often limiting dose. On the contrary, huge doses of intravenous injection, white cell reduction is the dose limiting toxicity. Low white cell counts often appear in medication for the first time after 7 to 14 days. Thrombocytopenia is not too obvious, appeared in 7~17. Monitoring of blood cell count is necessary.
Other adverse reactions are hair loss, dermatitis and pigment calm. There were acute and chronic conjunctivitis. Reversible cerebellar ataxia occurs in 1% of patients, possibly is related to the dose, occur at any time of the treatment process (often a few months later). After Cerebellar signs in the withdrawal can be last for a few of weeks. Myocardial ischemia occasionally appeared in the 5-FU intravenous drip. The drug in animals is caused by abnormal and may be carcinogenic.
Damage to the liver function of patients (e.g. extensive liver metastasis) fluorouracil should be reduced; The nutritional status of patients with poor medication should be cautious.
Using daily intermittent intravenous drip for 4~5d, can greatly reduce the toxic effects of blood. However, the results of clinical research mean rapid injection or intravenous drip method in the treatment of superiority. Long term intravenous drip infusion can be accompanied by pain, erythema and skin scaling of hand-foot comprehensive syndrome.
This medicine to FDA pregnancy category D.
- 9.7 Fluorofur
- Fluorofur is fluorine urea pyrimidine derivatives, and effect is similar with fluorouracil, but chemotherapy index double higher than fluorouracil and toxicity is only the 1/4 to 1/6 of fluorouracil. It is suitable for gastrointestinal cancer and breast cancer. There are oral, intravenous and anal suppository three formulations.
- 9.8 Chemical property
- It is white or white crystalline powder. Mp is 282-283℃ (decomposition), 0.1 mol/L hydrochloric acid solution has maximum absorption at 265nm wavelength. It is slightly soluble in water and ethanol, insoluble in chloroform and ether, soluble in dilute hydrochloric acid and sodium hydroxide solution. Medium toxicity, LD50 (mouse, i.p.) is 230mg/kg.
- 9.9 Uses
- 1. It is used for biochemical studies and antitumor drugs.
2. It is the anti tumor drug, also used for synthesis of flucytosine. 5-fluorouracil can be used in the study of rice in the biochemical studies, ear differentiation, genetic metabolic measurement, plant growth development research.
3. It is used for the digestive system cancer, head and neck cancer, gynecological cancer, lung cancer, liver cancer, treatment of bladder cancer and skin cancer.
4. Antimetabolite antitumor drugs.
5. Anti tumor drugs. There is a certain effect on a variety of tumors such as digestive tract cancer, breast cancer, ovarian cancer, chorionic epithelial cancer, cervical cancer, hepatocellular carcinoma, bladder cancer, skin cancer (topical), leukoplakia (topical) etc. Adverse reactions mainly are bone marrow transplantation, digestive tract reaction, serious person can have diarrhea, local injection site phlebitis, a few of which have nervous system reactions such as cerebellar degeneration and ataxia. The course of medication should strictly check the blood.
- 9.10 Methods of production
- 1. It is obtained by fluoride ethyl acetate by condensation, cyclization and hydrolysis.
(1). Condensation, cyclization. Sodium methoxide is input dry stainless steel reaction pot, stirring under vacuum concentration to sodium methoxide into white powder, cooling to 50℃, adding toluene, then cold to below 10℃, dropping ethyl formate. After adding remained below 10℃, dripping ethyl fluoroacetate. Completely, at about 30℃ stirring reaction for 8 hours. Static, obtain pale yellow thick mixture. In the condensation product, adding methanol and methyl isobutyl urea sulfate, stirring and heating to 66-70℃, reflux reaction for 6h. Atmospheric recovering methanol to the reaction material showing a thin paste, then vacuum distilled to viscous so far. Heating, dissolving in water, adding activated charcoal, filtered, and the filtrate with concentrated hydrochloric acid to pH3-4, crystallization, cooling and filtering, use cold water to wash the filter cake, using boiling water to regulate plasma immersion to recognize, filtering, water washing, drying, to 5-fluorouracil (-4-hydroxy-2-four oxygen pyrimidine C5H5FN2O2. (2). The hydrolysis of the cyclization product 5-Fluoro-4-hydroxy-2-methoxy pyrimidine and adding 20% hydrochloric acid in 60℃are hydrolysis for 4h, after processing to obtain 5-fluorouracil.
2. 2-methylthio-5-fluorouracil is under acidic conditions and reflux system to obtain 5-fluorouracil.
- 9.11 Description
- 5-Fluorouracil (5-FU) is a prodrug form of the thymidylate synthase inhibitor fluorodeoxyuridylate (FdUMP).1 It is also converted to the active metabolites FUTP and FdUTP, which induce RNA and DNA damage, respectively. In vivo, 5-FU (15 mg/kg) when administered in combination with docetaxel (Item No. 11637) reduces tumor growth in B88 and CAL 27 oral squamous cell carcinoma (OSCC) mouse xenograft models.2 Formulations containing 5-FU have been used in the treatment of colorectal, breast, gastric, and pancreatic cancers.
- 9.12 Chemical Properties
- White or almost white, crystalline powder
- 9.13 Chemical Properties
- Fluorouracil is a white crystalline solid. Practically odorless.
- 9.14 Originator
- Efudex, Roche, US,1962
- 9.15 Uses
- antineoplastic, pyrimidine antimetabolite
- 9.16 Uses
- 5-Fluoro Uracil is an active metabolite of Doxifluridine (D556750).
- 9.17 Uses
- A potent antineoplastic agent in clinical use. Also an inhibitor of DNA synthesis
- 9.18 Indications
- Fluorouracil (5-fluorouracil, 5-fluorouracil, Efudex, Adrucil) is a halogenated pyrimidine analogue that must be activated metabolically. The active metabolite that inhibits DNA synthesis is the deoxyribonucleotide 5-fluoro-2'deoxyuridine-S'-phosphate (FdUMP). 5- Fluorouracil is selectively toxic to proliferating rather than non-proliferating cells and is active in both the G1- and S-phases. The target enzyme inhibited by 5-fluorouracilfluorouracil is thymidylate synthetase.
methylenetetrahydrofolate dihydrofolate The carbon-donating cofactor for this reaction is N5,N10 methylenetetrahydrofolate, which is converted to dihydrofolate. The reduced folate cofactor occupies an allosteric site on thymidylate synthetase, which allows for the covalent binding of 5-FdUMP to the active site of the enzyme.
- 9.19 Manufacturing Process
- A mixture of 200 grams (2 mols) of dry sodium fluoroacetate and 442 grams (2.86 mols) of diethyl sulfate was refluxed for 31? hours in an oil bath. The reaction mixture was then distilled through a fractionating column, yielding 177.3 grams of crude ethyl fluoroacetate, having a boiling range of 116° to 120°C. The material was redistilled through a fractionating column, yielding purified ethyl fluoroacetate boiling at 114° to 118°C.
In a 2-liter, 3-neck, round bottom flask, provided with stirrer, dropping funnel and reflux condenser, was placed 880 ml of absolute diethyl ether, and 47.6 grams (1.22 mols) of potassium, cut into 5 mm pieces, was suspended therein. 220 ml of absolute ethanol was added dropwise, while stirring, whereby the heat of reaction produced refluxing. In order to obtain complete dissolution of the potassium, the mixture was finally refluxed on a steam bath. The reaction mixture was then cooled in an ice bath, and a mixture of 135 grams (1.22 mols) of ethyl fluoroacetate and 96.4 grams (1.3 mols) of freshly distilled ethyl formate was added dropwise, while stirring and cooling, over a period of 2? hours. Upon completion of the addition of the ethyl formate, the reaction mixture was stirred for an additional hour while cooling, and then was allowed to stand overnight at room temperature.
At the end of this time the crystalline precipitate which had formed was filtered off with suction, washed with diethyl ether, and dried in a vacuum desiccator. The product comprised essentially the potassium enolate of ethyl fluoromalonaldehydate (alternative nomenclature, the potassium salt of fluoromalonaldehydic acid ethyl ester).
A mixture of 103.6 grams (0.6 mol) of the freshly prepared potassium enolate of ethyl fluoromalonaldehydate, 83.4 grams (0.3 mol) of Smethylisothiouronium sulfate and 32.5 grams (0.6 mol) of sodium methoxide was refluxed with stirring in 1,500 ml of absolute methanol. At first the reactants dissolved to a great extent, but very shortly thereafter precipitation occurred. The reaction mixture was refluxed for 2 hours and at the end of this time was evaporated to dryness in vacuo. The residue was treated with 280 ml of water; incomplete dissolution was observed.
The mixture obtained was clarified by filtering it through charcoal. The filtrate was acidified (to a slight Congo red acid reaction) by adding concentrated aqueous hydrochloric acid, containing 37% by weight HCl (48 ml required). The material which crystallized from the acidified solution was filtered off, washed free of sulfates with water and dried at 100°C, yielding crude Smethyl ether of 2-thio-5-fluorouracil, having a melting range from 202° to 221°C. The latter material was recrystallized by dissolving it in 2,035 ml of boiling ethylacetate and cooling to -20°C, yielding S-methyl ether of 2-thio-5fluorouracil, MP 230° to 237°C, in a sufficient state of purity that it could be used directly for the next step. A sample of the material was recrystallized from water (alternatively, from ethyl acetate) thereby raising the melting point to 241° to 243°C. For analysis the material was further purified by subliming it in vacuo at 140° to 150°/0.1 mm
A solution of 10.0 grams of purified S-methyl ether of 2-thio-5-fluorouracil, MP 230° to 237°C, in 150 ml of concentrated aqueous hydrochloric acid (containing approximately 37% by weight HCl) was refluxed under nitrogen for 4 hours. The reaction mixture was then evaporated in vacuo. The crystalline brownish residue was recrystallized from water. The resulting recrystallized product was further purified by sublimation in vacuo at 190° to 200°C (bath temperature)/0.1 mm pressure. There was obtained 5fluorouracil, in the form of colorless or pinkish-tan crystals, MP 282° to 283°C (with decomposition).
- 9.20 Brand name
- Adrucil (Pharmacia & Upjohn); Adrucil (Sicor); Carac (Sanofi Aventis); Efudex (Valeant); Fluoroplex (Allergan).
- 9.21 Therapeutic Function
- Cancer chemotherapy
- 9.22 Synthesis Reference(s)
- Journal of Heterocyclic Chemistry, 20, p. 457, 1983 DOI: 10.1002/jhet.5570200236
Tetrahedron Letters, 21, p. 277, 1980 DOI: 10.1016/S0040-4039(00)71188-9
- 9.23 General Description
- The drug is available in a 500-mg or 10-mL vial for IV useand as a 1% and 5% topical cream. 5-FU is used in the treatmentof several carcinoma types including breast cancer,colorectal cancer, stomach cancer, pancreatic cancer, andtopical use in basal cell cancer of the skin. The mechanism ofaction includes inhibition of the enzyme TS by the deoxyribosemonophosphate metabolite, 5-FdUMP. The triphosphatemetabolite is incorporated into DNA and the ribosetriphosphate into RNA. These incorporations into growingchains result in inhibition of synthesis and function of DNAand RNA. Resistance can occur as a result of increased expressionof TS, decreased levels of reduced folate substrate5,10-methylenetetrahydrofolate, or increased levels of dihydropyrimidinedehydrogenase. Dihydropyrimidine dehydrogenaseis the main enzyme responsible for 5-FU catabolism.
Bioavailability following oral absorption is erratic.Administration of 5-FU by IV yields high drug concentrationsin bone marrow and liver. The drug does distribute intothe central nervous system (CNS). Significant drug interactionsinclude enhanced toxicity and antitumor activity of5-FU following pretreatment with leucovorin. Toxicities includedose-limiting myelosuppression, mucositis, diarrhea,and hand–foot syndrome (numbness, pain, erythema, dryness,rash, swelling, increased pigmentation, nail changes,pruritus of the hands and feet).
- 9.24 General Description
- White to nearly white crystalline powder; practically odorless. Used as an anti neoplastic drug, chemosterilant for insects.
- 9.25 Air & Water Reactions
- Insoluble in water.
- 9.26 Reactivity Profile
- 5-Fluorouracil may be sensitive to prolonged exposure to light. Solutions discolor on storage. 5-Fluorouracil can react with oxidizing agents and strong bases. Incompatible with methotrexate sodium.
- 9.27 Hazard
- Questionable carcinogen.
- 9.28 Health Hazard
- Minimum toxic dose in humans is approximately 450 mg/kg (total dose) over 30 days for the ingested drug. Intravenous minimum toxic dose in humans is a total dose of 6 mg/kg over three days. Depression of white blood cells occurred after intravenous administrative of a total dose of 480 mg/kg over 32 days. Occasional neuropathy and cardiac toxicity have been reported. Do not use during pregnancy. Patients with impaired hepatic or renal function, with a history of high-dose pelvic irradiation or previous use of alkylating agents should be treated with extreme caution. Patients with nutritional deficiencies and protein depletion have a reduced tolerance to 5-Fluorouracil.
- 9.29 Fire Hazard
- Emits very toxic fumes of flourides and nitrogen oxides when heated to decomposition. Avoid decomposing heat.
- 9.30 Biological Activity
- Anticancer agent. Metabolized to form fluorodeoxyuridine monophosphate (FdUMP), fluorodeoxyuridine triphosphate (FdUTP) and fluorouridine (FUTP). FdUMP inhibits thymidylate reductase causing a reduction in dTMP synthesis. FUTP and FdUTP are misincorporated into RNA and DNA respectively.
- 9.31 Biochem/physiol Actions
- A potent antitumor agent that affects pyrimidine synthesis by inhibiting thymidylate synthetase, thus depleting intracellular dTTP pools. It is metabolized to ribonucleotides and deoxyribonucleotides, which can be incorporated into RNA and DNA. Treatment of cells with 5-FU leads to an accumulation of cells in S-phase and has been shown to induce p53 dependent apoptosis.
- 9.32 Mechanism of action
- 5-Fluorouracil (FU) is converted intracellularly to several active metabolites: fluorodeoxyuridine monophosphate (FdUMP), fluorodeoxyuridine triphosphate (FdUTP), and fluorouridine triphosphate (FUTP). The active metabolites of 5-FU disrupt RNA synthesis (FUTP), inhibit the action of thymidylate synthase (TS)—a nucleotide synthetic enzyme (FdUMP)—and can also be directly misincorporated into DNA (FdUTP). The rate-limiting enzyme in 5-FU catabolism is dihydropyrimidine dehydrogenase (DPD), which converts 5-FU to dihydrofluorouracil (DHFU). Over 80% of administered 5-FU is normally catabolized primarily in the liver, where DPD is abundantly expressed.
5-Fluorouracil (5-FU) is converted to three major active metabolites: (1) fluorodeoxyuridine monophosphate (FdUMP), (2) fluorodeoxyuridine triphosphate (FdUTP), and (3) fluorouridine triphosphate (FUTP). The main mechanism of 5-FU activation is conversion to fluorouridine monophosphate (FUMP) either directly by orotate phosphoribosyl transferase (OPRT), or indirectly via fluorouridine (FUR) through the sequential action of uridine phosphorylase (UP) and uridine kinase (UK). FUMP is then phosporylated to fluorouridine diphosphate (FUDP), which can be either further phosphorylated to the active metabolite fluorouridine triphosphate (FUTP), or converted to fluorodeoxyuridine diphosphate (FdUDP) by ribonucleotide reductase (RR). In turn, FdUDP can either be phosphorylated or dephosphorylated to generate the active metabolites FdUTP and FdUMP respectively. An alternative activation pathway involves the thymidine phosphorylase catalyzed conversion of 5-FU to fluorodeoxyuridine (FUDR), which is then phosphorylated by thymidine kinase (TK) to the thymidylate synthase (TS) inhibitor, FdUMP. Dihydropyrimidine dehydrogenase (DPD)-mediated conversion of 5-FU to dihydrofluorouracil (DHFU) is the rate-limiting step of 5-FU catabolism in normal and tumor cells.
- 9.33 Mechanism of action
- Another action proposed for 5-fluorouracil may involve the incorporation of the nucleotide 5-fluorouridine triphosphate (5-FUTP) into RNA. The cytotoxic role of these “fraudulent” 5-fluorouracil-containing RNAs is not well understood.
Several possible mechanisms of resistance to 5-fluorouracil have been identified, including increased synthesis of the target enzyme, altered affinity of thymidylate synthetase for FdUMP, depletion of enzymes (especially uridine kinase) that activate 5-fluorouracil to nucleotides, an increase in the pool of the normal metabolite deoxyuridylic acid (dUMP), and an increase in the rate of catabolism of 5-fluorouracil.
The drug has been administered orally, but absorption by this route is erratic. The plasma half-life of 5- fluorouracil after intravenous injection is 10 to 20 minutes. It readily enters CSF. Less than 20% of the parent compound is excreted into the urine, the rest being largely metabolized in the liver.
- 9.34 Pharmacology
- Local inflammatory reactions characterized by erythema, edema, crusting, burning, and pain are common (and, some would argue, desirable) but may be minimized by reduced frequency of application or use in combination with a topical corticosteroid.
- 9.35 Clinical Use
- 5-Fluorouracil (Efudex, Fluoroplex) is an antimetabolite used for the topical treatment of actinic keratoses. It is also useful for the treatment of superficial basal cell carcinomas when conventional surgical modalities are impractical.
- 9.36 Clinical Use
- 5-Fluorouracil (FU) is widely used in the treatment of a range of cancers including breast and cancers of the aerodigestive tract, but has had the greatest impact in colorectal cancer. 5-FU-based chemotherapy improves overall and disease-free survival of patients with resected stage III colorectal cancer. Nonetheless, response rates for 5-FU-based chemotherapy as a first-line treatment for advanced colorectal cancer are only between 10 and 15%. Combination of 5-FU with newer chemotherapies, such as irinotecan and oxaliplatin, has improved the response rates for advanced colorectal cancer to between 40 and 50%.
- 9.37 Usage
- 5-Fluorouracil is used as an antitumor agent in the treatment of anal, breast, colorectal, oesophageal, stomach, pancreatic and skin cancers. It finds application as a suicide inhibitor due to its irreversible inhibition of thymidylate synthase. It is also used in the treatment of actinic keratoses and bowen's disease. Further, it serves as a potent antineoplastic agent in clinical use. In addition to this, it acts as a DNA synthesis inhibitor.
- 9.38 Clinical Use
- 5-Fluorouracil is used in several combination regimens in the treatment of breast cancer. It also has palliative activity in gastrointestinal adenocarcinomas, including those originating in the stomach, pancreas, liver, colon, and rectum. Other tumors in which some antitumor effects have been reported include carcinomas of the ovary, cervix, oropharynx, bladder, and prostate. Topical 5-fluorouracil cream has been useful in the treatment of premalignant keratoses of the skin and superficial basal cell carcinomas, but it should not be used in invasive skin cancer.
- 9.39 Side effects
- Patients who are genetically deficient in this enzyme will experience a more pronounced effect from this drug and are at significant risk for use-limiting toxicity. In general, women clear fluorouracil faster than men do. Dosage adjustments usually are not required in hepatic or renal dysfunction. Major toxicities are related to bone marrow depression, stomatitis/esophagopharyngitis, and potential GI ulceration. Nausea and vomiting are common. Solutions of fluorouracil are light sensitive, but discolored products that have been properly stored and protected from light are still safe to use.
- 9.40 Safety Profile
- Poison by ingestion, intraperitoneal, subcutaneous, and intravenous routes. Moderately toxic by parented and rectal routes. Experimental teratogenic and reproductive effects. Human systemic effects: EKG changes, bone marrow changes, cardiac, pulmonary, and gastrointestinal effects. Human mutation data reported. A human skin irritant. Questionable carcinogen. When heated to decomposition it emits very toxic fumes of Fand NOx.
- 9.41 Chemical Synthesis
- Fluorouracil, 4-fluorouracil (30.1.3.3), is made by condensing the ethyl ester of fluoroacetic acid with ethylformate in the presence of potassium ethoxide, forming hydroxy-methylenfluoroacetic ester (30.3.1), which cyclizes by reacting it with S-methylisothiourea to 2-methylthio-4-hydroxy-5-fluoropyrimidine, which is subsequently hydrolyzed by hydrochloric acid to fluorouracil (30.1.3.3). An alternative method of synthesizing5-fluorouracid is direct fluorination of uracil with fluorine or trifluoromethylhypofluoride.
- 9.42 Potential Exposure
- This material is used as an antineo plastic drug for cancer treatment and as a chemosterilant for insects.
- 9.43 Veterinary Drugs and Treatments
- 5-fluorouracil is a potent cytotoxic chemotherapeutic agent used for the topical therapy of equine limbal and eyelid squamous cell carcinoma. It is also used as an antimetabolite to limit fibrosis over the body of gonioimplant devices used to artificially shunt aqueous humor out of the eye in glaucoma as well as improve long-term filtering performance of the implant.
1% solution applied to the affected eye three times daily.
- 9.44 Shipping
- UN2811 Toxic solids, organic, n.o.s., Hazard Class: 6.1; Labels: 6.1-Poisonous materials, Technical Name Required.
- 9.45 Incompatibilities
- Incompatible with oxidizers (chlorates, nitrates, peroxides, permanganates, perchlorates, chlorine, bromine, fluorine, etc.); contact may cause fires or explo sions. Keep away from alkaline materials, strong bases, strong acids, oxoacids, epoxides, methotrexrate sodium, sources of heat.
10. Computational chemical data
- Molecular Weight: 130.07700g/mol
- Molecular Formula: C4H3FN2O2
- Compound Is Canonicalized: True
- XLogP3-AA: null
- Exact Mass: 130.01785550
- Monoisotopic Mass: 130.01785550
- Complexity: 199
- Rotatable Bond Count: 0
- Hydrogen Bond Donor Count: 2
- Hydrogen Bond Acceptor Count: 3
- Topological Polar Surface Area: 58.2
- Heavy Atom Count: 9
- Defined Atom Stereocenter Count: 0
- Undefined Atom Stereocenter Count: 0
- Defined Bond Stereocenter Count: 0
- Undefined Bond Stereocenter Count: 0
- Isotope Atom Count: 0
- Covalently-Bonded Unit Count: 1
- CACTVS Substructure Key Fingerprint: AAADcQBjMQAAAAAAAAAAAAAAAAAAAAAAAAAgAAAAAAAAAAAAAAAAHwAQAAAACADBgAQBAALAAACIAAFWUACAAAAAAAAAAIAIAECAAAAAAAAAAAAIByIAAMAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA==
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12. Realated Product Infomation
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![5-FLUOROURACIL, [6-3H]-](https://structimg.guidechem.com/7/43/112482.png)
