In the U.S.—

• Antineoplastic

Floxuridine ( flox-YOOR-i-deen) belongs to the group of medicines known as antimetabolites. It is used to treat some kinds of cancer.

Floxuridine interferes with the growth of cancer cells, which are eventually destroyed. Since the growth of normal body cells may also be affected by floxuridine, other effects will also occur. Some of these may be serious and must be reported to your doctor. Other effects, like hair loss, may not be serious but may cause concern. Some effects may not occur for months or years after the medicine is used.

Before you begin treatment with floxuridine, you and your doctor should talk about the good this medicine will do as well as the risks of using it.

Floxuridine is to be administered only by or under the immediate supervision of your doctor. It is available in the following dosage form:

Parenteral
• Injection (U.S.)

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For floxuridine, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to floxuridine.

Pregnancy—There is a chance that this medicine may cause birth defects if either the male or female is receiving it at the time of conception or if it is taken during pregnancy. Floxuridine has been shown to cause birth defects in mice and rats. In addition, many cancer medicines may cause sterility which could be permanent. Although sterility has not been reported with this medicine, the possibility should be kept in mind.

Be sure that you have discussed this with your doctor before receiving this medicine. It is best to use some kind of birth control while you are receiving floxuridine. Tell your doctor right away if you think you have become pregnant while receiving floxuridine.

Breast-feeding—Tell your doctor if you are breast-feeding or if you intend to breast-feed during treatment with this medicine. Because floxuridine may cause serious side effects, breast-feeding is generally not recommended while you are receiving it.

Children—There is no specific information comparing use of floxuridine in children with use in other age groups.

Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. Although there is no specific information comparing use of floxuridine in the elderly with use in other age groups, this medicine is not expected to cause different side effects or problems in older people than it does in younger adults.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving floxuridine, it is especially important that your health care professional know if you are taking any of the following:

• Amphotericin B by injection (e.g., Fungizone) or
• Antithyroid agents (medicine for overactive thyroid) or
• Azathioprine (e.g., Imuran) or
• Chloramphenicol (e.g., Chloromycetin) or
• Colchicine or
• Flucytosine (e.g., Ancobon) or
• Ganciclovir (e.g., Cytovene) or
• Interferon (Intron A, Roferon-A) or
• Plicamycin (e.g., Mithracin) or
• Zidovudine (e.g., AZT, Retrovir) or
• If you have ever been treated with radiation or cancer medicines—Floxuridine may increase the effects of these medicines or radiation on the blood

• Chickenpox (including recent exposure) or
• Herpes zoster (shingles)—Risk of severe disease affecting other parts of the body

• Hepatitis (history of)—Increased risk of hepatitis

• Kidney disease or
• Liver disease (other)—Effects of floxuridine may be increased because of slower removal from the body

• Infection—Floxuridine can decrease your body's ability to fight infection

Floxuridine sometimes causes nausea and vomiting. Tell your doctor if this occurs, especially if you have stomach pain.

Dosing—

The dose of floxuridine will be different for different patients. The dose that is used may depend on a number of things, including what the medicine is being used for, the patient's weight, and whether or not other medicines are also being taken. If you are receiving floxuridine at home, follow your doctor's orders or the directions on the label. If you have any questions about the proper dose of floxuridine, ask your doctor.

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly and to check for unwanted effects.

While you are being treated with floxuridine, and after you stop treatment with it, do not have any immunizations (vaccinations) without your doctor's approval. Floxuridine may lower your body's resistance and there is a chance you might get the infection the immunization is meant to prevent. In addition, other persons living in your household should not take oral polio vaccine since there is a chance they could pass the polio virus on to you. Also, avoid persons who have recently taken oral polio vaccine. Do not get close to them and do not stay in the same room with them for very long. If you cannot take these precautions, you should consider wearing a protective face mask that covers the nose and mouth.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Also, because of the way these medicines act on the body, there is a chance that they might cause other unwanted effects that may not occur until months or years after the medicine is used. These delayed effects may include certain types of cancer, such as leukemia. Discuss these possible effects with your doctor.

Check with your doctor or nurse immediately if any of the following side effects occur:

• More common
  • Diarrhea;  sores in mouth and on lips ;  stomach pain or cramps 
  
  

• Less common
  • Black, tarry stools;  heartburn;  nausea and vomiting;  scaling or redness of hands or feet;  swelling or soreness of the tongue  
  
  

• Rare
  • Blood in urine or stools;  cough or hoarseness ;  fever or chills;  lower back or side pain;  painful or difficult urination ;  pinpoint red spots on skin;  trouble in walking;  unusual bleeding or bruising ;  yellow eyes or skin 
  
  

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

• Less common or rare
  • Loss of appetite;  skin rash or itching  
  
  

This medicine sometimes causes temporary thinning of hair. After treatment with floxuridine has ended, normal hair growth should return.

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your health care professional.