Fluorouracil (often referred to as 5-FU) is an antineoplastic (anti-cancer) medication used to treat various types of cancer. It works by interfering with the synthesis of DNA and RNA, which are necessary for the growth and survival of both normal cells and cancer cells.

Fluorouracil (5-FU or 5 Fluorouracil, Efudix, Adrucil) is classified as an antimetabolite. It is a cytotoxic chemotherapeutic drug used to treat a variety of cancers.

Indications of 5 Fluorouracil:

• Breast cancer:
  • It is indicated for the management of breast carcinoma.
• Colon and rectal cancer:
  • Fluorouracil is used in the treatment of colon and rectal cancer.
• Gastric cancer:
  • Malignancies of the stomach can be treated by fluorouracil.
• Pancreatic cancer:
  • It is used for the management of pancreatic malignancy.
• Off Label Use of 5 Fluorouracil in Adults:
  • Anal carcinoma
  • Bladder cancer
  • Cervical cancer
  • Advanced esophageal cancer
  • Glaucoma surgery (adjunctive therapy)
  • Head and neck cancer
  • Advanced Hepatobiliary cancers
  • Pancreatic Neuroendocrine tumors
  • Advanced Penile squamous cell cancer
  • Unknown primary squamous cell cancer
  • Advanced Vulvar cancer

5 Fluorouracil dose in adults:

5 Fluorouracil dose in the treatment of Breast cancer: 

CEF or FEC regimen:

• Drugs used: 5-Fluorouracil, cyclophosphamide, and epirubicin.
• Dose of 5-Fluorouracil: 500 units (based on body area) on the first and eighth days, repeating every 28 days.
• How many times: This combination is given 6 times.

CMF regimen:

• Drugs used: 5-Fluorouracil, cyclophosphamide, and methotrexate.
• Dose of 5-Fluorouracil: 600 units (based on body area) on the first and eighth days, repeating every 28 days.
• How many times: This combination is given 6 times.

CAF or FAC regimen: (This is an off-label use, which means it's not the standard approved way, but some doctors might use it based on research.)

• Drugs used: 5-Fluorouracil, cyclophosphamide, and doxorubicin.
• Dose of 5-Fluorouracil: 500 units (based on body area) on the first and eighth days, repeating every 21 to 28 days.
• How many times: This combination is given 6 times.

In each of these, the "units" refer to "mg/m^2", which is a way to measure the dose based on a person's body surface area.

5 Fluorouracil dose in the treatment of colorectal cancer:

Standard 5-FU Combination:

• Dose: 400 units injection on the first day, then 1,200 to 1,500 units drip over 2 days every 2 weeks.
• Mixed with: leucovorin and either oxaliplatin or irinotecan.

Roswell Park regimen:

• Dose: 500 units injection on days 1, 8, 15, 22, 29, and 36 every 8 weeks.
• Mixed with: leucovorin.
• How many times: Given 4 times.

FOLFOX6 and mFOLFOX6 regimen:

• Dose: 400 units injection on the first day, then 1,200 units drip over 2 days every 2 weeks.
• Mixed with: leucovorin and oxaliplatin.
• Given until: The cancer gets worse or side effects become too much.

FOLFIRI regimen:

• Dose: 400 units injection on the first day, then 1,200 units drip over 2 days every 2 weeks. After 2 rounds, the drip can be increased to 1,500 units.
• Mixed with: leucovorin and irinotecan.
• Given until: The cancer gets worse or side effects become too much.

FLOX regimen (Not the usual approved way):

• Dose: 500 units injection on days 1, 8, 15, 22, 29, and 36 every 8 weeks.
• Mixed with: leucovorin and oxaliplatin.
• How many times: Given 3 times.

In all these, the "units" refer to "mg/m^2", which is a dose based on a person's body size.

5 Fluorouracil dose in the treatment of Gastric cancer:

Standard Treatment with Platinum:

• Dose: Between 200 and 1,000 units drip over 24 hours.
• How often and for how long: Varies, depending on the specific treatment plan.

CF regimen:

• Dose: 1,000 units drip over 4 days, twice (days 1-4 and days 29-32) in a 35-day cycle.
• Mixed with: cisplatin.
• Purpose: Used before surgery combined with radiation.

ECF regimen (when surgery can be done):

• Dose: 200 units drip daily for 21 days, every 3 weeks.
• Mixed with: epirubicin and cisplatin.
• How many times: 6 cycles (half before surgery, half after).

ECF or EOF regimen (for advanced disease):

• Dose: 200 units drip daily for 21 days, every 3 weeks.
• Mixed with: epirubicin and either cisplatin or oxaliplatin.
• How long: Planned for 24 weeks.

TCF or DCF regimen:

• Dose: 750 units drip daily for 5 days, every 3 weeks.
• Mixed with: docetaxel and cisplatin.
• Given until: The cancer worsens or side effects become too severe.

ToGA regimen (for HER2-positive cancer):

• Dose: 800 units drip daily for 5 days, every 3 weeks.
• Mixed with: cisplatin and trastuzumab (a targeted therapy).
• Given until: The cancer worsens or side effects become too severe.

In all these, the "units" refer to "mg/m^2", which helps determine the dose based on a person's body size.

5 Fluorouracil dose in the treatment of Pancreatic cancer: 

• Metastatic Disease (cancer has spread to other parts of the body):

FOLFIRINOX regimen:

• • Dose: 400 units injection on the first day, then 1,200 units drip over 2 days every 14 days.
  • Mixed with: leucovorin, irinotecan, and oxaliplatin.
  • Given until: The cancer gets worse or side effects become too harsh. Usually given for 12 cycles.
• After Surgery (when all visible cancer is removed):

mFOLFIRINOX regimen:

• • Dose: 2,400 units drip over 46 hours every 14 days.
  • Mixed with: leucovorin, irinotecan, and oxaliplatin.
  • Duration: 24 weeks (about 6 months).
• Chemoradiation Therapy (Not the usual approved way):
  • Dose: 250 units drip every day for 3 weeks, then continued during radiation treatment.
  • Purpose: Given with radiation to enhance its effect.
• Fluorouracil-Leucovorin (Also not the usual approved way):
  • Dose: 425 units injection daily for 5 days, every 28 days.
  • Mixed with: leucovorin.
  • How many times: 6 cycles.

Here, the "units" refer to "mg/m^2", which is a dose based on a person's body size.

5 Fluorouracil dose in the treatment of Anal carcinoma (off-label):

5-Fluorouracil dose:

• Dose: 1,000 units as a drip over 4 days, twice (days 1-4 and days 29-32).
• Used with: mitomycin (another drug) and radiation therapy.

5 Fluorouracil dose in the treatment of Bladder cancer (off-label):

5-Fluorouracil dose:

• Dose: 500 units as a continuous drip during specific radiation treatments (fractions 1-5 and 16-20).
• Used with: mitomycin (another drug) and radiation therapy.

5 Fluorouracil dose in the treatment of Cervical cancer (off-label):

5-Fluorouracil dose:

• Dose: 1,000 units drip over 4 days (days 1-4).
• Mixed with: cisplatin (another drug) and radiation therapy.
• How often: Every 3 weeks.
• How many times: Given 3 times (or 3 cycles).

5 Fluorouracil dose in the treatment of Esophageal cancer (off-label): 

CF regimen:

• Dose: 1,000 units drip over 4 days, twice (days 1-4 and days 29-32) in a 35-day cycle.
• Mixed with: cisplatin.
• Purpose: Used before surgery combined with radiation.

ECF regimen (when surgery can be done):

• Dose: 200 units drip daily for 21 days, every 3 weeks.
• Mixed with: epirubicin and cisplatin.
• How many times: 6 cycles (half before surgery, half after).

ECF or EOF regimen (for advanced disease):

• Dose: 200 units drip daily for 21 days, every 3 weeks.
• Mixed with: epirubicin and either cisplatin or oxaliplatin.
• How long: Planned for 24 weeks.

MCF regimen:

• Dose: 300 units drip daily for up to 6 months.
• Mixed with: mitomycin and cisplatin.

TCF or DCF regimen:

• Dose: 750 units drip daily for 5 days, every 3 weeks.
• Mixed with: docetaxel and cisplatin.
• Given until: The cancer gets worse or side effects become too harsh.

In these descriptions, the "units" refer to "mg/m^2", indicating the dose is adjusted based on a person's body size.

5 Fluorouracil dose in the treatment of Glaucoma surgery, adjunctive therapy (off-label): Ophthalmic:

During Surgery (topical application):

• Method: Use a sponge soaked in a 50 mg/mL solution of fluorouracil.
• How long: Place the sponge for 5 minutes.

After Surgery (subconjunctival injection, or injection under the thin tissue covering the white of the eye):

• Dose: 5 mg.
• How often: Once a day for 10 days OR once a day for 1 week and then every other day the next week. This makes a total of 10 doses.

5 Fluorouracil dose in the treatment of squamous cell cancer of the head and neck (off-label):  

Platinum-Fluorouracil (CF) regimen:

• Dose: 1,000 units drip over 4 days, every 3 weeks.
• Mixed with: cisplatin.
• How many times: At least 6 cycles.

OR

• Dose: 1,000 units drip over 4 days, every 4 weeks.
• Mixed with: carboplatin.

OR

• Dose: 600 units drip over 4 days, repeated twice (days 1-4, days 22-25, and days 43-46).
• Mixed with: carboplatin and radiation.

TPF regimen:

• Dose: 1,000 units drip over 4 days, every 3 weeks.
• Mixed with: docetaxel and cisplatin.
• How many times: 3 cycles, then followed by combined chemo and radiation.

OR

• Dose: 750 units drip daily for 5 days, every 3 weeks.
• Mixed with: docetaxel and cisplatin.
• How many times: Up to 4 cycles, then radiation if the cancer doesn't get worse.

Platinum, 5-FU, and cetuximab regimen:

• Dose: 1,000 units drip over 4 days, every 3 weeks.
• Mixed with: cetuximab and either cisplatin or carboplatin.
• How many times: Up to 6 cycles.

In all these simplifications, "units" refers to "mg/m^2", meaning the dose is adjusted based on a person's body size.

5 Fluorouracil dose in the treatment of Hepatobiliary cancer (off-label):

5-Fluorouracil dose:

• Dose: 600 units given as an injection on days 1, 8, and 15.
• How often: Every 4 weeks.
• Mixed with: gemcitabine and leucovorin.

It's worth noting that more research might be needed to confirm how effective this treatment is for hepatobiliary cancer.

5 Fluorouracil dose in the treatment of pancreatic Neuroendocrine tumors (off-label): 

5-Fluorouracil dose:

• Dose: 400 units given as an injection from day 1 to day 5.
• How often: Every 28 days.
• Mixed with: doxorubicin and streptozocin.
• How many times: At least 4 cycles and continued until the cancer gets worse or the side effects become too harsh.

More research might be required to determine how effective this treatment is for pancreatic neuroendocrine tumors.

5 Fluorouracil dose in the treatment of advanced Penile squamous cell cancer (off-label): 

5-Fluorouracil dose:

• Dose: Between 800 to 1,000 units given as a continuous drip over 4 days.
• How often: Every 21 days.
• Mixed with: cisplatin.

It's important to note that more research might be needed to understand how effective this treatment is for penile cancer.

5 Fluorouracil dose in the treatment of Unknown primary squamous cell cancer (off-label): 

First Method:

• Dose: 750 units given as a continuous drip over 5 days.
• How often: Every 21 days.
• Mixed with: docetaxel and cisplatin.
• How many times: 3 cycles.

Second Method:

• Dose: 500 units given as a continuous drip over 5 days.
• How often: Every 21 days.
• Mixed with: paclitaxel and cisplatin.
• How many times: 3 cycles.

Third Method:

• Dose: 400 units injection on the first day, followed by a 1,200 units drip over 2 days.
• How often: Every 2 weeks.
• Mixed with: leucovorin and oxaliplatin.

Fourth Method:

• Dose: 700 units given as a continuous drip over 5 days.
• How often: Every 28 days.
• Mixed with: cisplatin.
• Given until: The cancer gets worse or the side effects become too much.

It's important to note that more research might be needed to confirm the best way to use 5-Fluorouracil for this type of cancer.

5 Fluorouracil dose in the treatment of advanced Vulvar cancer, (off-label):

5-Fluorouracil dose:

• Dose: 750 units given as a continuous drip over 5 days.
• How often: Every 14 days.
• Mixed with: radiation treatment and mitomycin.
• How many times: 2 cycles.

It's worth noting that more research might be needed to confirm how effective this treatment is for vulvar cancer.

5 Fluorouracil dose in children:

Note: Dose, frequency, number of doses, and/or start date may vary by protocol and treatment phase. Refer to individual protocols.

5 Fluorouracil dose in the treatment of Hepatoblastoma: 

For babies, kids, and teenagers:

• Dose: 600 units given through an IV.
• How often: Every 3 weeks.
• When: On the 2nd or 3rd day.
• Mixed with: cisplatin and vincristine. Sometimes, it's also mixed with doxorubicin.

However, there's limited information on this treatment.

5 Fluorouracil dose in the treatment of Nasopharyngeal carcinoma:

For kids 8 years or older and teenagers:

• Dose: 1,000 units given as a continuous IV drip.
• How long: Lasts 3 to 5 days.
• How often: Every 3 to 4 weeks.
• How many times: Given 3 to 4 cycles.
• Used with: Other cancer drugs.

But, there's limited info on this treatment.

5 Fluorouracil Pregnancy Risk Factor D

• Animal studies showed problems like increased resorptions (loss of pregnancy), embryo death, and birth defects.
• How fluorouracil works suggests it might harm the fetus if given to pregnant women. This is also stated by the drug’s manufacturer.
• Both men and women who can have children should use reliable birth control during fluorouracil treatment and for 3 months after stopping it.
• If a pregnant woman has breast cancer, she might receive chemotherapy, which can include fluorouracil. However:
  • It's best to avoid giving this drug in the first 3 months of pregnancy.
  • After 35 weeks into the pregnancy, this drug shouldn't be used.
  • It's also best not to give the drug within 3 weeks before the baby is due.
• The European Society for Medical Oncology has guidelines on treating cancer during pregnancy. They suggest:
  • Refer pregnant patients with cancer to special centers with experience in this area.
  • A team of specialists, including a baby doctor, pregnancy doctor, and cancer doctors, should handle the care.
  • If chemotherapy is needed, avoid giving it in the first 3 months of pregnancy.
  • There should be a gap of 3 weeks between the last chemo dose and the baby's birth.
  • After 33 weeks of pregnancy, chemo, in general, should be stopped.
• One more thing to note: fluorouracil might affect the ability to have children, for both men and women.

Use 5 Fluorouracil during breastfeeding

• We don't know if fluorouracil goes into breast milk.
• The company that makes the drug recommends that if a mother is taking fluorouracil, she should decide between stopping breastfeeding or stopping the medication.
• This is because there might be a risk of harmful effects on the baby.
• The decision will be based on what's most important for the mother.

5 Fluorouracil Dose adjustment in renal disease:

The company that makes the drug hasn't given specific instructions for adjusting the dose based on kidney function. However, they advise to be careful.

• If the kidney's cleaning capacity (CrCl) is less than 50 mL/minute, or if a continuous kidney cleaning treatment (CRRT) is used: No change to the regular dose is needed.
• If a person is on hemodialysis (a type of kidney treatment):
  • Some experts say: Give the regular dose after the hemodialysis on the days of dialysis.
  • Others say: Give half the regular dose after the hemodialysis.

5 Fluorouracil Dose adjustment in liver disease:

The company that makes the drug doesn't give specific instructions for adjusting the dose if someone has liver problems. But they do say to be careful.

• If the liver test (bilirubin level) is more than 5 mg/dL: Don't use the drug.
• If there's some liver damage (specific level not mentioned): Start with less than half the usual dose. If there aren't any bad reactions, the dose can be increased later.

Side effects of 5 Fluorouracil

Toxicity depends on the duration of treatment and/or rate of administration.

• Cardiovascular:
  • Angina Pectoris
  • Cardiac Arrhythmia
  • Cardiac Failure
  • Cerebrovascular Accident
  • Ischemic Heart Disease
  • Local Thrombophlebitis
  • Myocardial Infarction
  • Vasospasm
  • Ventricular Ectopy
• Central Nervous System:
  • Cerebellar Syndrome (Acute)
  • Confusion
  • Disorientation
  • Euphoria
  • Headache
• Dermatologic:
  • Alopecia
  • Changes In Nails (Including Nail Loss)
  • Dermatitis
  • Hyperpigmentation (Supravenous)
  • Maculopapular Rash (Pruritic)
  • Palmar-Plantar Erythrodysesthesia
  • Skin Fissure
  • Skin Photosensitivity
  • Stevens-Johnson Syndrome
  • Toxic Epidermal Necrolysis
  • Xeroderma
• Gastrointestinal:
  • Anorexia
  • Diarrhea
  • Esophagopharyngitis
  • Gastrointestinal Hemorrhage
  • Gastrointestinal Ulcer
  • Mesenteric Ischemia (Acute)
  • Nausea
  • Stomatitis
  • Tissue Sloughing (Gastrointestinal)
  • Vomiting
• Hematologic & Oncologic:
  • Agranulocytosis
  • Anemia
  • Leukopenia (Nadir: Days 9 To 14; Recovery By Day 30)
  • Pancytopenia
  • Thrombocytopenia
• Hypersensitivity:
  • Anaphylaxis
  • Hypersensitivity Reaction (Generalized)
• Ophthalmic:
  • Lacrimal Stenosis
  • Lacrimation
  • Nystagmus
  • Photophobia
  • Visual Disturbance
• Respiratory:
  • Epistaxis

Contraindications to Injection 5 Fluorouracil:

U.S. manufacturer's information:

• There are no specific situations listed where the drug shouldn't be used.

Canadian information:

• The drug shouldn't be used in people who:
  • Are allergic to fluorouracil or any ingredient in the drug.
  • Are weak or in poor health.
  • Have poor nutrition.
  • Have a weak bone marrow, especially after radiation or after treatment with other cancer drugs.
  • Have serious infections.

Warnings and precautions

Suppression of bone marrow

• Fluorouracil can lead to severe and even deadly blood problems (neutropenia, thrombocytopenia, and anemia).
• The lowest level of white blood cells (neutrophils) usually happens around 9 to 14 days after taking the drug.
• Doctors should check blood counts before each treatment round.
• If the drug is taken weekly, or at a similar frequency, blood counts should be checked weekly.
• Doctors should also check if there are clinical reasons to check blood counts.
• If blood counts are very bad (grade 4), the drug should be stopped.
• Once blood counts get better (grade 1 or lower), the drug can be taken again, but with a lower dose.

Cardiotoxicity

• After people used the drug, there were reports of heart issues like angina, heart attack, irregular heartbeats, and heart failure.
• Risk factors for these heart problems are giving the drug as a constant drip (instead of a quick injection) and having heart artery issues.
• If someone gets heart problems from the drug, the drug should be stopped.
• We don't know if it's safe to start the drug again after heart problems get better.

In a statement from the American Heart Association:

• The drug fluorouracil might either hurt the heart directly (reversibly) or make existing heart problems worse (moderate to major level).

Toxicity to the GI:

• Fluorouracil can cause severe diarrhea.
• If someone gets very bad (grade 3 or 4) diarrhea, the drug should be stopped. Once the diarrhea is better or only mild (grade 1 or lower), the drug can be taken again, but with a smaller dose.
• For people with bad diarrhea, they may need fluids, balance their electrolytes, and/or take medicine to stop the diarrhea.
• The drug can also cause issues like mouth sores, throat pain, or damage to the throat lining. This can lead to the skin inside the mouth or throat peeling or ulcers.
• Giving the drug as a quick injection, instead of a constant drip, might make mouth sores happen more often.
• If someone gets very bad (grade 3 or 4) mouth or throat problems, the drug should be stopped. When the problem is better or only mild (grade 1 or lower), the drug can be taken again, but with a smaller dose.

Hand-foot syndrome

• Fluorouracil can cause a condition called hand-foot syndrome (HFS).
• What does HFS feel like? You might feel tingling, pain, or swelling in your hands and feet. They can become red, tender, and the skin might peel off.
• HFS is more likely if you get the drug as a continuous drip instead of a quick injection. It's also more common in people who've had chemotherapy before.
• Usually, HFS starts after taking fluorouracil for about 8 to 9 weeks, but it can happen sooner.
• If you have HFS, you might need special care to feel better.
• If HFS is medium to severe (grade 2 or 3), the drug should be stopped. Once it's better or only mild (grade 1 or lower), the drug can be taken again, but with a smaller dose.

Hyperammonemic Encephalopathy:

• Fluorouracil might cause a brain problem called hyperammonemic encephalopathy, even if the person doesn't have liver disease or another clear reason for it.
• Signs of this problem include: sudden changes in how the brain works, confusion, not knowing where you are, coma, or unsteady movements. These signs can show up within 3 days after starting the fluorouracil treatment.
• This condition has been linked to a high level of ammonia in the blood.
• If someone shows signs of this brain problem, the drug should be stopped. They might also need treatment to lower the ammonia in their blood.
• We don't know if it's safe to start the drug again after the brain problem gets better.

Neurotoxicity:

• Fluorouracil might cause problems with the brain and nerves. Some people reported sudden issues with a part of the brain called the cerebellum and other brain-related problems.
• Signs of these problems include confusion, not knowing where you are, unsteady movements, or vision problems.
• If someone has these signs, the drug should be stopped.
• We don't know if it's safe to start the drug again after the brain or nerve problem gets better.

Deficiency in dihydropyrimidine hydrogenase

• Some people have changes in a gene that makes them lack an enzyme called dihydropyrimidine dehydrogenase (DPD). This enzyme helps the body process fluorouracil.
• Those with very low or no DPD are at a higher risk for severe and dangerous side effects from fluorouracil. This includes things like mouth sores, diarrhea, low white blood cell count, and brain issues. These problems can show up quickly and can be severe or even deadly.
• People with only a bit of DPD can also face severe or life-threatening side effects when taking fluorouracil.
• If someone shows signs of very early or unusually harsh side effects, it could mean they have little to no DPD. In such cases, the drug should be reduced in dosage or stopped completely.
• For those with no DPD, there's no safe dose of fluorouracil. And for those with a bit of DPD, there's no clear guideline on the right dose because there's not enough data.

Monitoring parameters:

Blood Tests:

• Complete Blood Count (CBC): Check before each treatment round. If treatment is weekly or similar, do this test every week. Also, do it if there are clinical reasons.
• Kidney Tests: To check how well kidneys are working.
• Liver Tests (LFTs): To check liver health.
• Blood Clotting Tests: INR and prothrombin time, especially if the patient is also taking blood thinners like coumarin.

Watch For Symptoms:

• Hand-Foot Syndrome: Redness, pain, or swelling in the hands and feet.
• Heart Problems: Like chest pain or irregular heartbeat.
• Brain and Nerve Issues: Confusion, unsteady movements, or vision problems.
• Mouth Sores (Stomatitis): Painful sores in the mouth.
• Diarrhea: Frequent loose or watery stools.
• Brain Issue from High Ammonia (Hyperammonemic Encephalopathy): Sudden changes in brain function, confusion, or coma.

How to administer 5 Fluorouracil?

Through IV (Intravenous)

• The rate at which it's given can vary. Always check the specific instructions.
• It can be given in three ways:
  • Directly and quickly into the vein (IV push).
  • Slowly over a short period (IV bolus).
  • Slowly over a longer period (continuous infusion).
• Fluorouracil can be irritating to the veins, so be careful to avoid leaking it outside the vein (extravasation).

Eye Application (off-label method)

• During Surgery: Cleanly apply sponges soaked in fluorouracil directly to the eye surgery site for glaucoma for 5 minutes.
• After Surgery: Injections are given under the thin layer covering the white of the eye (subconjunctival). But make sure to inject in areas that are 90 to 180 degrees away from where the surgery happened.

Mechanism of action of 5 Fluorouracil:

• Fluorouracil is like a fake building block for DNA and RNA.
• After it gets activated in the body, it tricks cells by taking the place of a real building block in RNA, which stops the cell from growing.
• Another activated form of the drug stops a key process, making it hard for the cell to create DNA properly.

Distribution:

• Fluorouracil spreads all around the body. It reaches the brain, bone marrow, intestines, and liver.

Metabolism:

• The liver processes fluorouracil using a special enzyme.
• To work, fluorouracil changes into active forms called F-UMP and F-dUMP.

How Long It Stays:

• After a quick injection, the drug's effects start fading within 8 to 20 minutes.

Leaving the Body:

• Fluorouracil gets out of the body through urine.
• About 5% to 20% of it remains unchanged in the urine within 6 hours.
• The rest breaks down into different forms and leaves over 3 to 4 hours.

International Brands of Fluorouracil:

• Adrucil
• 5-Fluril
• 5-FU
• Agicil
• Curacil
• Fivoflu
• Flonida
• Fluonco
• Flurablastin
• Fluracedyl
• Fluroblastin
• Fluroblastine
• Fluroxan
• Fu Ke
• La-Fu
• Pharmauracil
• Raciwel
• Ribofluor
• Sinofuan Implant
• Triosules
• Utoral

5 Fluorouracil Brand Names in Pakistan:

Fluorouracil Injection 25 mg/ml
Pharmauracil	Pharmedic (Pvt) Ltd.

Fluorouracil Injection 50 mg/ml
5-Fu	Highnoon Laboratories Ltd.
Curacil	Shafaz Pharma International (Pvt) Ltd.
Fluorouracil	Atco Laboratories Limited
Fluracil	Bio Pharma
Secouracil	S. Ejazuddin & Company
Utoral	Al-Habib Pharmaceuticals.

Fluorouracil Injection 100 mg/ml
Fluorouracil	Atco Laboratories Limited

Fluorouracil Injection 250 mg/ml
Fivuflu	Atco Laboratories Limited

Fluorouracil Injection 500 mg/ml
Fivuflu	Atco Laboratories Limited