Last update March 24, 2019

Fluorouracil (Topical use)

Likely Compatibility

Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.

Fluorouracil is an analogue of uracil which acts as an antimetabolite and is used as a cream or solution in the local treatment of precancerous and cancerous skin lesions.

It is also administered intravenously for other types of cancer. It is excreted in breastmilk in undetectable, clinically insignificant amounts (Peccatori 2012) that can be explained by its pharmacokinetics: rapid degradation to non-active metabolites and very low liposolubility (Pistilli 2013).

Because absorption through the skin is minimal, the topical application of fluorouracil over a small body surface does not pose any risk to the infant, therefore it is not necessary to interrupt breastfeeding (Hale 2017 p388).

It is advisable to avoid application in places that may come into direct contact with the infant, or clean well before the infant can come into contact with the treated area of the mother’s skin.

Given the strong existing evidence on the benefits of breastfeeding for the development of babies and the health of mothers, it is advisable to evaluate the risk-benefit of any maternal treatment, including chemotherapy, advising each mother who wishes to continue with breastfeeding on an individual basis (Koren 2013).


See below the information of this related product:

  • Fluorouracil (Unsafe. Moderate/severe adverse effects. Compatible under certain circumstances. Follow-up recommended. Use safer alternative or discontinue breastfeeding from 5 to 7 T ½ . Read Commentary.)

Alternatives

We do not have alternatives for Fluorouracil (Topical use).

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

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Group

Fluorouracil (Topical use) belongs to this group or family:

Tradenames

Main tradenames from several countries containing Fluorouracil (Topical use) in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 6 - 10 (Dermat.) %
Molecular weight 130 daltons
Protein Binding 10 (8 - 12) %
VD 15.5 l/Kg
pKa 7.76 -
T½ 0.27 (0.13 - 0.34) hours

References

  1. Hale TW, Rowe HE. Medications & Mothers' Milk. A Manual of Lactation Pharmacology. Springer Publishing Company. 2017
  2. Pistilli B, Bellettini G, Giovannetti E, Codacci-Pisanelli G, Azim HA Jr, Benedetti G, Sarno MA, Peccatori FA. Chemotherapy, targeted agents, antiemetics and growth-factors in human milk: how should we counsel cancer patients about breastfeeding? Cancer Treat Rev. 2013 May;39(3):207-11. Abstract
  3. Koren G, Carey N, Gagnon R, Maxwell C, Nulman I, Senikas V; Society of Obstetricians and Gynaecologists of Canada. Cancer chemotherapy and pregnancy. J Obstet Gynaecol Can. 2013 Mar;35(3):263-278. Abstract Full text (link to original source) Full text (in our servers)
  4. Peccatori FA, Giovannetti E, Pistilli B, Bellettini G, Codacci-Pisanelli G, Losekoot N, Curigliano G, Azim HA Jr, Goldhirsch A, Peters GJ. "The only thing I know is that I know nothing": 5-fluorouracil in human milk. Ann Oncol. 2012 Abstract Full text (link to original source) Full text (in our servers)
  5. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Abstract Full text (link to original source) Full text (in our servers)

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