Uses
What is topical fluorouracil used for?
Topical fluorouracil is commonly used to treat a skin condition called actinic keratosis (a type of precancerous growth), also called solar keratosis. This skin condition creates rough scaly patches usually on the skin of the face, ears, or scalp which may be caused by too much sun exposure. These patches may be considered the beginning stages of skin cancer. Topical fluorouracil may also be used to treat the superficial (beginning stage) of basal cell carcinoma (a type of skin cancer).
Topical fluorouracil may also be used for other conditions as determined by your healthcare provider.
How does topical fluorouracil work (mechanism of action)?
Topical fluorouracil interferes with the ability of cells to grow and divide. The medicine causes cell death, especially among cells that grow more rapidly such as those found in actinic keratoses and superficial basal cell carcinoma.
How is topical fluorouracil supplied (dosage forms)?
Topical fluorouracil is available as Carac, Efudex, Tolak, and generic topical fluorouracil in the following dosage forms that are applied to the skin.
- 0.5% topical cream
- 4% topical cream
- 5% topical cream
- 2% topical solution
- 5% topical solution
How should I store topical fluorouracil?
Topical fluorouracil should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place with the container tightly closed.
Side Effects
What are the most common side effects of topical fluorouracil?
The most common side effects of topical fluorouracil are local skin reactions such as skin redness, dryness, burning, pain, itching and swelling at the site of application. Tell your healthcare provider if you have any of these side effects that bother you.
There may be other side effects of topical fluorouracil that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.
What are the serious side effects of topical fluorouracil?
While less common, the most serious side effects of topical fluorouracil are described below, along with what to do if they happen.
Severe Allergic Reactions. Topical fluorouracil may cause allergic reactions, which can be serious. Stop using topical fluorouracil and get help right away if you have any of the following symptoms of a serious allergic reaction.
- Breathing problems or wheezing
- Racing heart
- Fever or general ill feeling
- Swollen lymph nodes
- Swelling of the face, lips, mouth, tongue, or throat
- Trouble swallowing or throat tightness
- Itching, skin rash, or pale red bumps on the skin called hives
- Nausea or vomiting
- Dizziness, feeling lightheaded, or fainting
- Stomach cramps
- Joint pain
Eye Problems. Topical fluorouracil may cause eye irritation, including burning, watering, stinging, swelling, and itching. Do not apply the medicine to your eyelids or the skin around your eyes. If topical fluorouracil accidentally gets into your eyes, flush your eyes with a large amount of water and get medical help right away.
Sensitivity to Sunlight. Your skin may be very sensitive to light from the sun and devices that give off similar light, such as sunlamps and tanning beds, while you are using certain drugs, including topical fluorouracil. This is called photosensitivity. Use sunscreen and wear a hat and clothes that cover your skin if you need to be in the sunlight. Exposing your skin to this kind of light, even for a short time, can cause your skin to be severely sunburned, blistered, or swollen. Tell your healthcare provider right away if any of these happen.
Warnings & Precautions
Who should not use topical fluorouracil?
Allergies to Ingredients. People who are allergic to any of the following should not use topical fluorouracil.
- Carac
- Efudex
- Tolak
- Fluorouracil
- Any of the ingredients in the specific product dispensed
Your pharmacist can tell you of all the ingredients in the specific topical fluorouracil products they stock.
Pregnancy. Do not use topical fluorouracil if you are pregnant or may become pregnant. If you become pregnant, contact your healthcare professional right away. See the Pregnancy section below for more details.
Dihydropyrimidine Dehydrogenase Enzyme Deficiency (DPD deficiency). Certain people may have a genetic condition where they do not break down some drugs very well, including topical fluorouracil. This condition may increase the possibility that topical fluorouracil will cause serious adverse effects. Do not use topical fluorouracil and tell your healthcare provider if you have a history of DPD deficiency. If you develop stomach pain, bloody diarrhea, vomiting, fever, or chills, stop using topical fluorouracil right away and contact your healthcare provider.
What should I know about topical fluorouracil before using it?
Do not use topical fluorouracil unless it has been prescribed to you by a healthcare provider. Use it as prescribed.
Do not share topical fluorouracil with other people, even if they have the same condition as you. It may harm them.
Keep topical fluorouracil out of the reach of children.
Do not use creams, lotions, other medicines, or cosmetics on the skin being treated with topical fluorouracil without talking with your healthcare provider.
Do not cover the skin that has topical fluorouracil on it with any kind of dressing or bandage without talking with your healthcare provider.
Skin irritation at the application site may continue for a few days or weeks after you stop using the medicine.
Keep topical fluorouracil out of the reach of pets and throw away any item used to apply topical fluorouracil in a trash container that is out of the reach of pets. Be careful to avoid getting topical fluorouracil on any items or surfaces that pets can reach. Topical fluorouracil may be fatal to a pet if the pet eats the medicine or licks the container or area of skin where topical fluorouracil is applied. Get emergency help right away from your veterinarian if your pet starts vomiting or having a seizure if your pet licks or eats anything that has topical fluorouracil on it.
Make sure you wash your hands thoroughly after applying or touching the area where topical fluorouracil is applied on your skin. Do not touch your eyes, nose, or mouth without washing your hands.
If you develop stomach pain, bloody diarrhea, vomiting, fever, or chills, stop using topical fluorouracil right away and contact your healthcare provider. You may have a genetic condition called DPD deficiency.
What should I tell my healthcare provider before using topical fluorouracil?
Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if topical fluorouracil is right for you.
In particular, make sure that you discuss any of the following.
Peanut Allergy. Some topical fluorouracil products contain peanut oil. Tell your healthcare provider if you have an allergy to peanuts.
Other skin conditions. Tell your healthcare provider about any other skin conditions or skin treatments you may be using, including products for acne, anti-aging, or steroids applied to the skin. Tell your healthcare provider if you have irritated or open areas of the skin where the treatment will be applied.
Pregnancy. Topical fluorouracil may cause harm to an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. Talk with your healthcare provider about birth control methods while taking topical fluorouracil and for some time after using topical fluorouracil. If you become pregnant, stop taking topical fluorouracil right away and contact your healthcare provider.
Breastfeeding. It is not known if topical fluorouracil passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should stop breastfeeding or stop using topical fluorouracil.
Interactions
Does topical fluorouracil interact with foods or drinks?
There are no known interactions between topical fluorouracil and foods or drinks.
It is unknown if drinking alcohol will affect topical fluorouracil.
Does topical fluorouracil interact with other medicines (drug interactions)?
There are no known interactions between topical fluorouracil and other medicines. Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.
Overdose/Missed Dose
What should I do if I accidentally use too much topical fluorouracil?
If you or someone else has used too much topical fluorouracil, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.
What should I do if I miss a dose of topical fluorouracil?
If you miss a dose, use it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only use the next dose. Do not use double or extra doses.
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