Fluorouracil & Fluorouracil Prodrugs/Brivudine Interactions
This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.
Medical warning:
Very Serious. These medicines may interact and cause very harmful effects and are usually not taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.
How the interaction occurs:
Brivudine may slow down how quickly your body removes fluorouracil.
What might happen:
The amount of fluorouracil in your body may increase and cause additional or more severe side effects. Deaths have been reported.
What you should do about this interaction:
Do not take capecitabine, fluorouracil, or tegafur at the same time that you are taking brivudine, or if you have taken brivudine within the last 4 weeks, without consulting with your healthcare professional. Contact your healthcare professionals (e.g. doctor or pharmacist) right away if you have been prescribed brivudine together with capecitabine, fluorouracil, or tegafur. Also let your healthcare professional know right away if you have taken brivudine in the last 4 weeks and are starting a treatment cycle with capecitabine, fluorouracil, or tegafur. Seek medical attention right away if you develop pain, swelling, redness, or sores in your mouth or throat; pain, swelling, redness, or tingling on your hands or feet; diarrhea; fever, chills, or other signs of an infection; rash; unusual bleeding or bruising (such as black or tarry stool, blood in your urine); unusual tiredness, dizziness, or weakness; or chest pain.
- 1.Xeloda (capecitabine) UK Summary of Product Characteristics. Roche Products Limited April, 2019.
- 2.Ratz Bravo AE, Hofer S, Krahenbuhl S, Ludwig C. Fatal drug-drug interaction of brivudine and capecitabine. Acta Oncol 2009;48(4):631-3.
- 3.Garcia Herrera AN, Moncayola Vicen JC. Lethal interaction between 5-fluorouracil and brivudine. An Sist Sanit Navar 2018 Aug 29; 41(2):277-278.
- 4.Garcia Fernandez V, Garrido Arevalo M, Labrada Gonzalez E, Hidalgo Correas FJ. Fatal drug-drug interaction between 5-fluorouracil and brivudine. Farm Hosp 2013 Jan-Feb;37(1):72-3.
- 5.Baena-Canada JM, Martinez MJ, Garcia-Olmedo O, Jimenez-Barcenas R, Muriel-Cueto P. Interaction between capecitabine and brivudin in a patient with breast cancer. Nat Rev Clin Oncol 2010 Jan;7(1):55-8.
- 6.Spanish Agency of Medicines and Health Products (AEMPS). Safety Note: Brivudine (Brinix, Nervinex and Nervol): Life-Threatening Interaction with 5-Fluoropyrimidines. Available at: https://www.aemps.gob.es/informa/notasInformativas/medicamentosUsoHumano/s eguridad/2012/NI-MUH_FV_07-2012.htm June 1, 2012.
- 7.Spanish Agency of Medicines and Health Products (AEMPS). Safety Note: Brivudine (Nervinex): reminder that its administration is contraindicated together with antineoplastics, especially 5-fluoropyrimidines, due to the potentially deadly interaction. Available at: https://www.aemps.gob.es/informa/notasInformativas/medicamentosUsoHumano/s eguridad/2017/NI-MUH_FV_09-2017-brivudina-Nervinex.htm September 7, 2017.
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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.