Chemically, it is pyrimidine and is identical to uracil (found naturally in the body), but has a fluorine atom instead of a hydrogen atom at the C-5 position. It works via two mechanisms: firstly, inhibiting thymidylate synthase, an enzyme involved in nucleotide metabolism and, secondly, it is misincorporated into RNA and DNA, disrupting their functions.
It is often co-administered with other chemotherapeutic agents, including methotrexate, irinotecan and oxaliplatin. It has traditionally been given intravenously, but is available orally as a prodrug, capecitabine.
Cautions and Interactions
- Hand-foot syndrome (Palmar-plantar erythrodysaesthesia)
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