From the Guidelines
The recommended dosing regimen for 5-fluorouracil (5-FU) in cancer treatment is 1000 mg/m² (continuous infusion) once per day on days 1-4 (week 1) and 29-32 (week 5), as part of a combination regimen with mitomycin-C (MMC) or cisplatin, as stated in the ASCO guideline 1.
Dosing Regimens
- For anal cancer, the recommended dose is 1000 mg/m² (continuous infusion) once per day on days 1-4 (week 1) and 29-32 (week 5) when used in combination with MMC or cisplatin 1.
- For colorectal cancer, common regimens include 425 mg/m² intravenously daily for 5 days every 4 weeks, or 500-600 mg/m² as a weekly infusion, with dose adjustments necessary for patients with renal or hepatic impairment 1.
Combination Therapies
- 5-FU can be used in combination with other agents such as leucovorin, oxaliplatin, and irinotecan, with specific dosing regimens outlined in the guidelines 1.
Administration and Monitoring
- Treatment should be administered under oncology supervision with appropriate antiemetics and hydration to manage side effects like nausea, mucositis, and myelosuppression.
- Close monitoring for toxicities is essential, with dose adjustments made as necessary to minimize adverse effects.
From the FDA Drug Label
DOSAGE AND ADMINISTRATION: ... The FDA drug label does not answer the question.
From the Research
Recommended Dosing Regimen for 5-Fluorouracil (5FU)
The recommended dosing regimen for 5-fluorouracil (5FU) in cancer treatment varies depending on the type of cancer, patient population, and treatment schedule.
- For metastatic carcinoma of the pancreas, a continuous ambulatory 5FU infusion of 200-300 mg/m2/day has been used 2.
- In a Phase I trial, the maximum tolerated dose of continuous venous infusion of 5FU was found to be 450 mg/m2/day, with mucositis being the principal dose-limiting toxic effect 3.
- For metastatic colorectal cancer, a weekly schedule of 5FU with high-dose folinic acid modulation has been used, with a recommended dose of 720 mg/m2 per week 4.
- In a Multicenter Phase II study, high-dose 5FU was administered as a continuous intravenous infusion at a dose of 60 mg/kg/48 hours (2400 mg/m2/48 hours) in combination with leucovorin and recombinant interferon-alpha-2b for patients with advanced colorectal cancer 5.
- For metastatic breast cancer, a low-dose continuous intravenous infusion of 5FU at an initial daily dose of 250 mg/m2 has been used, administered continuously for 21 days followed by a 7-day rest 6.
Toxicity and Tolerance
The toxicity and tolerance of 5FU vary depending on the dosing regimen and patient population.