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Drug Safety-related Labeling Changes (SrLC)

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FLUOROURACIL (NDA-012209)

(FLUOROURACIL)

Safety-related Labeling Changes Approved by FDA Center for Drug Evaluation and Research (CDER)

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07/29/2016 (SUPPL-40)

Approved Drug Label (PDF)

5 Warnings and Precautions

Dihydropyrimidine Dehydrogenase Deficiency

  • Based on postmarketing reports, patients with certain homozygous or certain compound heterozygous mutations in the DPD gene that result in complete or near complete absence of DPD activity are at increased risk for acute early-onset of toxicity and severe, life-threatening, or fatal adverse reactions caused by XELODA (e.g., mucositis, diarrhea, neutropenia, and neurotoxicity). Patients with partial DPD activity may also have increased risk of severe, life threatening, or fatal adverse reactions caused by XELODA.
  • Withhold or permanently discontinue XELODA based on clinical assessment of the onset, duration and severity of the observed toxicities in patients with evidence of acute early-onset or unusually severe toxicity, which may indicate near complete or total absence of DPD activity. No XELODA dose has been proven safe for patients with complete absence of DPD activity. There is insufficient data to recommend a specific dose in patients with partial DPD activity as measured by any specific test.