Cardiotoxicity of commercial 5-fluorouracil vials stems from the alkaline hydrolysis of this drug.
1992

Cardiotoxicity of 5-Fluorouracil

Sample size: 33 publication Evidence: high

Author Information

Author(s): L. Lemaire, M.C. Malet-Martino, M. de Forni, R. Martino, B. Lasserre

Primary Institution: Groupe de RMN Biome'dicale, Laboratoire des IMRCP, Universite Paul Sabatier

Hypothesis

The cardiotoxicity of 5-fluorouracil (FU) is due to impurities present in the injected vials.

Conclusion

The study found that a degradation compound of FU, formed during storage in alkaline conditions, is responsible for the cardiotoxicity of this drug.

Supporting Evidence

  • FAC was detected in the urine of patients treated with FU.
  • Cardiac events occurred in 9.3% of patients receiving high doses of FU.
  • Intracellular citrate levels rose significantly in treated hearts.

Takeaway

5-fluorouracil, a cancer treatment, can harm the heart because of bad stuff that forms when the medicine is stored incorrectly.

Methodology

The study used isolated perfused rabbit hearts and analyzed urine samples from patients treated with FU.

Limitations

The study primarily focused on specific vials of FU and may not generalize to all formulations.

Participant Demographics

15 patients treated with continuous i.v. infusion of FU, including 6 with cardiac symptoms.

Statistical Information

P-Value

<0.0005

Statistical Significance

p<0.05

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