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플루오로우라실

Fluorouracil

5-fluorouracil

항종양제 - 피리미딘 길항제IVIntralesionalTopical개고양이말

다른 이름: Adrucil · Efudix · 5-FU · 5-fluorouracil · fluorouracilo · fluorouracilum · NSC-19893 · Ro-2-9757 · WR-69596

VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료

150 mg/m2 IV weekly, or 5-10 mg/kg IV weeklyIV· weekly

체표면적(mg/m²) 기반 용량입니다. 투여 전에 체중을 체표면적으로 환산해야 합니다.

용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.

동물 종별 용량

🌎 NA — North America🌍 EU — Europe

개

적응증용량경로빈도기간지역
Canine mammary carcinoma (in combination with doxorubicin and cyclophosphamide-FAC protocol), dermal squamous cell carcinoma and GI tract tumors150 mg/m2 IV weekly, or 5-10 mg/kg IV weeklyIVweekly—🌎 NA
Systemic carcinomas150 mg/m2IVonce weekly OR once every 3 weeks when combined with carboplatin6 weeks (if used weekly)🌍 EU
Basal cell and squamous cell carcinomaApply to affected areatopicalq24hAs directed by oncologist🌍 EU
  • Systemic carcinomas: Reduce dose by half in patients with liver, renal, or bone marrow impairment.
  • Basal cell and squamous cell carcinoma: Wear gloves when applying. Prevent the dog from licking the area.

고양이

적응증용량경로빈도기간지역
ALLCONTRAINDICATEDALL——🌎 NA
All indicationsDO NOT USEPO/IM/IV/SC/topicalnullnull🌍 EU
  • ALL: Do NOT use in any form on cats
  • All indications: Strictly contraindicated. Causes potentially fatal neurotoxicity.

말

적응증용량경로빈도기간지역
Intratumoral injection with epinephrine into certain skin neoplasms (squamous cell carcinoma, melanoma, sarcoid)0.3 mL of 1:1000 epinephrine is added to each mL of 5-FU solution up to a maximum of 3 mL of epinephrine per total volume of 5-FU injected.Intratumoral——🌎 NA
  • Intratumoral injection with epinephrine into certain skin neoplasms (squamous cell carcinoma, melanoma, sarcoid): Epinephrine may result in white hair growth and can cause transient excitation, tachycardia, and shaking if absorbed systemically in sufficient quantities.

용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.

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개요

플루오로우라실(5-FU)은 수의학에서 특정 유형의 암을 치료하는 데 사용되는 피리미딘 유사체 항종양제입니다.

  • ​개​: 유선암(종종 독소루비신 및 시클로포스파미드와 함께 FAC 프로토콜의 일부로 사용됨), 피부 편평세포암 및 위장관 종양에 전신적으로 사용됩니다.
  • ​말​: 편평세포암, 흑색종, 말 사코이드와 같은 피부 종양을 치료하기 위해 국소적으로 또는 병변 내 주사(종종 에피네프린과 병용)로 사용됩니다.

​매우 중요한 종간 차이​: 5-FU는 ​고양이에게 절대 금기​입니다. 고양이는 이 약물을 안전하게 대사하는 데 필요한 경로가 부족하여, 아주 미량(예: 사람용 연고의 우발적 섭취)에도 심각하고 빠르게 진행되며 종종 치명적인 신경독성을 유발합니다.

작용 기전

Fluorouracil is a prodrug that acts as a cell-cycle phase-specific (S-phase) antimetabolite. It enters the cell and is converted into two primary active metabolites:

  • ​FUMP (fluorouridine monophosphate)​ → Inhibits the enzyme thymidylate synthase, which blocks the synthesis of deoxythymidine triphosphate (dTTP). This severely disrupts DNA synthesis and repair.
  • ​FUTP (fluorouridine triphosphate)​ → Falsely incorporates into RNA, disrupting RNA processing, function, and subsequent protein synthesis.

By halting both DNA and RNA functions, the drug induces apoptosis in rapidly dividing cancer cells.

안전성·주의사항

금기사항

  • CATS (Do NOT use in any form, including topical)
  • Patients with known hypersensitivity to the drug
  • Patients in poor nutritional states
  • Patients with depressed or reduced bone marrow function
  • Patients with concurrent serious infections
  • Pregnancy (Known teratogen - FDA Category D)
  • Cats (strictly contraindicated due to fatal neurotoxicity)
  • Patients with severe bone marrow suppression
  • Patients with severe hepatic or renal impairment (unless dose is adjusted)
  • Pregnancy and lactation

부작용

  • Dose-dependent myelosuppression (leukopenia, thrombocytopenia)
  • Gastrointestinal toxicity (nausea, vomiting, hemorrhagic diarrhea, GI ulceration/sloughing, stomatitis)
  • Neurotoxicity (ataxia, disorientation, seizures)
  • Fatal neurotoxicity in cats (even with topical exposure)
  • Anorexia
  • Diarrhoea
  • Leucopenia (nadir between 7 and 14 days)
  • Anaemia
  • Alopecia
  • Hyperpigmentation
  • Dermatitis
  • Cerebellar ataxia

주의

Fluorouracil has a very narrow therapeutic index and should only be administered by clinicians experienced with cancer chemotherapeutic agents.

Feline Toxicity: Cats develop severe, potentially fatal neurotoxicity. It is contraindicated in cats in any form.

Reproductive Safety: 5-FU is a known teratogen. Pregnant women and pregnant veterinary staff should avoid handling this medication or the bodily fluids/waste of treated animals. If a nursing dam requires treatment, milk replacer should be used as the drug inhibits DNA/RNA synthesis.

약물 상호작용

Leucovorin

May increase the gastrointestinal toxic effects of 5-FU

CimetidineMajor

Inhibits the metabolism of 5-FU, potentially increasing toxicity

CarboplatinMajor

Synergism in human oncology, but combination may be more toxic in small animals

MethotrexateMajor

Synergistic if administered before 5-FU; antagonistic if administered afterwards

VincristineMajor

Increases the cytotoxicity of 5-FU

모니터링

  • CBCs (nadirs usually occur between days 9-14 with recovery by day 30)
  • Gastrointestinal adverse effects (vomiting, diarrhea, anorexia)
  • Central nervous system adverse effects (ataxia, seizures)
  • Liver enzymes (alkaline phosphatase, serum transaminase), serum bilirubin, and lactic dehydrogenase (may increase)
  • Tumor response/Efficacy
  • Complete Blood Count (CBC) to monitor for leucopenia and thrombocytopenia (nadir 7-14 days)
  • Renal function parameters
  • Hepatic function parameters
  • Gastrointestinal signs (vomiting, diarrhea, stomatitis)
  • Neurological signs

약동학

반감기

고양이Prolonged (contributes to severe toxicity)개Short (minutes to hours depending on administration rate)

흡수

Administered systemically via the IV route.

분포

Primarily distributed into tumor cells, intestinal mucosa, liver, and bone marrow.

대사

Converted via intracellular mechanisms to active metabolites (FUMP and FUTP); the majority of the drug is metabolized by the liver.

배설

A small amount (about 15% of dose) is excreted unchanged into the urine.

과다투여

Overdoses are extremely serious and potentially fatal.

  • Dogs: The lowest reported toxic dose is 8.6 mg/kg (mild GI irritation/vomiting). Seizures and death have been reported at doses as low as 10.3 mg/kg, with survival rates potentially as low as 25%.
  • Cats: Very small ingestions (such as licking human topical creams) can cause death.

Clinical Signs: Onset is rapid (30 minutes to 6 hours). Signs include acute nausea, vomiting, hemorrhagic diarrhea, abdominal pain, GI sloughing, ataxia, severe nonresponsive seizures, severe dose-dependent myelosuppression affecting all cell lines, metabolic acidosis, and multi-organ failure.

Treatment:

  • Aggressive GI decontamination and protection if ingestion was very recent (though rapid onset may render this ineffective).
  • Intensive supportive care: antiemetics, fluid support, pain control, and temperature regulation.
  • Seizure control: Diazepam is often unrewarding; barbiturates or general anesthesia are frequently required.
  • Broad-spectrum antibiotics to prevent secondary infections.
  • Filgrastim (Neupogen®) can be considered to stimulate bone marrow stem cell proliferation in dogs.
  • Intensive hematologic monitoring (CBCs every 3-4 days) for at least 3-4 weeks.

제품

제형

  • Injection solution
  • Topical solution
  • Injectable solution: 250 mg/vial, 500 mg/vial, 2500 mg/vial
  • Topical cream: 5%

인용의약품

  • Fluorouracil Injection: 50 mg/mL in 10 mL, 20 mL, 50 mL, & 100 mL vials and 10 mL amps (Adrucil®; generic)
  • Topical creams and solutions: 0.5% to 5% (used for actinic keratoses and superficial basal cell carcinomas)
  • Efudix 5% cream
  • Fluorouracil injectable solutions (various generics)

규제 현황

European Union✓ 승인됨처방전의약품EMA

Human-approved drug used under the cascade.

United Kingdom✓ 승인됨처방전의약품VMD

POM. Used under the prescribing cascade.

규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU

보관·안정성

Store injection between 15-30°C; avoid freezing and exposure to light. Slight color changes in the solution can be ignored. If a precipitate forms, the solution can be heated to 60°C and shaken vigorously to redissolve the drug. Cool to body temperature before administering. If unsuccessful in redissolving the drug, it should not be used.

보호자 정보

​고양이 보호자를 위한 매우 중요한 경고​: 5-FU가 포함된 사람용 연고(피부 병변에 사용)는 고양이에게 ​매우 독성이 강하며 종종 치명적​입니다. 아주 조금만 핥거나 약이 묻은 곳을 밟고 그루밍을 하는 것만으로도 사망에 이를 수 있습니다. 이러한 약물은 고양이가 절대 닿을 수 없는 곳에 보관하십시오.

  • ​심각한 부작용​: 이것이 강력한 항암제임을 이해해야 합니다. 심각한 위장 장애, 골수 억제(감염 위험 증가) 및 신경계 증상을 유발할 수 있습니다.
  • ​모니터링​: 반려동물의 백혈구 수치가 안전하게 유지되는지 확인하기 위해 혈액 검사(CBC)를 위한 재진 일정을 엄격히 준수해야 합니다.
  • ​가정 내 안전​: 이 약물은 기형 유발 물질(선천적 결함을 유발할 수 있음)로 알려져 있으며 체액으로 배설되므로, 임산부, 수유부 및 어린이는 치료 후 며칠 동안 약물이나 반려동물의 배설물(소변/대변)과의 접촉을 피해야 합니다. 배설물을 치울 때는 장갑을 착용하십시오.

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