Special precautions for disposal and other handling: Due to the possible mutagenic and carcinogenic effects, enhanced safety precautions for hospital staff and physicians apply. While handling fluorouracil any contact with skin and mucous membranes should be avoided. Failing this, immediately wash with soap and water.
In the event of contact with the eyes, the affected area should be washed with copious amounts of water; and medical attention should be sought. All provisions must be made to allow for absolutely aseptic work. The use of a workspace with laminar flow is recommended. Protective clothing must be worn while handling fluorouracil.
Pregnant staff must not work with fluorouracil.
Inactivation: 700 °C Sodium hypochlorite (liquor natrii hypochlorosi) diluted with 10 parts of water; Concentrated NaOH over several hours.
The ready solution should be used immediately after preparation.
If a precipitate has formed as a result of exposure to low temperatures, redissolve by careful heating to 60°C accompanied by shaking. Allow to cool prior to use.
Loss of efficacy due to the adsorption of fluorouracil in the glass infusion container has been described in the literature.
The handling and disposal regulations for cytostatic agents must be met.
Any unused medicinal product or waste material should be disposed of in accordance with local requirements.
Incompatibilities: Fluorouracil should only be diluted with physiological saline or 5% glucose solution.
Fluorouracil must not be diluted with strongly buffered solutions with pH <8, since fluorouracil precipitates in this environment. Do not mix with other chemotherapeutic solutions.
Incompatibilities with following substances have been reported: Cisplatin, cytarabine, diazepam, doxorubicin, droperidol, filgrastim, gallium nitrate, leucovorin, methotrexate, metoclopramide, morphine, ondansetron, parenteral nutrition solutions, vinorelbine.
Calcium folinate: Fluorouracil must not be mixed in the same infusion with calcium folinate because a precipitate may form. Fluorouracil 50 mg/ml with calcium folinate 20 mg/ml, with or without dextrose 5% in water, has been shown to be incompatible when mixed in different amounts and stored at 4°C, 23°C or 32°C in polyvinyl chloride containers.