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Also known as: 50-91-9, 5-fluorodeoxyuridine, 2'-deoxy-5-fluorouridine, Fluorodeoxyuridine, Fudr, 5-fluoro-2'-deoxyuridine
Molecular Formula
C9H11FN2O5
Molecular Weight
246.19  g/mol
InChI Key
ODKNJVUHOIMIIZ-RRKCRQDMSA-N
FDA UNII
039LU44I5M

Floxuridine
An antineoplastic antimetabolite that is metabolized to fluorouracil when administered by rapid injection; when administered by slow, continuous, intra-arterial infusion, it is converted to floxuridine monophosphate. It has been used to treat hepatic metastases of gastrointestinal adenocarcinomas and for palliation in malignant neoplasms of the liver and gastrointestinal tract.
Floxuridine is an Antimetabolite.
1 2D Structure

Floxuridine

2 Identification
2.1 Computed Descriptors
2.1.1 IUPAC Name
5-fluoro-1-[(2R,4S,5R)-4-hydroxy-5-(hydroxymethyl)oxolan-2-yl]pyrimidine-2,4-dione
2.1.2 InChI
InChI=1S/C9H11FN2O5/c10-4-2-12(9(16)11-8(4)15)7-1-5(14)6(3-13)17-7/h2,5-7,13-14H,1,3H2,(H,11,15,16)/t5-,6+,7+/m0/s1
2.1.3 InChI Key
ODKNJVUHOIMIIZ-RRKCRQDMSA-N
2.1.4 Canonical SMILES
C1C(C(OC1N2C=C(C(=O)NC2=O)F)CO)O
2.1.5 Isomeric SMILES
C1[C@@H]([C@H](O[C@H]1N2C=C(C(=O)NC2=O)F)CO)O
2.2 Other Identifiers
2.2.1 UNII
039LU44I5M
2.3 Synonyms
2.3.1 MeSH Synonyms

1. 5 Fluorodeoxyuridine

2. 5-fluorodeoxyuridine

3. 5-fudr

4. Fluorodeoxyuridine

5. Fudr

2.3.2 Depositor-Supplied Synonyms

1. 50-91-9

2. 5-fluorodeoxyuridine

3. 2'-deoxy-5-fluorouridine

4. Fluorodeoxyuridine

5. Fudr

6. 5-fluoro-2'-deoxyuridine

7. Fdurd

8. Deoxyfluorouridine

9. Fluoruridine Deoxyribose

10. Floxuridin

11. 5fdu

12. Floxuridinum

13. Floxiridina

14. 5-fluoro-2-desoxyuridine

15. 5-fluorouracil 2'-deoxyriboside

16. 5 Fluorodeoxyuridine

17. Beta-5-fluoro-2'-deoxyuridine

18. Floxuridinum [inn-latin]

19. Floxiridina [inn-spanish]

20. 5-fluoro-1-((2r,4s,5r)-4-hydroxy-5-(hydroxymethyl)tetrahydrofuran-2-yl)pyrimidine-2,4(1h,3h)-dione

21. 1-(2-deoxy-beta-d-ribofuranosyl)-5-fluorouracil

22. 5-fluoro-2-deoxyuridine

23. Uridine, 2'-deoxy-5-fluoro-

24. 5-fluorouracil Deoxyriboside

25. Nsc-27640

26. 1beta-d-2'-deoxyribofuranosyl-5-flurouracil

27. 1-beta-d-2'-deoxyribofuranosyl-5-flurouracil

28. 5-fudr

29. Fdur

30. (+)-5-fluoro-2'-deoxyuridine

31. Chebi:60761

32. (+)-5-fluorodeoxyuridine

33. 5-fdurd

34. 5-fluoro-1-[(2r,4s,5r)-4-hydroxy-5-(hydroxymethyl)oxolan-2-yl]-1,2,3,4-tetrahydropyrimidine-2,4-dione

35. Chembl917

36. Mls000069439

37. 039lu44i5m

38. Nsc 27640

39. Uridine, 2'-deoxy-5'-fluoro-

40. Ncgc00023722-05

41. Smr000059051

42. Dsstox_cid_3057

43. Ro 5-0360

44. Dsstox_rid_76855

45. Dsstox_gsid_23057

46. Fdu

47. Cas-50-91-9

48. 5-fluoro-1-((2r,4s,5r)-4-hydroxy-5-hydroxymethyl-tetrahydro-furan-2-yl)-1h-pyrimidine-2,4-dione

49. Hsdb 3227

50. Einecs 200-072-5

51. Mfcd00006530

52. Fudr (tn)

53. 5-fluoro-2'-deoxy-beta-uridine

54. Brn 0090221

55. Floxidine

56. Uridine, 2'-deoxy-5-fluoro

57. Nsc27640

58. Unii-039lu44i5m

59. Floxuridine [usan:usp:inn]

60. Ai3-50691

61. 5-floxuridine

62. Floxuridine,(s)

63. 5-fluoro-durd

64. Floxuridine (fludara)

65. Floxuridine (usp/inn)

66. Floxuridine [mi]

67. Opera_id_1559

68. Floxuridine [inn]

69. 2-deoxy-5'-fluorouridine

70. Floxuridine [hsdb]

71. Floxuridine [usan]

72. Epitope Id:138108

73. 5-fluor-1-(beta-2'-deoxyribofuranosyl)pyrimidin-2,4(1h,3h)-dion [czech]

74. Floxuridine [vandf]

75. Schembl4424

76. 2''-deoxy-5-fluorouridine

77. 2'-deoxy-5-fluoro Uridine

78. 5-fluoro-2''-deoxyuridine

79. Floxuridine [mart.]

80. Floxuridine [usp-rs]

81. Floxuridine [who-dd]

82. 5-24-06-00291 (beilstein Handbook Reference)

83. Mls002695934

84. Mls006011768

85. 5-fluoro-2''-deoxy-uridine

86. 2'-deoxy-5-fluoro-d-uridine

87. Gtpl4801

88. Dtxsid3023057

89. Floxuridine [orange Book]

90. Floxuridine [usp Impurity]

91. Hms2090i12

92. Hms2230n22

93. Hms3715a11

94. Floxuridine [usp Monograph]

95. Bcp02871

96. Hy-b0097

97. Zinc3813010

98. Tox21_110892

99. 5-fluor-1-(beta-2'-deoxyribofuranosyl)pyrimidin-2,4(1h,3h)-dion

100. Bbl033765

101. Bdbm50340678

102. S1299

103. Stk801909

104. Akos005622662

105. Tox21_110892_1

106. Bcp9000691

107. Ccg-220965

108. Cs-1827

109. Db00322

110. Ps-7520

111. Sri-9246-15

112. Sri-9246_18

113. Ncgc00023722-03

114. Ncgc00023722-06

115. Ncgc00023722-08

116. 1-[(4s,2r,5r)-4-hydroxy-5-(hydroxymethyl)oxolan-2-yl]-5-fluoro-1,3-dihydropyri Midine-2,4-dione

117. 136353-77-0

118. Ac-16391

119. Bcp0726000269

120. D2235

121. En300-52649

122. D04197

123. 006f530

124. Sr-01000000001

125. J-700034

126. Q5462356

127. Sr-01000000001-2

128. Brd-k47832606-001-26-9

129. Brd-k47832606-001-30-1

130. 5-fluoro-2'-deoxyuridine, Thymidylate Synthase Inhibitor

131. Z802671482

132. 1-(beta-d-2-deoxy-erythro-pentofuranosyl)-5-fluorouracil

133. Floxuridine, United States Pharmacopeia (usp) Reference Standard

134. 5-fluoro-1-(4-hydroxy-5-hydroxymethyl-tetrahydro-furan-2-yl)-1h-pyrimidine-2,4-dione

135. 5-fluoro-1-((2r,4s,5r)-4-hydroxy-5-(hydroxymethyl)-tetrahydrofuran-2-yl)pyrimidine-2,4(1h,3h)-dione

136. 5-fluoro-1-[(2r,4s,5r)-4-hydroxy-5-(hydroxymethyl)tetrahydrofuran-2-yl]pyrimidine-2,4-dione

2.4 Create Date
2005-06-24
3 Chemical and Physical Properties
Molecular Weight 246.19 g/mol
Molecular Formula C9H11FN2O5
XLogP3-1.2
Hydrogen Bond Donor Count3
Hydrogen Bond Acceptor Count6
Rotatable Bond Count2
Exact Mass246.06519962 g/mol
Monoisotopic Mass246.06519962 g/mol
Topological Polar Surface Area99.1 Ų
Heavy Atom Count17
Formal Charge0
Complexity386
Isotope Atom Count0
Defined Atom Stereocenter Count3
Undefined Atom Stereocenter Count0
Defined Bond Stereocenter Count0
Undefined Bond Stereocenter Count0
Covalently Bonded Unit Count1
4 Drug and Medication Information
4.1 Drug Information
1 of 2  
Drug NameFloxuridine
PubMed HealthFloxuridine (Injection)
Drug ClassesAntineoplastic Agent
Drug LabelFloxuridine for Injection, USP, an antineoplastic antimetabolite, is available as a sterile, nonpyrogenic, lyophilized powder for reconstitution. Each vial contains 500 mg of floxuridine which is to be reconstituted with 5 mL of sterile water for i...
Active IngredientFloxuridine
Dosage FormInjectable
RouteInjection
Strength500mg/vial
Market StatusPrescription
CompanyFresenius Kabi Usa; Eurohlth Intl

2 of 2  
Drug NameFloxuridine
PubMed HealthFloxuridine (Injection)
Drug ClassesAntineoplastic Agent
Drug LabelFloxuridine for Injection, USP, an antineoplastic antimetabolite, is available as a sterile, nonpyrogenic, lyophilized powder for reconstitution. Each vial contains 500 mg of floxuridine which is to be reconstituted with 5 mL of sterile water for i...
Active IngredientFloxuridine
Dosage FormInjectable
RouteInjection
Strength500mg/vial
Market StatusPrescription
CompanyFresenius Kabi Usa; Eurohlth Intl

4.2 Therapeutic Uses

Antimetabolites, Antineoplastic; Antiviral Agents

National Library of Medicine's Medical Subject Headings online file (MeSH, 1999)


Floxuridine, given by continuous regional intra-arterial infusion, is indicated for palliative management of colorectal carcinoma metastatic to the liver that has not responded to other treatment. Floxuridine is most useful when the disease has not extended beyond an area capable of infusion via a single artery. /Included in US product labeling/

Thomson/Micromedex. Drug Information for the Health Care Professional. Volume 1, Greenwood Village, CO. 2006., p. 1477


Floxuridine also is indicated for carcinoma of the ovary and kidney not responsive to other antimetabolites. /Not Include in the US product label/

Thomson/Micromedex. Drug Information for the Health Care Professional. Volume 1, Greenwood Village, CO. 2006., p. 1477


Floxuridine has also been used for carcinoma of the breast, ovary, cervix, urinary bladder, kidney, and prostate not responsive to other antimetabolites. /NOT included in US product labeling/

USP Convention. USPDI - Drug Information for the Health Care Professional. 15 th ed. Volume 1. Rockville, MD: United States Pharmacopeial Convention, Inc., 1995. (Plus updates.), p. 1334


4.3 Drug Warning

Floxuridine is metabolized to fluorouracil, but the full spectrum of fluorouracil toxicity is not expected with floxuridine because of regional administration of the drug by intra-arterial infusion. However, the possibility of typical adverse effects of fluorouracil during floxuridine therapy should be considered.

McEvoy, G.K. (ed.). American Hospital Formulary Service. AHFS Drug Information. American Society of Health-System Pharmacists, Bethesda, MD. 2006., p. 1045


Nausea, vomiting, and diarrhea are common adverse effects; anorexia, cramps, and pain also may occur. Stomatitis is one of the most common signs of specific toxicity. Enteritis occurs frequently and duodenal ulcer, duodenitis, gastritis, gastroenteritis, glossitis, GI bleeding, and pharyngitis also have been reported.

McEvoy, G.K. (ed.). American Hospital Formulary Service. AHFS Drug Information. American Society of Health-System Pharmacists, Bethesda, MD. 2006., p. 1045


Leukopenia and anemia occur commonly with floxuridine therapy; thrombocytopenia also may occur. The patient's hematologic status must be carefully monitored.

McEvoy, G.K. (ed.). American Hospital Formulary Service. AHFS Drug Information. American Society of Health-System Pharmacists, Bethesda, MD. 2006., p. 1045


Pancytopenia and agranulocytosis have been reported in patients receiving fluorouracil; because of its pharmacologic similarity, these adverse hematologic effects might occur in patients receiving floxuridine.

McEvoy, G.K. (ed.). American Hospital Formulary Service. AHFS Drug Information. American Society of Health-System Pharmacists, Bethesda, MD. 2006., p. 1045


For more Drug Warnings (Complete) data for FLOXURIDINE (25 total), please visit the HSDB record page.


4.4 Drug Indication

For palliative management of gastrointestinal adenocarcinoma metastatic to the liver, when given by continuous regional intra-arterial infusion in carefully selected patients who are considered incurable by surgery or other means. Also for the palliative management of liver cancer (usually administered by hepatic intra-arterial infusion).


5 Pharmacology and Biochemistry
5.1 Pharmacology

Floxuridine is an anti-metabolite or a pyrimidine analog that works by disrupting the process S-phase of cell division, selectively targeting rapidly dividing cells. Due to the structural similarities, antimetabolites act as pyrimidine-like molecules and prevent normal pyrimidines from being incorporated into DNA. After successful biotransformation, floxuridine is converted into an active component, flurouracil, which blocks the enzyme which converts cytosine nucleosides into the deoxy derivative. Flurouracil also physically prevents the incorporation of thymidine nucleotides into the DNA strand by taking their place, further preventing DNA synthesis.


5.2 MeSH Pharmacological Classification

Antimetabolites, Antineoplastic

Antimetabolites that are useful in cancer chemotherapy. (See all compounds classified as Antimetabolites, Antineoplastic.)


5.3 FDA Pharmacological Classification
5.3.1 Active Moiety
FLOXURIDINE
5.3.2 FDA UNII
039LU44I5M
5.3.3 Pharmacological Classes
Deoxyuridine [CS]; Antimetabolite [EPC]
5.4 ATC Code

L - Antineoplastic and immunomodulating agents

L01 - Antineoplastic agents

L01B - Antimetabolites

L01BC - Pyrimidine analogues

L01BC09 - Floxuridine


5.5 Absorption, Distribution and Excretion

Route of Elimination

Floxuridine can be excreted as unchanged drug, urea, fluorouracil, a-fluoro-bureidopropionic acid, dihydrofluorouracil, a-fluoro-b-guanidopropionic acid and a-fluoro-b-alanine via the kidneys. Floxuridine may also be excreted as respiratory carbon dioxide.


... Floxuridine /is/ ... administered parenterally, since absorption after ingestion ... is unpredictable and incomplete.

Gilman, A.G., T.W. Rall, A.S. Nies and P. Taylor (eds.). Goodman and Gilman's The Pharmacological Basis of Therapeutics. 8th ed. New York, NY. Pergamon Press, 1990., p. 1229


It is not known whether floxuridine is distributed into milk.

McEvoy, G.K. (ed.). American Hospital Formulary Service. AHFS Drug Information. American Society of Health-System Pharmacists, Bethesda, MD. 2006., p. 1046


Some /Floxuridine/ crosses the blood-brain barrier; active metabolites are localized intracellularly.

Thomson/Micromedex. Drug Information for the Health Care Professional. Volume 1, Greenwood Village, CO. 2006., p. 1478


Elimination /is/ respiratory (as carbon dioxide), about 60%. Renal /elimination accounts for/ 10 to 13% (as unchanged drug and metabolites).

Thomson/Micromedex. Drug Information for the Health Care Professional. Volume 1, Greenwood Village, CO. 2006., p. 1478


5.6 Metabolism/Metabolites

Hepatic.


Biotransformation /is/ hepatic and in tissues, extensive, to the monophosphate derivative and fluorouracil; after continuous intra-arterial infusion, conversion to the monophosphate derivative is enhanced; largely converted to fluorouracil after rapid intravenous or intra-arterial injection.

Thomson/Micromedex. Drug Information for the Health Care Professional. Volume 1, Greenwood Village, CO. 2006., p. 1478


Following infusion of small doses of floxuridine, most of the drug appears to be anabolized to FUDR-MP, the active metabolite of the drug. When single doses are administered rapidly, floxuridine is apparently rapidly catabolized to fluorouracil.

McEvoy, G.K. (ed.). American Hospital Formulary Service. AHFS Drug Information. American Society of Health-System Pharmacists, Bethesda, MD. 2006., p. 1046


Floxuridine and fluorouracil are metabolized in the liver. Metabolic degradation of floxuridine is less when the drug is given by continuous infusion than when given by single injections. The drug is excreted intact and as urea, fluorouracil, a-fluoro--ureidopropionic acid, dihydrofluorouracil, alpha-fluoro-beta-guanidopropionic acid, and alpha-fluoro-beta-alanine in the urine and as respiratory carbon dioxide.

McEvoy, G.K. (ed.). American Hospital Formulary Service. AHFS Drug Information. American Society of Health-System Pharmacists, Bethesda, MD. 2006., p. 1046


Metabolic degradation occurs, particularly in the liver. Floxuridine is converted by thymidine or deoxyuridine phosphorylases into 5-fluorouracil. 5-Fluorouracil is inactivated by reduction of the pyrimidine ring; this reaction is carried out by dihydrouracil dehydrogenase, which is found in liver, intestinal mucosa, and other tissues. Inherited deficiency of this enzyme leads to greatly increased sensitivity to the drug. The product of this reaction, 5-fluoro-5,6-dihydrouracil is ultimately degraded to alpha-fluoro-beta-alanine ... .

Gilman, A.G., T.W. Rall, A.S. Nies and P. Taylor (eds.). Goodman and Gilman's The Pharmacological Basis of Therapeutics. 8th ed. New York, NY. Pergamon Press, 1990., p. 1229


5.7 Mechanism of Action

Floxuridine rapidly undergoes catabolism to form 5-fluorouracil, which is the active component of the drug. 5-Fluorouracil primarily works by interfering with DNA synthesis; however, it may also inhibit the formation of fraudulent RNA via physical incorporation into the RNA. It is also an inhibitor of riboside phophorylase, preventing the utilization of pre-formed uracil in RNA synthesis. Floxuridine can also form 5-fluoro-2'-deoxyuridine-5'-phosphate (FUDR-MP), which is the monophosphate of floxuridine that inhibits thymidylate synthetase that plays a role in the methylation of deoxyuridylic acid to thymidylic acid during DNA synthesis. FUDR-MP thus interferes with DNA synthesis.


Floxuridine is an antimetabolite. The monophosphate of the drug, 5-fluoro-2'-deoxyuridine-5'-phosphate (FUDR-MP), inhibits thymidylate synthetase, thus inhibiting methylation of deoxyuridylic acid to thymidylic acid and thereby interfering with the synthesis of DNA. Following administration of a single dose of floxuridine, the drug is catabolized to fluorouracil and produces the same antimetabolic effects as the latter drug. In addition to interfering with DNA synthesis, metabolites of fluorouracil become incorporated to a small extent into RNA, producing a fraudulent RNA. Fluorouracil also inhibits utilization of preformed uracil in RNA synthesis by blocking uracil riboside phosphorylase.

McEvoy, G.K. (ed.). American Hospital Formulary Service. AHFS Drug Information. American Society of Health-System Pharmacists, Bethesda, MD. 2006., p. 1046


Floxuridine is an antimetabolite of the pyrimidine analog type. Floxuridine is considered to be cell cycle-specific for the S-phase of cell division. Activity occurs as the result of activation in the tissue, and includes inhibition of DNA and, as a result of action of the fluorouracil metabolite, RNA synthesis.

Thomson/Micromedex. Drug Information for the Health Care Professional. Volume 1, Greenwood Village, CO. 2006., p. 1477


Fluorouracil requires enzymatic conversion to the nucleotide in order to exert its cytotoxic activity. Several routes are available for the formation of the 5'-monophosphate nucleotide in animal cells. Fluorouracil may be converted to fluorouridine by uridine phosphorylase and then to 5'-monophosphate nucleotide by uridine kinase or it may react directly with 5-phosphoribosyl- 1 -pyrophosphate, catalyzed by the enzyme orotate phosphoribosyl transferase, to form 5'-monophosphate nucleotide. Fluorouracil may also be converted directly to floxuridine by the enzyme thymidine phosphorylase. Many metabolic pathways are available to 5'-monophosphate nucleotide, including incorporation into RNA. A reaction sequence crucial for antineoplastic activity involves reduction of the diphosphate nucleotide by the enzyme ribonucleotide diphosphate reductase to the deoxynucleotide level and the eventual formation of 5-fluoro-2'-deoxyuridine-5'-phosphate. This complex metabolic pathway for the generation of the actual growth inhibitor, 5-fluoro-2'-deoxyuridine-5'-phosphate, may be bypassed through use of the deoxyribonucleoside of fluorouracil--floxuridine--which is converted directly to 5-fluoro-2'-deoxyuridine-5'-phosphate by thymidine kinase. However, floxuridine is a good substrate for both thymidine and uridine phosphorylases. and it can also be degraded to fluorouracil.

Gilman, A.G., T.W. Rall, A.S. Nies and P. Taylor (eds.). Goodman and Gilman's The Pharmacological Basis of Therapeutics. 8th ed. New York, NY. Pergamon Press, 1990., p. 1228


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