Drug General Information (ID: DDIZN1XQR7)
  Drug Name Folic acid Drug Info Fluorouracil Drug Info
  Drug Type Small molecule Small molecule
  Therapeutic Class Vitamins Immunosuppressive Agents
  Structure

 Mechanism of Folic acid-Fluorouracil Interaction (Severity Level: Major)
     Potentiated the pharmacological effects (Unspecific) Click to Show/Hide Mechanism Graph
      Drug Name Folic acid Fluorouracil
      Mechanism Potentiate the pharmacologic effects of 5-fluorouracil 5-Fluorouracil derivative
      Key Mechanism Factor 1
Factor Name Pharmacodynamics
Factor Description Enhanced pharmacological effects leading to increased adverse reactions.
      Mechanism Description
  • Potentiate the pharmacologic effects by the combination of Folic acid and Fluorouracil 

Recommended Action
      Management Caution is advised if 5-FU or any of its prodrugs (e.g., capecitabine, tegafur) are prescribed in combination with leucovorin. A lower dosage of 5-FU or the prodrug may be required. Therapy with leucovorin and fluorouracil should not be initiated or continued in patients with symptoms of gastrointestinal toxicity until such symptoms have resolved. Closely monitor patients with diarrhea until it resolves. Monitor for other potential toxicities of 5-FU such as neutropenia, thrombocytopenia, stomatitis, cutaneous reactions, and neuropathy. Patients should be instructed to avoid taking folic acid supplementation or multivitamin preparations containing folic acid without first speaking with their physician.

References
1 Product Information. Xeloda (capecitabine). Roche Laboratories, Nutley, NJ.
2 Clippe C, Freyer G, Milano G, Trillet-Lenoir V "Lethal toxicity of capecitabine due to abusive folic acid prescription?" Clin Oncol (R Coll Radiol) 15 (2003): 299-300. [PMID: 12924465]
3 EMEA. European Medicines Agency "EPARs. European Union Public Assessment Reports."