Cycle length: 14 days. | |||
Drug | Dose and route | Administration | Given on days |
Leucovorin¶ | 400 mg/m2 IV | Dilute with 250 mL D5WΔ and administer over two hours. | Day 1 |
Fluorouracil (FU) | 400 mg/m2 IV bolus | Slow IV push over five minutes (administer immediately after leucovorin). | Day 1 |
FU | 2400 mg/m2 IV | Dilute in 500 to 1000 mL D5WΔ and administer over 46 hours (begin immediately after FU IV bolus). To accommodate an ambulatory pump for outpatient treatment, can be administered undiluted (50 mg/mL) or the total dose can be diluted in 100 to 150 mL NS.Δ | Day 1 |
Pretreatment considerations: | |||
Emesis risk |
| ||
Infection prophylaxis |
| ||
Dose adjustment for baseline liver or kidney dysfunction |
| ||
Monitoring parameters: | |||
| |||
| |||
Suggested dose modifications for toxicity: | |||
Myelotoxicity |
| ||
Diarrhea |
| ||
Neurologic toxicity |
| ||
Cardiotoxicity |
| ||
If there is a change in body weight of at least 10%, doses should be recalculated. |
ANC: absolute neutrophil count; CBC: complete blood count; D5W: 5% dextrose in water; G-CSF: granulocyte-colony stimulating factors; IV: intravenous; NS: normal saline; WBC: white blood cell.
* This is a modification of the original de Gramont regimen of short-term infusional FU plus leucovorin,[4] which eliminates the day 2 bolus doses of FU and leucovorin.
¶ Leucovorin dose is given for d,l-racemic mixture.[5] Use half the dose for LEVOleucovorin (l-leucovorin).
Δ Diluent solutions should not be modified without consulting a detailed reference due to potential incompatibility(ies).
Do you want to add Medilib to your home screen?