Fluorouracil 50 mg/mL Injection, Solution — NDC 70700-187-23 (Billing 70700-0187-23)
This is a package of Fluorouracil 50 mg/mL Injection, Solution from Xiromed LLC, marketed since Aug 2021 and currently FDA-listed. It is this product's only package size.
NDC database record
One package, one record: these facts belong to NDC 70700-187-23 alone.
- Record
- FDA NDC Directory package listing · Human prescription drug
- Code segments
- 70700 labeler · 187 product · 23 package
- Package marketed since
- Aug 13, 2021
- Sample package
- No — commercial package
- Listing certified through
- Dec 31, 2027
- Barcode (UPC-A, from the NDC)
- 3 7070018723 4
- Medicaid fills, this package
- 488 prescriptions in the last four reported quarters
- FDA record last changed
- Jul 24, 2026
Identity & classification
Regulatory identifiers FDA, NLM and CMS codes for this package
Drug-database identifiers Medi-Span GPI and First Databank GCN / HICL / AHFS classification
- GSN (GCN sequence number): 061670
- GCN: 97456
- GPI-14 (Medi-Span): 21300030002025
- HICL (First Databank): 003907
- AHFS class code: 10:00.00.00
- RxCUI (RxNorm): 1791701
Where does this data come from?
- FDA openFDA NDC Directory · synced Oct 1, 2026
- FDA label on DailyMed · label index refreshed Oct 5, 2026
- RxNorm (NLM RxNav) · catalog refreshed Oct 1, 2026
- Medi-Span GPI (licensed)
- First Databank (licensed) · refreshed Oct 1, 2026
RxNorm drug class
This medicine belongs to the Nucleoside Metabolic Inhibitor class.
Where does this data come from?
- RxClass (NLM) · catalog refreshed Oct 1, 2026
Clinical
- It depends on the form. By IV, it treats colon, rectal, breast, stomach and pancreatic cancers. As a skin cream or solution, it treats actinic keratosis (sun-damaged patches) and,...
- Follow your label and prescriber. Tolak is applied once daily after washing and drying the area. The 5% cream and solution are applied twice daily. Use a nonmetal applicator or glo...
- How do I use the skin cream or solution?
- Redness, dryness, scaling, crusting, itching, stinging or burning, swelling and raw spots are very common. They usually peak at the end of treatment and fade within about 4 weeks a...
Patient education
Supplement & herbal interactions
Some supplements/herbs that may interact with Fluorouracil — tap one for details:
Fluorouracil may be associated with lower levels of 2 nutrients — worth a chat with your pharmacist, not a cause for alarm.
Where does this data come from?
- MedlinePlus (NLM) · refreshed Oct 1, 2026
- FDA label on DailyMed · label index refreshed Oct 5, 2026
Ask a licensed pharmacist directly — free, answered by our team.
Pricing
A drug doesn't have one price. Each row is a different public payment system, and none is what you'd pay at the counter — that depends on your insurance. The ⓘ on each row explains what it measures.
| Price system | Per mL | Per package |
|---|---|---|
| Retail pharmacies payNADAC · weekly | Not in the retail survey — common for institutional, discontinued, or low-volume packs. | |
| Medicaid paysCMS SDUD · 12 mo | $0.3612 | $72.24 / 200 ml |
| Medicare drug plans payPart D · quarterly | No Part D plan price is available for this NDC in our data. | |
| Medicare Part B allowsASP · J9190 | $2.024 / J9190 unit | — |
Where does this data come from?
- CMS NADAC weekly file
- CMS ASP pricing files · refreshed Sep 20, 2026
- CMS Medicaid State Drug Utilization Data · through Q1 2026
- CMS Part D plan pricing files · refreshed Sep 24, 2026
- VA National Acquisition Center price file
Billing & reimbursement
Where does this data come from?
- CMS ASP NDC-HCPCS crosswalk · refreshed Sep 22, 2026
- DMEPDAC NDC-HCPCS crosswalk
- openFDA NSDE billing units · refreshed Sep 7, 2026
Packaging — all sizes for this product
| Package NDC | Description | Marketing start | Marketing end | Status |
|---|---|---|---|---|
| 70700-0187-23 You're viewing this Main listing | 10 VIAL in 1 CARTON / 20 mL in 1 VIAL | 2021-08-13 | — | Active |
Therapeutic equivalents
| Product | Labeler | Pack | NADAC/unit | TE | Status | Price vs. this |
|---|---|---|---|---|---|---|
| Fluorouracil 50 mg/mL 16729-0276-11 | Accord | 1 vial | — | — | FDA listed | — |
| Fluorouracil 50 mg/mL 55150-0497-10 | Eugia | 10 vials | — | AP | FDA listed | — |
| Fluorouracil 50 mg/mL 63323-0117-59 | Fresenius | 1 vial | — | AP | FDA listed | — |
| Fluorouracil 50 mg/mL 68001-0524-30 | BluePoint | 10 vials | — | AP | FDA listed | — |
| Fluorouracil 50 mg/mL 68083-0270-10 | Gland | 10 vials | — | AP | FDA listed | — |
| Fluorouracil 50 mg/mLthis 70700-0187-23 | Xiromed | 10 vials | — | AP | FDA listed | — |
| Fluorouracil 50 mg/mL 46708-0751-50 | Alembic | 1 vial | — | AP | FDA listed | — |
| Fluorouracil 50 mg/mL 46708-0779-31 | Alembic | 1 vial | — | AP | FDA listed | — |
| Fluorouracil 50 mg/mL 62332-0779-31 | Alembic | 1 vial | — | AP | FDA listed | — |
| Fluorouracil 50 mg/mL 68001-0627-27 | BluePoint | 1 vial | — | AP | FDA listed | — |
| Fluorouracil 50 mg/mL 68083-0269-10 | Gland | 10 vials | — | AP | FDA listed | — |
| Fluorouracil 50 mg/mL 68001-0628-32 | BluePoint | 1 vial | — | AP | FDA listed | — |
| Fluorouracil 50 mg/mL 68001-0525-27 | BluePoint | 1 vial | — | AP | FDA listed | — |
| Fluorouracil 50 mg/mL 68083-0292-01 | Gland | 1 vial | — | AP | FDA listed | — |
| Fluorouracil 50 mg/mL 55150-0498-01 | Eugia | 1 vial | — | AP | FDA listed | — |
| Fluorouracil 50 mg/mL 70700-0186-23 | Xiromed | 10 vials | — | AP | FDA listed | — |
| Fluorouracil 50 mg/mL 62332-0751-50 | Alembic | 1 vial | — | AP | FDA listed | — |
| Fluorouracil 50 mg/mL 70700-0189-22 | Xiromed | 1 vial | — | AP | FDA listed | — |
| Fluorouracil 50 mg/mL 55150-0496-10 | Eugia | 10 vials | — | AP | FDA listed | — |
| Fluorouracil 50 mg/mL 55150-0499-01 | Eugia | 1 vial | — | AP | FDA listed | — |
| fluorouracil 50 mg/mL 25021-0215-98 | Sagent | 1 bottle | — | AP | FDA listed | — |
| Fluorouracil 50 mg/mL 71288-0154-76 | Meitheal | 1 vial | — | AP | FDA listed | — |
| Fluorouracil 50 mg/mL 68083-0293-01 | Gland | 1 vial | — | AP | FDA listed | — |
| Fluorouracil 50 mg/mL 84549-0117-10 | ProPharma | 10 ml | — | AP | FDA listed | — |
| Fluorouracil 50 mg/mL 70700-0188-22 | Xiromed | 1 vial | — | AP | FDA listed | — |
| Fluorouracil 50 mg/mL 71288-0170-75 | Meitheal | 1 vial | — | AP | FDA listed | — |
| Fluorouracil 50 mg/mL 23155-0972-41 | Heritage | 10 vials | — | AP | FDA listed | — |
| Fluorouracil 50 mg/mL 23155-0975-31 | Heritage | 1 vial | — | AP | FDA listed | — |
| Fluorouracil 50 mg/mL 23155-0973-41 | Heritage | 10 vials | — | AP | FDA listed | — |
| Fluorouracil 50 mg/mL 23155-0974-31 | Heritage | 1 vial | — | AP | FDA listed | — |
Where does this data come from?
- FDA openFDA NDC Directory · synced Oct 1, 2026
- FDA Orange Book · refreshed Oct 3, 2026
- CMS NADAC weekly file
Availability & generic status
This product is an FDA-approved generic. Other versions of the same drug are listed under Therapeutic equivalents, least expensive first.
Where does this data come from?
- FDA Orange Book · refreshed Oct 3, 2026
Inactive Ingredients / Excipients
Inactive ingredients, also called excipients, are components of the drug product other than the active ingredient. They may include fillers, dyes, coatings, preservatives, flavors, or other formulation ingredients.
Where does this data come from?
IACT rows and label-wide narrative are kept separate; availability and product-level specificity depend on the submitted label.- FDA label on DailyMed · label index refreshed Oct 5, 2026
- FDA openFDA NDC Directory · synced Oct 1, 2026
Inactive ingredient FAQ
Are inactive ingredients the same for every manufacturer?
Why might an inactive ingredient be missing?
Can inactive ingredients matter?
Manufacturer & labeler
More NDCs from Xiromed LLC labeler code 70700
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- Fluorouracil 50 mg/mL Injection, Solution NDC 70700-186-23
- Fluorouracil 50 mg/mL Injection, Solution NDC 70700-188-22
- Fluorouracil 50 mg/mL Injection, Solution NDC 70700-189-22
- Estradiol .75 mg/.75g Gel NDC 70700-194-35
- Estradiol 1.25 mg/1.25g Gel NDC 70700-195-35
- Progesterone vaginal insert 100 mg Insert NDC 70700-201-70
- JAIMIESS levonorgestrel and ethinyl estradiol and ethinyl estradiol tablets Kit NDC 70700-206-93
Where does this data come from?
- FDA openFDA NDC Directory · synced Oct 1, 2026
- Drugs@FDA
Full prescribing information FDA SPL
🎯 Indications and Usage ▾
1 INDICATIONS & USAGE Fluorouracil is indicated for the treatment of patients with: Fluorouracil is a nucleoside metabolic inhibitor indicated for the treatment of patients with • Adenocarcinoma of the Colon and Rectum ( 1.1 ) • Adenocarcinoma of the Breast ( 1.2 ) • Gastric Adenocarcinoma ( 1.3 ) • Pancreatic Adenocarcinoma ( 1.4 )
1.1 Adenocarcinoma of the Colon and Rectum
1.2 Adenocarcinoma of the Breast
1.3 Gastric Adenocarcinoma
1.4 Pancreatic Adenocarcinoma
1.1 Adenocarcinoma of the Colon and Rectum
1.2 Adenocarcinoma of the Breast
1.3 Gastric Adenocarcinoma
1.4 Pancreatic Adenocarcinoma
⏱️ Dosage and Administration ▾
2 DOSAGE & ADMINISTRATION •Fluorouracil is recommended for administration either as an intravenous bolus or as an intravenous infusion. (2.1 ) •See Full Prescribing Information for dose individualization (2.1) and dose modifications due to adverse reactions (2.6 ) •See Full Prescribing Information for recommended doses of fluorouracil for adenocarcinoma of the colon and rectum ( 2.2 ) and for recommended doses of fluorouracil as a component of a chemotherapy regimen for adenocarcinoma of the breast (2.3 ), gastric adenocarcinoma ( 2.4 ), pancreatic adenocarcinoma ( 2.5 )
2.1General Dose Information Fluorouracil is recommended for administration either as an intravenous bolus or as an intravenous infusion. Do not inject the entire contents of the vial directly into patients. Individualize the dose and dosing schedule of fluorouracil based on tumor type, the specific regimen administered, disease state, response to treatment, and patient risk factors.
2.2Recommended Dosage for Adenocarcinoma of the Colon and Rectum The recommended dose of fluorouracil, administered in an infusional regimen in combination with leucovorin alone, or in combination with leucovorin and oxaliplatin or irinotecan, is 400 mg/m 2 by intravenous bolus on Day 1, followed by 2400 mg/m 2 to 3000 mg/m 2 intravenously as a continuous infusion over 46 hours every two weeks. The recommended dose of fluorouracil, if administered in a bolus dosing regimen in combination with leucovorin, is 500 mg/m 2 by intravenous bolus on Days 1, 8, 15, 22, 29, and 36 in 8-week cycles.
2.3Recommended Dosage for Adenocarcinoma of the Breast The recommended dose of fluorouracil, administered as a component of a cyclophosphamide-based multidrug regimen, is 500 mg/m 2 or 600 mg/m 2 intravenously on Days 1 and 8 every 28 days for 6 cycles.
2.4Recommended Dosage for Gastric Adenocarcinoma The recommended dose of fluorouracil, administered as a component of a platinum-containing multidrug chemotherapy regimen, is 200 mg/m 2 to 1000 mg/m 2 intravenously as a continuous infusion over 24 hours. The frequency of dosing in each cycle and the length of each cycle will depend on the dose of fluorouracil and the specific regimen administered.
2.5Recommended Dosage for Pancreatic Adenocarcinoma The recommended dose of fluorouracil, administered as an infusional regimen in combination with leucovorin or as a component of a multidrug chemotherapy regimen that includes leucovorin, is 400 mg/m 2 intravenous bolus on Day 1, followed by 2400 mg/m 2 intravenously as a continuous infusion over 46 hours every two weeks.
2.6Dose Modifications Withhold fluorouracil for any of the following: Development of angina, myocardial infarction/ischemia, arrhythmia, or heart failure in patients with no history of coronary artery disease or myocardial dysfunction [see Warnings and Precautions ( 5.2 )] Hyperammonemic encephalopathy [see Warnings and Precautions ( 5.3 )] Acute cerebellar syndrome, confusion, disorientation, ataxia, or visual disturbances [see Warnings and Precautions ( 5.4 )] Grade 3 or 4 diarrhea [see Warnings and Precautions ( 5.5 )] Grade 2 or 3 palmar-plantar erythrodysesthesia (hand-foot syndrome) [see Warnings and Precautions ( 5.6 )] Grade 3 or 4 mucositis [see Warnings and Precautions ( 5.8 )] Grade 4 myelosuppression [see Warnings and Precautions ( 5.7 )] Upon resolution or improvement to Grade 1 diarrhea, mucositis, myelosuppression, or palmar-plantar erythrodysesthesia, resume fluorouracil administration at a reduced dose.
There is no recommended dose for resumption of fluorouracil administration following development of any of the following adverse reactions: Cardiac toxicity Hyperammonemic encephalopathy Acute cerebellar syndrome, confusion, disorientation, ataxia, or visual disturbances
2.7Preparation for Administration Fluorouracil is supplied in a single dose vial. The 10 mL/20 mL vial is only intended for preparation in a Pharmacy Admixture Service under appropriate conditions… [Excerpted — this section continues on DailyMed.]
💊 Dosage Forms and Strengths ▾
3 DOSAGE FORMS & STRENGTHS Fluorouracil injection USP is supplied as single dose vial containing 500 mg/10 mL (50 mg/mL) and 1 g/20 mL (50 mg/mL) fluorouracil. Injection: 500 mg in a 10 mL vial in Single dose vial ( 3 ) 1 g in a 20 mL vial in Single dose vial ( 3 )
⛔ Contraindications ▾
4 CONTRAINDICATIONS None. None (4)
⚠️ Warnings and Cautions ▾
5 WARNINGS AND PRECAUTIONS • Increased Risk of Serious or Fatal Adverse Reactions in Patients with Low or Absent Dipyrimidine Dehydrogenase Activity: Withhold or permanently discontinue fluorouracil in patients with evidence of acute early-onset or unusually severe toxicity, which may indicate near complete or total absence of dipyrimidine dehydrogenase (DPD) activity. No fluorouracil dose has been proven safe in patients with absent DPD activity. ( 5.1 ) • Cardiotoxicity: Fluorouracil can cause cardiotoxicity, including angina, myocardial infarction/ischemia, arrhythmia, and heart failure.
Withhold fluorouracil for cardiac toxicity. ( 5.2 ) • Hyperammonemic Encephalopathy: Altered mental status, confusion, disorientation, coma, or ataxia with elevated serum ammonia level can occur within 72 hours of initiation of fluorouracil. Withhold fluorouracil and initiate ammonia-lowering therapy.
( 5.3 ) • Neurologic Toxicity: Fluorouracil can cause acute cerebellar syndrome, confusion, disorientation, ataxia, or visual disturbances. Withhold fluorouracil for neurologic toxicity. ( 5.4 ) • Diarrhea: Fluorouracil can cause severe diarrhea.
Withhold fluorouracil for severe diarrhea until resolved. ( 5.5 ) • Palmar-Plantar Erythrodysesthesia (Hand-Foot Syndrome): Fluorouracil can cause hand-foot syndrome. If severe, discontinue fluorouracil until resolved or decreased to Grade 1, then resume at a reduced dose.
( 5.6 ) • Myelosuppression: Fluorouracil can cause severe and fatal myelosuppression. Withhold fluorouracil until severe myelosuppression resolves, then resume at a reduced dose. ( 5.7) • Mucositis: Fluorouracil can cause severe mucositis.
Discontinue fluorouracil until resolved or decreased to Grade 1, then resume at a reduced dose. ( 5.8 ) • Increased Risk of Elevated INR with Warfarin: Concurrent administration with warfarin can result in clinically significant increases in coagulation parameters: Closely monitor INR and prothrombin time. ( 5.9 ) • Embryofetal Toxicity: Fluorouracil can cause fetal harm.
Advise females and males of reproductive potential of the potential risk to a fetus. ( 5.10 , 8.1 , 8.6 )
5.1Increased Risk of Serious or Fatal Adverse Reactions in Patients with Low or Absent Dipyrimidine Dehydrogenase (DPD) Activity Based on postmarketing reports, patients with certain homozygous or certain compound heterozygous mutations in the DPD gene that result in complete or near complete absence of DPD activity are at increased risk for acute early-onset of toxicity and severe, life-threatening, or fatal adverse reactions caused by fluorouracil (e.g., mucositis, diarrhea, neutropenia, and neurotoxicity). Patients with partial DPD activity may also have increased risk of severe, life-threatening, or fatal adverse reactions caused by fluorouracil.
Withhold or permanently discontinue fluorouracil based on clinical assessment of the onset, duration and severity of the observed toxicities in patients with evidence of acute early-onset or unusually severe toxicity, which may indicate near complete or total absence of DPD activity. No fluorouracil dose has been proven safe for patients with complete absence of DPD activity. There is insufficient data to recommend a specific dose in patients with partial DPD activity as measured by any specific test.
5.2Cardiotoxicity Fluorouracil can cause cardiotoxicity, including angina, myocardial infarction/ischemia, arrhythmia, and heart failure, based on postmarketing reports. Reported risk factors for cardiotoxicity are administration by continuous infusion rather than intravenous bolus and presence of coronary artery disease. Withhold fluorouracil for cardiotoxicity.
The risks of resumption of fluorouracil in patients with cardiotoxicity that has resolved have not been established.
5.3Hyperammonemic Encephalopathy Fluorouracil can cause hyperammonemic encephalopathy in the absence of liver disease or other identifiable cause, based on postmarketing reports. Signs or symptoms of hyper… [Excerpted — this section continues on DailyMed.]
🤒 Adverse Reactions ▾
6 ADVERSE REACTIONS SECTION The following adverse reactions are discussed in more detail in other sections of the labeling: • Increased risk of serious or fatal adverse reactions in patients with low or absent dipyrimidine dehydrogenase activity [see Warnings and Precautions ( 5.1 )] • Cardiotoxicity [see Warnings and Precautions ( 5.2 )] • Hyperammonemic encephalopathy [see Warnings and Precautions ( 5.3 )] • Neurologic toxicity [see Warnings and Precautions ( 5.4 )] • Diarrhea [see Warnings and Precautions ( 5.5 )] • Palmar-plantar erythrodysesthesia (hand-foot syndrome) [see Warnings and Precautions ( 5.6 )] • Myelosuppression [see Warnings and Precautions ( 5.7 )] • Mucositis [see Warnings and Precautions ( 5.8) ] • Increased risk of elevated INR when administrated with warfarin [see Warnings and Precautions ( 5.9 )] To report SUSPECTED ADVERSE REACTIONS, contact Xiromed, LLC at 844-XIROMED (1-844-947-6633) or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch
6.2Postmarketing Experience The following adverse reactions have been identified during postapproval use of fluorouracil. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. Hematologic: pancytopenia [see Warnings and Precautions ( 5.7 )] Gastrointestinal: gastrointestinal ulceration, nausea, vomiting Allergic Reactions: anaphylaxis and generalized allergic reactions Neurologic: nystagmus, headache Dermatologic: dry skin; fissuring; photosensitivity, as manifested by erythema or increased pigmentation of the skin; vein pigmentation Ophthalmic: lacrimal duct stenosis, visual changes, lacrimation, photophobia Psychiatric: euphoria Miscellaneous: thrombophlebitis, epistaxis, nail changes (including loss of nails)
6.2Postmarketing Experience The following adverse reactions have been identified during postapproval use of fluorouracil. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. Hematologic: pancytopenia [see Warnings and Precautions ( 5.7 )] Gastrointestinal: gastrointestinal ulceration, nausea, vomiting Allergic Reactions: anaphylaxis and generalized allergic reactions Neurologic: nystagmus, headache Dermatologic: dry skin; fissuring; photosensitivity, as manifested by erythema or increased pigmentation of the skin; vein pigmentation Ophthalmic: lacrimal duct stenosis, visual changes, lacrimation, photophobia Psychiatric: euphoria Miscellaneous: thrombophlebitis, epistaxis, nail changes (including loss of nails)
🔄 Drug Interactions ▾
7 DRUG INTERACTIONS
7.1Anticoagulants and CYP 2C9 Substrates Elevated coagulation times have been reported in patients taking fluorouracil concomitantly with warfarin. While pharmacokinetic data are not available to assess the effect of fluorouracil administration on warfarin pharmacokinetics, the elevation of coagulation times that occurs with the fluorouracil prodrug capecitabine is accompanied by an increase in warfarin concentrations. Thus, the interaction may be due to inhibition of cytochrome P450 2C9 by fluorouracil or its metabolites.
👥 Use in Specific Populations ▾
8 USE IN SPECIFIC POPULATIONS •Nursing Mothers: Discontinue drug or discontinue nursing. ( 8.3 ) •Females and Males of Reproductive Potential: Provide pregnancy planning and prevention counseling. ( 5.10 , 8.1 , 8.6 )
8.1Pregnancy Pregnancy Category D Risk Summary There are no adequate and well-controlled studies with fluorouracil in pregnant women. Based on its mechanism of action, fluorouracil can cause fetal harm when administered to a pregnant woman. Administration of fluorouracil to rats and mice during selected periods of organogenesis, at doses lower than a human dose of 12 mg/kg, caused embryolethality and teratogenicity.
Malformations included cleft palate and skeletal defects. In monkeys, maternal doses of fluorouracil higher than an approximate human dose of 12 mg/kg resulted in abortion. If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, apprise the patient of the potential hazard to a fetus [see Clinical Pharmacology ( 12.1 )].
Animal Data Malformations including cleft palate, skeletal defects and deformed appendages (paws and tails) were observed when fluorouracil was administered by intraperitoneal injection to mice at doses at or above 10 mg/kg (approximately 0.06 times a human dose of 12 mg/kg on a mg/m 2 basis) for 4 days during the period of organogenesis. Similar results were observed in hamsters administered fluorouracil intramuscularly at doses lower than those administered in commonly used clinical treatment regimens. In rats, administration of fluorouracil by intraperitoneal injection at doses greater than 15 mg/kg (approximately 0.2 times a human dose of 12 mg/kg on a mg/m 2 basis) for a single day during organogenesis resulted in delays in growth and malformations including microanophthalmos.
In monkeys, administration of fluorouracil during organogenesis at doses approximately equal to a human dose of 12 mg/kg on a mg/m 2 basis resulted in abortion; at a 50% lower dose, resorptions and decreased fetal body weights were reported.
8.3Nursing Mothers It is not known whether fluorouracil or its metabolites are present in human milk. Because many drugs are present in human milk and because of the potential for serious adverse reactions in nursing infants from fluorouracil, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
8.4Pediatric Use The safety and effectiveness in pediatric patients have not been established.
8.5Geriatric Use Reported clinical experience has not identified differences in safety or effectiveness between the elderly and younger patients.
8.6Females and Males of Reproductive Potential Contraception Females Based on its mechanism of action, fluorouracil can cause fetal harm when administered to a pregnant woman. Advise females of reproductive potential to use effective contraception during treatment with fluorouracil and for up to 3 months following cessation of therapy [see Use in Specific Populations ( 8.1 )] . Males Fluorouracil may damage spermatozoa.
Advise males with female partners of reproductive potential to use effective contraception during and for 3 months following cessation of therapy with fluorouracil [see Nonclinical Toxicology ( 13.1 )]. Infertility Females Advise females of reproductive potential that, based on animal data, fertility may be impaired while receiving fluorouracil [see Nonclinical Toxicology ( 13.1) ]. Males Advise males of reproductive potential that, based on animal data, fertility may be impaired while receiving fluorouracil [see Nonclinical Toxicology ( 13.1) ].
8.6 Females and Males of Reproductive Potential
8.6 Females and Males of Reproductive Potential
🤰 Pregnancy ▾
8.1Pregnancy Pregnancy Category D Risk Summary There are no adequate and well-controlled studies with fluorouracil in pregnant women. Based on its mechanism of action, fluorouracil can cause fetal harm when administered to a pregnant woman. Administration of fluorouracil to rats and mice during selected periods of organogenesis, at doses lower than a human dose of 12 mg/kg, caused embryolethality and teratogenicity.
Malformations included cleft palate and skeletal defects. In monkeys, maternal doses of fluorouracil higher than an approximate human dose of 12 mg/kg resulted in abortion. If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, apprise the patient of the potential hazard to a fetus [see Clinical Pharmacology ( 12.1 )].
Animal Data Malformations including cleft palate, skeletal defects and deformed appendages (paws and tails) were observed when fluorouracil was administered by intraperitoneal injection to mice at doses at or above 10 mg/kg (approximately 0.06 times a human dose of 12 mg/kg on a mg/m 2 basis) for 4 days during the period of organogenesis. Similar results were observed in hamsters administered fluorouracil intramuscularly at doses lower than those administered in commonly used clinical treatment regimens. In rats, administration of fluorouracil by intraperitoneal injection at doses greater than 15 mg/kg (approximately 0.2 times a human dose of 12 mg/kg on a mg/m 2 basis) for a single day during organogenesis resulted in delays in growth and malformations including microanophthalmos.
In monkeys, administration of fluorouracil during organogenesis at doses approximately equal to a human dose of 12 mg/kg on a mg/m 2 basis resulted in abortion; at a 50% lower dose, resorptions and decreased fetal body weights were reported.
🧒 Pediatric Use ▾
8.4Pediatric Use The safety and effectiveness in pediatric patients have not been established.
🧓 Geriatric Use ▾
8.5Geriatric Use Reported clinical experience has not identified differences in safety or effectiveness between the elderly and younger patients.
8.6Females and Males of Reproductive Potential Contraception Females Based on its mechanism of action, fluorouracil can cause fetal harm when administered to a pregnant woman. Advise females of reproductive potential to use effective contraception during treatment with fluorouracil and for up to 3 months following cessation of therapy [see Use in Specific Populations ( 8.1 )] . Males Fluorouracil may damage spermatozoa.
Advise males with female partners of reproductive potential to use effective contraception during and for 3 months following cessation of therapy with fluorouracil [see Nonclinical Toxicology ( 13.1 )]. Infertility Females Advise females of reproductive potential that, based on animal data, fertility may be impaired while receiving fluorouracil [see Nonclinical Toxicology ( 13.1) ]. Males Advise males of reproductive potential that, based on animal data, fertility may be impaired while receiving fluorouracil [see Nonclinical Toxicology ( 13.1) ].
🆘 Overdosage ▾
10 OVERDOSAGE Administer uridine triacetate within 96 hours following the end of fluorouracil infusion for management of fluorouracil overdose.
🧬 Clinical Pharmacology ▾
12 CLINICAL PHARMACOLOGY
12.1Mechanism of Action Fluorouracil is a nucleoside metabolic inhibitor that interferes with the synthesis of deoxyribonucleic acid (DNA) and to a lesser extent inhibits the formation of ribonucleic acid (RNA); these affect rapidly growing cells and may lead to cell death. Fluorouracil is converted to three main active metabolites: 5-fluoro-2′-deoxyuridine-5′-monophosphate (FdUMP), 5-fluorouridine-5′triphosphate (FUTP) and 5-fluoro-2′-deoxyuridine-5′-triphosphate (FdUTP). These metabolites have several effects including the inhibition of thymidylate synthase by FdUMP, incorporation of FUTP into RNA and incorporation of FdUTP into DNA.
12.3Pharmacokinetics Distribution Following bolus intravenous injection, fluorouracil distributes throughout the body including the intestinal mucosa, bone marrow, liver, cerebrospinal fluid and brain tissue. Elimination Following bolus intravenous injection, 5 – 20 % of the parent drug is excreted unchanged in the urine in six hours. The remaining percentage of the administered dose is metabolized, primarily in the liver.
The metabolites of fluorouracil (e.g., urea and α-fluoro-ßalanine) are excreted in the urine over 3 to 4 hours. Following bolus intravenous injection of fluorouracil, as a single agent, the elimination half-life increased with dose from 8 to 20 minutes.
🧬 Mechanism of Action ▾
12.1Mechanism of Action Fluorouracil is a nucleoside metabolic inhibitor that interferes with the synthesis of deoxyribonucleic acid (DNA) and to a lesser extent inhibits the formation of ribonucleic acid (RNA); these affect rapidly growing cells and may lead to cell death. Fluorouracil is converted to three main active metabolites: 5-fluoro-2′-deoxyuridine-5′-monophosphate (FdUMP), 5-fluorouridine-5′triphosphate (FUTP) and 5-fluoro-2′-deoxyuridine-5′-triphosphate (FdUTP). These metabolites have several effects including the inhibition of thymidylate synthase by FdUMP, incorporation of FUTP into RNA and incorporation of FdUTP into DNA.
📦 How Supplied / Storage and Handling ▾
16 HOW SUPPLIED/STORAGE AND HANDLING
16.1How Supplied Fluorouracil injection USP is supplied in single dose vial available in a box containing ten vials, as listed below: NDC 70700-186-22: Vial containing 500 mg/10 mL (50 mg/mL) fluorouracil NDC 70700-187-22: Vial containing 1 g/20 mL (50 mg/mL) fluorouracil 10 mL vials are packaged 10 vials per shelf pack with NDC 70700-186-23 20 mL vials are packaged 10 vials per shelf pack with NDC 70700-187-23
16.2Storage Store at 20° to 25°C (68° to 77°F) [see USP Controlled Room Temperature]. Do not Freeze. Protect from light. Retain in carton until time of use. Fluorouracil is a cytotoxic drug. Follow applicable special handling and disposable procedures [see References ( 15 )] .
16.1How Supplied Fluorouracil injection USP is supplied in single dose vial available in a box containing ten vials, as listed below: NDC 70700-186-22: Vial containing 500 mg/10 mL (50 mg/mL) fluorouracil NDC 70700-187-22: Vial containing 1 g/20 mL (50 mg/mL) fluorouracil 10 mL vials are packaged 10 vials per shelf pack with NDC 70700-186-23 20 mL vials are packaged 10 vials per shelf pack with NDC 70700-187-23
16.2Storage Store at 20° to 25°C (68° to 77°F) [see USP Controlled Room Temperature]. Do not Freeze. Protect from light. Retain in carton until time of use. Fluorouracil is a cytotoxic drug. Follow applicable special handling and disposable procedures [see References ( 15 )] .
📋 Description ▾
11 DESCRIPTION Fluorouracil injection USP, a nucleoside metabolic inhibitor, is a colorless to faint yellow, aqueous, sterile, nonpyrogenic injectable solution available in 10 mL and 20 mL, a sterile preparation that contains single dose vial for intravenous administration. Each mL contains 50 mg fluorouracil in water for injection, USP. The pH is adjusted to approximately 9.2 with sodium hydroxide.
Chemically, fluorouracil, a fluorinated pyrimidine, is 5-fluoro-2,4 (1H,3H)-pyrimidinedione. Its structural formula is: Molecular formula: C 4 H 3 FN 2 O 2 Molecular weight : 130.08 Fluorouracil-Structure
💬 Information for Patients ▾
17 PATIENT COUNSELING INFORMATION Advise: Patients to notify their healthcare provider if they have a known DPD deficiency. Advise patients if they have complete or near complete absence of DPD activity, they are at an increased risk of severe and life-threatening mucositis, diarrhea, neutropenia and neurotoxicity [see Warnings and Precautions ( 5.1 )] . Patients of the risk of cardiotoxicity.
Advise patients to immediately contact their healthcare provider or to go to an emergency room for new onset of chest pain, shortness of breath, dizziness, or lightheadedness [see Warnings and Precautions ( 5.2 )]. Patients to immediately contact their healthcare provider or go to an emergency room for new onset of confusion, disorientation, or otherwise altered mental status; difficulty with balance or coordination; or visual disturbances [see Warnings and Precautions ( 5.3, 5.4)]. Patients to contact their healthcare provider for severe diarrhea or for painful mouth sores with decreased oral intake of food or fluids [see Warnings and Precautions ( 5.5 , 5.8)].
Patients to contact their healthcare provider for tingling or burning, redness, flaking, swelling, blisters, or sores on the palms of their hands or soles of their feet [see Warnings and Precautions ( 5.6 )]. Patients of the importance of keeping appointments for blood tests. Instruct patients to monitor their temperature on a daily basis and to immediately contact their healthcare provider for fever or other signs of infection [see Warnings and Precautions ( 5.7 )].
Patients to notify their healthcare provider of all drugs they are taking, including warfarin or other coumarin-derivative anticoagulants. Advise patients of the importance of keeping appointments for blood tests [see Warnings and Precautions ( 5.9 )]. Females of reproductive potential and males with female partners of reproductive potential to use effective contraception during treatment with fluorouracil and for up to 3 months after the last dose of fluorouracil.
Instruct female patients to contact their healthcare provider if they become pregnant, if pregnancy occurs during fluorouracil treatment or during the 3 months following the last dose [see Warnings and Precautions ( 5.10 ) , Use in Specific Populations (8.1 and 8.6), and Nonclinical Toxicology ( 13.1 )]. Females and males of reproductive potential may have impaired fertility while receiving fluorouracil, based on animal data [see Use in Specific Populations (8.6) and Nonclinical Toxicology ( 13.1 )]. Nursing mothers to discontinue nursing [see Use in Specific Populations ( 8.3 )].
Manufactured for: Xiromed, LLC Florham Park, NJ 07932 Product of India PI-186-23-01 Rev. 02/2022 PSLEA-020505-01
🍼 Nursing Mothers ▾
8.3Nursing Mothers It is not known whether fluorouracil or its metabolites are present in human milk. Because many drugs are present in human milk and because of the potential for serious adverse reactions in nursing infants from fluorouracil, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
🧬 Pharmacokinetics ▾
12.3Pharmacokinetics Distribution Following bolus intravenous injection, fluorouracil distributes throughout the body including the intestinal mucosa, bone marrow, liver, cerebrospinal fluid and brain tissue. Elimination Following bolus intravenous injection, 5 – 20 % of the parent drug is excreted unchanged in the urine in six hours. The remaining percentage of the administered dose is metabolized, primarily in the liver.
The metabolites of fluorouracil (e.g., urea and α-fluoro-ßalanine) are excreted in the urine over 3 to 4 hours. Following bolus intravenous injection of fluorouracil, as a single agent, the elimination half-life increased with dose from 8 to 20 minutes.
🧪 Nonclinical Toxicology ▾
13 NONCLINICAL TOXICOLOGY
13.1Carcinogenesis & Mutagenesis & Impairment Of Fertility Carcinogenicity studies have not been performed with fluorouracil. Fluorouracil was mutagenic in vitro in the bacterial reverse mutation (Ames) assay and induced chromosomal aberrations in hamster fibroblasts in vitro and in mouse bone marrow in the in vivo mouse micronucleus assay. Administration of fluorouracil intraperitoneally to male rats at dose levels equal to or greater than 1.7-fold the human dose of 12 mg/kg induced chromosomal aberrations in spermatogonia and inhibition of spermatogonia differentiation resulting in transient infertility.
In female rats, intraperitoneal administration of fluorouracil during the pre-ovulatory phases of oogenesis at dose levels equal to or greater than 0.33 times a human dose of 12 mg/kg resulted in decreased incidence of fertile matings, increased pre-implantation loss, and fetotoxicity.
📄 Carcinogenesis, Mutagenesis, Impairment of Fertility ▾
13.1Carcinogenesis & Mutagenesis & Impairment Of Fertility Carcinogenicity studies have not been performed with fluorouracil. Fluorouracil was mutagenic in vitro in the bacterial reverse mutation (Ames) assay and induced chromosomal aberrations in hamster fibroblasts in vitro and in mouse bone marrow in the in vivo mouse micronucleus assay. Administration of fluorouracil intraperitoneally to male rats at dose levels equal to or greater than 1.7-fold the human dose of 12 mg/kg induced chromosomal aberrations in spermatogonia and inhibition of spermatogonia differentiation resulting in transient infertility.
In female rats, intraperitoneal administration of fluorouracil during the pre-ovulatory phases of oogenesis at dose levels equal to or greater than 0.33 times a human dose of 12 mg/kg resulted in decreased incidence of fertile matings, increased pre-implantation loss, and fetotoxicity.
📚 References ▾
15 REFERENCES “OSHA Hazardous Drugs.” OSHA. http://www.osha.gov/SLTC/hazardousdrugs/index.html
📄 Package Label / Principal Display Panel ▾
PRINCIPAL DISPLAY PANEL - Fluorouracil Injection, USP NDC 70700-186-22 Container Label-10mL Fluorouracil Injection, USP NDC 70700-186-22 Container Label-10mL PRINCIPAL DISPLAY PANEL - 10 mL Container Label
PRINCIPAL DISPLAY PANEL - Fluorouracil Injection, USP NDC 70700-186-23 Carton-10mL Fluorouracil Injection, USP NDC 70700-186-23 Carton Label - 10mL PRINCIPAL DISPLAY PANEL - 10 mL Carton Label
PRINCIPAL DISPLAY PANEL - Fluorouracil Injection, USP NDC 70700-187-22 Container Label-20mL Fluorouracil Injection, USP NDC 70700-187-22 Container Label-20mL PRINCIPAL DISPLAY PANEL - 20 mL Container Label
PRINCIPAL DISPLAY PANEL - Fluorouracil Injection, USP NDC 70700-187-23 Carton-20mL Fluorouracil Injection, USP NDC 70700-187-23 Carton Label - 20mL PRINCIPAL DISPLAY PANEL - 20 mL Carton Label
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| NDC identity (package / product / labeler codes) | ✓ Available |
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| Active ingredient / dosage form / route | ✓ Available |
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