Fluoropyrimidine-induced cardiotoxicity

Table 1 Management of fluoropyrimidine-induced cardiotoxicity and rechallenge

Management of acute cardiotoxicity	Rechallenge with fluoropyrimidine	Antidote
Stop fluoropyrimidine chemotherapy	Switch from continuous infusion to bolus administration	Uridine triacetate
Administration of antianginal drugs and antiplatelets	Dose reduction with antianginal drugs administration: (1) Preatreatment 3 to 4 h before fluoropyrimidine; (2) Administration during the treatment with 5-FU; (3) Posttreatment 12 or 24 h after fluoropyrimidine
Monitor patient’s cardiac enzymes, ECG	Use of alternative fluoropyrimidine agents (S1, TAS-102)
Coronarography with revascularization if acute coronary syndrome is suspected	Use of alternative non-fluoropyrimidine agents
Stress test or coronary CT angiography in patient’s with persistent minor or mild symptoms

ECG: Electrocardiography; CT: Computed tomography; 5-FU: 5-fluorouracil.