A chemotherapy given by infusion into the liver's artery
Floxuridine
A chemotherapy delivered by infusion into the liver's artery, used for cancer that has spread to the liver.
What is Floxuridine?
Floxuridine is a chemotherapy used to treat cancer that has spread to the liver, often from bowel cancer. Rather than being given into a general vein, it is usually delivered directly into the artery that supplies the liver, so most of the medicine reaches the cancer there. It works by interfering with the DNA building blocks cancer cells need to divide. The main risks are toxicity to the bowel and the liver's bile ducts, and a drop in blood counts. It is given only under specialist cancer care.
Education and reference only. This is a plain-language guide to Floxuridine — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Floxuridine is a chemotherapy medicine belonging to a group called fluoropyrimidines, which work against fast-dividing cancer cells. It is used mainly for cancer that has spread to the liver, particularly from the bowel. Its distinctive feature is that it is usually given as a continuous infusion straight into the hepatic artery, the blood vessel that supplies the liver, often through a small implanted pump. Delivering it this way concentrates the treatment in the liver where the cancer is, while limiting how much reaches the rest of the body. It is used by specialist teams in selected situations.
How it works
Cancer cells need to copy their DNA in order to divide. Floxuridine is taken up by cells and turned into substances that block the making of DNA building blocks and interfere with DNA itself, so the cancer cells cannot divide and die off. Because it is given directly into the liver's artery, a large share of the medicine acts on the liver cancer before the rest of the body is exposed, which can make it more effective there. However, the medicine still affects the healthy liver, bile ducts and bowel lining, which is the source of its main side effects.
Company & origin
Originated / developed by: Specialist manufacturers.
A specialist chemotherapy given by infusion into the artery supplying the liver, used for cancer that has spread to the liver.
Practical use
How to take Floxuridine
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- It is given as an infusion into the artery supplying the liver, usually through a specialist pump or line set up by your team.
- Attend all monitoring appointments and blood tests, as treatment is adjusted closely to your results.
- Report any yellowing of the skin or eyes urgently, as this can be a sign of bile-duct toxicity.
- Report severe diarrhoea, tummy pain or mouth soreness, as bowel side effects may need treatment paused.
- Contact your team urgently if you have a high temperature, feel unwell, or notice unusual bruising or bleeding.
Weighing it up
Advantages & disadvantages of Floxuridine
Advantages
- Concentrates chemotherapy in the liver, where the cancer is, by being given into the liver's artery.
- Can be effective for cancer that has spread to the liver in selected people.
- Limits how much medicine reaches the rest of the body compared with a general vein.
Disadvantages
- Can inflame and damage the liver's bile ducts, causing jaundice and abnormal liver tests.
- Can cause significant bowel side effects such as diarrhoea, tummy pain and mouth soreness.
- Lowers blood counts and requires a specialist pump or line and very close monitoring.
Practical use
Good to know
The dominant safety concerns with floxuridine relate to where it is delivered. Because it is concentrated in the liver, it can inflame and damage the bile ducts (a problem called biliary toxicity), which may show up as yellowing of the skin or eyes (jaundice) or abnormal liver blood tests; this is watched for closely and may mean pausing treatment. It can also cause significant bowel toxicity, such as diarrhoea, tummy pain, mouth soreness and inflammation of the stomach lining. Like other chemotherapy, it can lower blood counts, raising the risk of infection, bleeding and anaemia. Because of these risks the treatment is delivered through a carefully managed pump or line and is monitored very closely with blood tests and symptom checks. Any jaundice, severe diarrhoea or signs of infection should be reported urgently.
Who should not take it / use with caution
- People who have had a serious allergic reaction to floxuridine should not have it.
- It is generally avoided in pregnancy and while breastfeeding because of harm to the baby.
- It is not suitable where the liver or bile ducts are already too damaged, under specialist judgement.
Monitoring
- Regular liver blood tests to watch for bile-duct toxicity.
- Blood counts and symptom checks for infection, bleeding and anaemia.
- Close monitoring of the pump or line and of bowel side effects.
Side effects
- Bile-duct inflammation, which can cause jaundice and abnormal liver blood tests.
- Bowel toxicity, such as diarrhoea, tummy pain, mouth soreness and stomach inflammation.
- A drop in blood counts, raising the risk of infection, bleeding and anaemia.
Key interactions
- Other medicines that affect the bone marrow can add to its effect on blood counts.
- Other medicines that can harm the liver may add to its effect on the bile ducts.
- Tell your team about all medicines and supplements, as some can change how it works.
Available as: A solution given as an infusion, usually into the artery supplying the liver.
Answers
Floxuridine: frequently asked questions
What is floxuridine used for?
It is a chemotherapy used to treat cancer that has spread to the liver, often from the bowel, delivered directly into the artery that supplies the liver.
Why is it given into the liver's artery?
Giving it into the artery that supplies the liver concentrates the treatment where the cancer is, while limiting how much reaches the rest of the body.
What is bile-duct toxicity?
Because the medicine is concentrated in the liver, it can inflame and damage the bile ducts, sometimes causing jaundice or abnormal liver tests, which is why liver tests are watched closely.
What bowel side effects can it cause?
It can cause diarrhoea, tummy pain, mouth soreness and inflammation of the stomach lining; severe symptoms should be reported as treatment may need pausing.
When should I call my team urgently?
Report yellowing of the skin or eyes, severe diarrhoea, or a high temperature or feeling unwell, as these can be signs of serious side effects.
The wider class
About Chemotherapy (fluoropyrimidine)
Floxuridine belongs to the chemotherapy (fluoropyrimidine) class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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