Example orders for simplified biweekly 5-FU & leucovorin (sLV5FU2) in colon cancer

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Simplified biweekly 5-FU & leucovorin (sLV5FU2)

Original reference may be found at simplified biweekly 5-FU & leucovorin (sLV5FU2)

Example regimen #1

• Folinic acid (Leucovorin) 400 mg/m2 IV over 2 hours on days 1 & 15, given first
• Fluorouracil (5-FU) 400 mg/m2 IV bolus over 10-15 minutes on day 1 after leucovorin
• Fluorouracil (5-FU) 1200 mg/m2/day (total dose of 2400 mg/m2) IV continuous infusion over 46 hours on days 1-2, to start after 5-FU bolus

28-day cycles

Supportive medications:

• Dexamethasone (Decadron) 12 mg PO 30 minutes prior to chemotherapy
• Ondansetron (Zofran) 16 mg IV 30 minutes prior to chemotherapy
• Lorazepam (Ativan) 0.5-1 mg PO prn nausea/anxiety, given 30 minutes prior to chemotherapy

Hydration:

• 500 ml D5W at KVO rate as running IV for chemotherapy infusion. Give up to 500 ml D5W.

Monitoring:

• Hold if ANC <1500 or platelets <75 and notify physician.
• Comprehensive metabolic panel (chem 10 & LFTs) before each treatment
• Monitor for possible hand-foot syndrome
• Assess for mucositis at every visit

Comments:

• My institution administers this regimen in 28-day cycles.