Uridine triacetate (Vistogard)

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General information

Class/mechanism: Pyrimidine analog, antidote to Fluorouracil (5-FU) and Capecitabine (Xeloda). Uridine triacetate is an acetylated pro-drug of uridine. After oral administration, uridine triacetate is deacetylated into uridine, which competitively inhibits cell damage and cell death caused by fluorouracil/capecitabine.[1][2][3]
Route: PO
Extravasation: n/a

For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as Micromedex, Lexicomp, UpToDate (courtesy of Lexicomp), or the prescribing information.[1]

Dosing

  • Adults: Uridine triacetate (Vistogard) 10 g PO every 6 hours x 20 doses[1]
  • Pediatric patients: Uridine triacetate (Vistogard) 6.2 g/m2 (maximum of 10 g per dose) PO every 6 hours x 20 doses[1]

Diseases for which it is used

  • Overdose of, or early-onset, severe, or life-threatening toxicity from fluorouracil or capecitabine.

Patient drug information

History of changes in FDA indication

  • 12/11/2015: FDA approved for patients:
    • "following a fluorouracil or capecitabine overdose regardless of the presence of symptoms, or
    • "who exhibit early-onset, severe or life-threatening toxicity affecting the cardiac or central nervous system, and/or earlyonset, unusually severe adverse reactions (e.g., gastrointestinal toxicity and/or neutropenia) within 96 hours following the end of fluorouracil or capecitabine administration."

Also known as

  • Brand name: Vistogard

References