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Efudex
Efudex is the brand name for fluorouracil, a topical medication used primarily to treat pre-cancerous skin lesions such as actinic keratosis and superficial basal cell carcinoma. Fluorouracil is a type of antimetabolite that works by interfering with the DNA synthesis of abnormal cells, leading to their destruction. Efudex is commonly prescribed to patients with sun-damaged skin or certain types of skin cancer.
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Frequently Asked Questions
How long does it take for Efudex to work?
The treatment course for Efudex typically lasts 2 to 4 weeks for actinic keratosis and up to 10-12 weeks for basal cell carcinoma. Healing may continue for several weeks after you stop applying the cream.
What should I expect during treatment?
During treatment, it is normal to experience redness, burning, crusting, and peeling. These reactions indicate that Efudex is working. However, if the skin reaction becomes severe or intolerable, consult your doctor.
Can I go out in the sun while using Efudex?
Avoid sun exposure on the treated area as much as possible, as fluorouracil increases the skin's sensitivity to UV light. When going outdoors, wear protective clothing and use sunscreen on untreated areas.
What should I do if I miss a dose of Efudex?
If you miss a dose, apply it as soon as you remember. If it is close to the time of your next dose, skip the missed dose and continue with your regular schedule. Do not apply extra cream to make up for a missed dose.
Can I use makeup or skincare products while using Efudex?
You should avoid using makeup, skincare products, or other topical treatments on the treated area unless directed by your healthcare provider, as these may interfere with the effectiveness of Efudex or cause additional irritation.
Comprehensive Drug Guide
How Does Efudex Work?
Fluorouracil in Efudex works by inhibiting the synthesis of thymidine, a nucleotide necessary for DNA replication. This disruption leads to the death of rapidly dividing abnormal skin cells, such as those found in actinic keratosis or basal cell carcinoma, while leaving normal cells relatively unharmed.
Common Dosages
Efudex is available in two forms:
- 2% cream or solution: For milder cases of actinic keratosis
- 5% cream or solution: For more severe or extensive cases, and for superficial basal cell carcinoma
Typical Dosing
- For actinic keratosis: Apply a thin layer of the 2% or 5% cream to the affected area twice daily for 2 to 4 weeks. Treatment may be extended based on the response.
- For superficial basal cell carcinoma: Apply the 5% cream to the lesion twice daily for 3 to 6 weeks, or as directed by your healthcare provider. In some cases, treatment may extend to 10-12 weeks.
Typical Dosing
FDA Approved Indications
- Actinic keratosis (a pre-cancerous skin condition caused by sun damage)
- Superficial basal cell carcinoma (a form of skin cancer that affects the outer layer of the skin)
Who Shouldn't Take Efudex?
- Known hypersensitivity to fluorouracil or any component of the formulation
- Pregnancy, as fluorouracil can harm an unborn baby
- DPD (dihydropyrimidine dehydrogenase) enzyme deficiency, as it may increase the risk of severe side effects
Advice From The Pharmacist
- Apply Efudex only to the affected areas, avoiding contact with healthy skin. Use gloves or wash your hands thoroughly after application.
- Protect the treated area from sunlight and avoid using other topical skin products unless advised by your healthcare provider.
- Expect redness, burning, and irritation as part of the normal healing process. This means the medication is working to destroy abnormal skin cells.
- Avoid using Efudex on mucous membranes, including the eyes, mouth, or lips.
Side Effects of Efudex
Common Side Effects
- Redness
- Burning or itching at the application site
- Skin peeling
- Crusting or scaling
Uncommon/Severe Side Effects
- Severe allergic reactions (swelling, rash, difficulty breathing)
- Intense pain or blistering at the application site
- Infection at the site of application
Risks and Warnings of Efudex
- Sun Sensitivity: Fluorouracil increases the skin's sensitivity to sunlight, and exposure to UV rays can worsen side effects. Wear protective clothing and use sunscreen on untreated areas.
- Severe Skin Reactions: If severe skin reactions such as blistering, ulceration, or intense pain occur, discontinue use and contact your healthcare provider.
- Pregnancy Risk: Efudex should not be used during pregnancy as it can cause birth defects. Women of childbearing potential should use effective contraception during treatment.
Interactions with Efudex
Common Drug Interactions
- Topical Products: Using other topical medications or skincare products on the same area may increase irritation or reduce the effectiveness of Efudex.
- Photosensitizing Drugs: Certain medications that increase sensitivity to sunlight (e.g., tetracyclines, retinoids) may worsen the side effects of Efudex.
Alternatives to Efudex
- Imiquimod (Aldara): A topical immunomodulator used to treat actinic keratosis and basal cell carcinoma by stimulating the immune system to attack abnormal cells.
- Cryotherapy: A procedure where pre-cancerous lesions or small skin cancers are frozen off using liquid nitrogen.
- Surgical Removal: For more advanced cases of basal cell carcinoma, excisional surgery may be required to remove the cancerous tissue.
- Ingenol mebutate (Picato): A topical gel used for treating actinic keratosis.