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Incompatibilities: Admixture with acidic drugs or drugs that decompose in an alkaline environment should be avoided. Fluorouracil is reported to be incompatible with cytarabine, diazepam, methotrexate, platinum compounds, doxorubicin (and presumably other anthracyclines that are unstable at alkaline pH), and calcium folinate (leucovorin) or levoleucovorin calcium.
Special precautions for disposal: Handling Precautions: As with all antineoplastic agents, trained personnel should prepare DBL Fluorouracil Injection BP. This should be performed in a designated area (preferably a cytotoxic laminar flow cabinet with table surfaces protected with disposable plastic-backed absorbent paper, should be designated for the handling of the drug). Protective gown, mask, gloves and appropriate eye protection should be worn when handling fluorouracil. Where solution accidentally contacts skin or mucosa, the affected area should be immediately washed, thoroughly with soap and water and a physician contacted. If the drug is ingested or inhaled inadvertently, immediate medical attention should be sought. It is recommended that pregnant personnel not handle cytotoxic agents such as fluorouracil.
Luer-Lock fitting syringes are recommended. Large bore needles are recommended to minimise pressure and possible formation of aerosols. Aerosols may also be reduced by using a venting needle during preparation.
Items used to prepare DBL Fluorouracil Injection BP, or articles associated with body waste should be disposed of by placing in a double sealed polythene bag and incinerated at 1100°C.
Spills and Disposal: If spill occurs, restrict access to the affected area. Wear two pairs of latex rubber gloves, a suitable mask, a protective gown and safety glasses. Limit the spread of the spill by covering with a suitable material such as absorbent towels or adsorbent granules. Spills may also be treated with 5% sodium hypochlorite. Collect the absorbent/adsorbent and other debris from the spill and place in a leakproof plastic container and label accordingly. Cytotoxic waste should be regarded as toxic and hazardous and clearly labelled 'CYTOTOXIC WASTE FOR INCINERATION AT 1100°C'. Waste material should be incinerated at 1100°C for at least 1 second. Clean the remaining spill area with copious amounts of water.
Single use only, Discard unused portion.
If a precipitate has formed as a result of exposure to low temperature, redissolve by heating to 60°C accompanied by vigorous shaking. Allow to cool to body temperature prior to use.
