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Pre-treatment testing to identify DPD-deficient patients at increased risk of severe and fatal toxicity
For Healthcare Professionals
• Patients with partial or complete dihydropyrimidine dehydrogenase (DPD)
deficiency are at increased risk of severe and fatal toxicity during treatment with
fluoropyrimidines (5-FU, capecitabine, tegafur).
• Phenotype and/or genotype testing before initiation of treatment with
fluoropyrimidines is recommended.
• Treatment with 5-FU, capecitabine or tegafur-containing medicinal products is
contraindicated in patients with known complete DPD deficiency.
• Consider a reduced starting dose in patients with identified partial DPD deficiency.
• Therapeutic drug monitoring (TDM) of fluorouracil may improve clinical outcomes
in patients receiving continuous 5-FU infusions.
