Fluorouracil or capecitabine interfere with DNA synthesis to cause cell death, which slows down cancer growth. However, in addition to working against cancer cells, it also affects your normal cells. This is caused by a lack of uridine, one of the components of the process required to make DNA. Uridine triacetate works by replenishing the amount of uridine in your body, which stops cell death caused by fluorouracil and capecitabine.
This medication is available in oral granule form.
What Is Vistogard Used For?
The Food and Drug Administration (FDA) approved uridine triacetate to treat an overdose of fluorouracil or capecitabine. You may be prescribed this if your prescriber has determined that you meet the criteria below:
Brand Name(s): Vistogard, Xuriden
Drug Availability: Prescription
Administration Route: Oral
Therapeutic Classification: Pyrimidine analog
Available Generically: No
Controlled Substance: No
Active Ingredient: Uridine triacetate
Dosage Form(s): Granules
Fluorouracil or capecitabine overdose, regardless of symptomsEarly-onset, severe reactions or symptoms that involve the heart or central nervous system or unusually severe adverse reactions, such as neutropenia (low white blood cell count), within the first 96 hours of fluorouracil or capecitabine administration
However, the agency has set limitations for Vistogard’s use. Vistogard will not be prescribed:
For non-emergency side effects of fluorouracil or capecitabine, such as nausea or diarrheaIf more than 96 hours have passed since administering the cancer medications
An overdose of fluorouracil can have different symptoms, including:
Heart attack Heart failure Confusion Severe diarrhea Inflammation of your stomach, or mucositis Hand-foot syndrome, a disorder that involves tingling, burning, or redness of your hands and feet
How to Take Vistogard
Always follow directions from your healthcare provider on how to take Vistogard. It is dispensed in granule form in single-dose packets.
To take this medication:
Mix your packet of granules with 3 to 4 ounces of soft, such as a cup of applesauce, pudding, or yogurt, before taking it. Do not chew the granules. Take the mixture within 30 minutes of preparing it. Drink a full glass of water afterward. Take the full recommended course of medication, even if you are feeling well.
Storage
Store Vistogard in a cool, dry place at room temperature (77 F). Keep it protected from exposure to high humidity or moisture. Do not store it in the bathroom. These environments can impact how well medications work.
It is also important to ensure that this medication is kept away and out of reach of children and pets to prevent accidental consumption.
Off-Label Uses
Healthcare providers may prescribe uridine triacetate for off-label uses, meaning for conditions not specifically indicated by the FDA.
Uridine triacetate can also be used for a condition known as hereditary orotic aciduria. This rare disease results in changes in DNA synthesis and decreases the amount of uridine you have available. The lack of uridine may lead to low amounts of iron in the body that cannot be treated by standard methods such as iron supplementation. Vistogard treats this disease by replenishing your body’s uridine, reducing the effects of orotic aciduria.
What Are the Side Effects of Vistogard?
This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 800-FDA-1088.
Common Side Effects
The most common side effects of Vistogard are:
Nausea and vomiting Diarrhea
Severe Side Effects
Vistogard is a generally well-tolerated medication with no documented severe side effects.
Long-Term Side Effects
Vistogard does not have documented side effects that occur after it has been stopped.
Dosage: How Much Vistogard Should I Take?
Modifications
Vistogard usually does not require special dosing. It is dosed the same even if you have problems with your kidney or liver.
If you experience a serious side effect, you or your healthcare provider may send a report to the FDA’s MedWatch Adverse Event Reporting Program or by phone (800-332-1088).
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
For oral dosage form (oral granules): For treatment of hereditary orotic aciduria: Adults and children—Dose is based on body weight and must be determined by your doctor. The starting dose is 60 milligrams (mg) per kilogram (kg) of body weight (1 to 3 packets) once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 120 mg per kg of body weight (2 to 4 packets) once a day. For emergency treatment of patients who have an overdose of fluorouracil or capecitabine: Adults—10 grams (1 packet) every 6 hours for 20 doses. Children—Dose is based on body size and must be determined by your doctor. The starting dose is 6. 2 grams per square meter (m[2]) of body size (not to exceed 10 grams per dose) every 6 hours for 20 doses.
However, if your child needs this medication, the dose will need to be adjusted based on height and weight.
Missed Dose
If you miss a dose of Vistogard, take it as soon as you remember. If you are closer to the next dose than the missed one, then skip the missed dose and take only the next scheduled dose. You should not take more than one dose at a time.
If you miss a dose of Vistogard, your symptoms may not improve.
Overdose: What Happens If I Take Too Much Vistogard?
Vistogard is a safe medication that is well tolerated, even in large doses. There is not much data on what happens if you take too much of it, but it would likely induce side effects such as nausea, vomiting, and diarrhea.
Precautions
What Other Medications Interact With Vistogard?
Vistogard is intended to be used to treat overdoses related to fluorouracil and capecitabine. However, if you are not experiencing an overdose, this medication can prevent those medications from working appropriately.
If someone collapses or isn’t breathing after taking Vistogard, call 911 immediately.
What Medications Are Similar?
Other medications can be used to reverse toxicities related to chemotherapy, such as:
Mesnex (mesna)Dexrazoxane
Mesna is commonly used with Cytoxan (cyclophosphamide) to prevent hemorrhagic cystitis, or bladder damage, which is a common side effect of Cytoxan. Similarly, dexrazoxane is used to prevent the side effects associated with Adriamycin (doxorubicin), including heart damage.
This is a list of drugs that are similar to Vistogard. It is NOT a list of drugs recommended to take with Vistogard. In fact, you should not take these drugs together. Talk to your pharmacist or a healthcare provider if you have questions.
How Can I Stay Healthy While Taking Vistogard?
To stay healthy while taking Vistogard, it is important to use it exactly as prescribed to effectively treat chemotherapy toxicity. Continue to take the full course even if you start to feel better after your first dose.
Along with taking this medication as prescribed, make sure to get plenty of rest, stay hydrated and eat a healthy diet as instructed by your healthcare provider.
The author would like to recognize and thank Chong Yol Gacasan Kim for contributing to this article.
