ISMP Critical Advisory for Oncology Pharmacy: Preventing Fluoropyrimidine Toxicity Through Pharmacogenetic Testing
Pharmacogenetic screening for DPYD variants prior to initiating 5-fluorouracil (5-FU) or capecitabine therapy is essential to prevent severe, and sometimes fatal, adverse reactions.
A recent bulletin from ISMP Canada highlights serious incidents involving undetected DPD deficiency, underscoring the need for proactive safety measures in oncology practice.
Pharmacy professionals in oncology settings are key to improving outcomes:
• Champion pre-treatment DPYD testing and ensure results are integrated into clinical workflows.
• Educate patients and caregivers on early signs of toxicity and when to seek urgent care.
• Support therapeutic drug monitoring and emergency access to uridine triacetate (Vistogard).
• Collaborate with multidisciplinary teams to update protocols and enhance safety.