Cardio-Oncology: Fluoropyrimidine Chemotherapy Treatment with 5-fluorouracil (5FU) or capecitabine

Although rare, side effects from chemotherapy with fluoropyrimidine may affect patients' hearts.

Learn About This Chemotherapy

Treatment using drugs to kill cancer cells is called chemotherapy. More than 100 chemotherapy drugs are used in cancer treatments.

If you have cancer, your treatment will depend on the type of cancer you have and how far it has progressed. While your treatment will target the cancer cells, sometimes it also may cause heart problems. Although these heart side effects are rare, it’s important to understand and be aware of them.

Chemotherapy with fluoropyrimidine, which includes 5-fluorouracil (5FU) and capecitabine, may be used to treat solid tumors such as those involving your stomach and intestine (gastrointestinal), breast, or head and neck.

These medicines belong to a type of chemotherapy called antineoplastic or antimetabolite, which describes how they work on cancer cells. The drugs stop cancer cells from forming DNA — which contains genetic information — and growing.

This chemotherapy is often well tolerated, but you can have side effects depending on other medications you are taking. Your health history including age, risk factors for heart disease, and other chemotherapy treatments can also play a role in whether you develop complications.

The most common side effects with this chemotherapy are fatigue, nausea, diarrhea and lab abnormalities. It also can cause heart side effects including chest pain, spasm of the heart arteries or irregular heart rhythms, which can be felt as palpitations.

Use this condition center to learn more about damage to your heart, also called cardiotoxicity, from chemotherapy using 5-fluorouracil or capecitabine. 


Published: January 2019
Authors: Suparna Clasen, MD; Rupal O’Quinn, MD, FACC; Joseph R. Carver, MD, FACC
Medical Reviewers: Deb Sundloff, DO, FACC; Bonnie Ky, MD, MSCE, FACC

These modules were developed in collaboration with the Eastern Cooperative Group—American College of Radiology Imaging Network (ECOG-ACRIN) Cardiotoxicity Working Group and Patient Advocacy Group.

Infographic: Cancer Treatment and Your Heart