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Fluoropyrimidine Chemotherapy

Treatment with 5-fluorouracil (5FU) or capecitabine

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.

Fluoropyrimidine includes 5-fluorouracil (5FU) and capecitabine. Chemotherapy with fluoropyrimidine 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. Your health history, including age, risk factors for heart disease, other medications, and other cancer treatments, can play a role in whether you develop complications.

The most common side effects of this chemotherapy are fatigue, nausea, diarrhea and lab abnormalities. It also can cause heart side effects including spasm of the heart arteries (coronary vasospasm) and irregular heart rhythms (arrhythmias). Spasm of the heart arteries can be felt as chest pain, tightness, pressure, squeezing or burning. Irregular heart rhythms 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. 

  • Last Edited 03/15/2023

Authors: Suparna Clasen, MD; Rupal O’Quinn, MD; Joseph R Carver, MD