Moderate to severe reaction on your first or second round of chemotherapy

Moderate to severe reaction on your first or second round of chemotherapy

While it is common for side effects to occur to a mild or moderate degree with 5-FU or Xeloda, if you think that you are having a moderate to severe reaction on your first or second round of chemotherapy, you should contact your healthcare provider immediately. Unmanaged, early-onset severe toxicities can result in acute respiratory distress syndrome, and sepsis leading to multisystem organ failure, septic shock and death. Be sure to speak to your doctor about these risks prior to starting treatment.

Warning Signs Of Severe Toxicity (Grade 3 Or 4):

According to the Colon Cancer Alliance (CCA), the following symptoms can be signs of a life-threatening toxicity especially if they occur during the first or second round of treatment.

TALK TO YOUR HEALTH CARE PROVIDER IMMEDIATELY if you think you are experiencing these symptoms as it is critical that you receive treatment as soon as possible.

  • Diarrhea more than 7 times what is normal for you and/or incontinence
  • Mucositis- oral and/or anal that interferes with eating, drinking, swallowing or daily activities
  • Nausea to the point where you are unable to eat or drink
  • Vomiting more than than 6 times

  • Bleeding (hemorrhage), including black tarry stools or “coffee ground” vomit

  • Severe hand and foot syndrome, including pain, blisters, bleeding and peeling that interferes with daily activities

  • Cardiac arrhythmias (irregular heart beats), chest pain or heart attack, acute pulmonary edema, congestive heart failure, cardiac arrest

  • Neurologic cerebellar syndrome (uncoordination), dizziness, queasiness, disorientation, seizures, coma

AUDT recommends that you also speak to your healthcare provider immediately if you experience any severe or worsening of the common “side effects”, as deadly toxicities do not always present the same in each patient.

The only approved antidote for life-threatening toxicities is Uridine triacetate (Vistogard®) which must be given within 96 hours of your last dose of 5-FU or Xeloda to reduce or prevent further toxicity from developing.

For more information, see the full “5-FU & XELODA: Side Effects vs. Symptoms” fact sheet at:

Further information on side effects vs. severe toxicities can be found here:

Working with Your Oncologist

Working with Your Oncologist

You will need to initiate discussion of testing for DPD/DPYD deficiency with your oncologist because it is NOT the standard of care in the US.

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