Uridine Triacetate (Oral)

This article contains information on the uses, side effects, dosage, interactions, warnings and storage of the drug uridine triacetate (pronounced YOOR-ih-deen try-A-seh-tayt).

What is uridine triacetate?

Uridine triacetate, formerly known as vistonuridine, is an orally active synthetic uridine pro-drug. Uridine triacetate is used to treat hereditary orotic aciduria under the brand name Xuriden. (1) It is also used for the emergency treatment of cardiac or central nervous system toxicity or other serious side effects which occur from taking the cancer or chemotherapy treatments fluorouracil (also known as 5-FU) or capecitabine, under the brand name Vistogard. (2) Uridine triacetate comes in the form of oral granules. When consumed, uridine triacetate is deacetylated by nonspecific enzymes in the body, which circulates uridine throughout the body. Uridine competitively inhibits cell damage and/or cell death which can be caused by capecitabine and fluorouracil. Uridine triacetate delivers 4-6 times more uridine into systemic circulation when compared to equimolar doses of uridine itself. Maximum concentrations of uridine in plasma following oral doses are generally achieved within 2 to 3 hours. (5)

Hereditary orotic aciduria also referred to as uridine monophosphate synthase (UMPS) deficiency, is a rare metabolic disease caused by uridine deficiency. Uridine triacetate works by replacing the uridine that patients with hereditary orotic aciduria cannot produce. (3) When administered, uridine triacetate can be used by nearly all cells to make uridine nucleotides, which makes up for the genetic deficiency in synthesis present in patients who have been diagnosed with hereditary orotic aciduria. (1)

Uridine triacetate is also used for the emergency treatment of children and adults who have either received too much of the cancer and chemotherapy medications fluorouracil or capecitabine or who develop certain severe or life-threatening toxicities within four days of receiving fluorouracil or capecitabine. This can include effects on your heart, nervous system, stomach, intestines, or blood cells. Uridine triacetate works by slowing down cell damage caused by cancer and chemotherapy medications capecitabine and/or fluorouracil. (4) Pre-administering with uridine triacetate can improve efficacy and a reduction in the toxic side effects of fluorouracil or capecitabine. (1)

This drug is available only with your doctor's prescription.

What conditions does uridine triacetate treat?

  • Hereditary orotic aciduria
  • Fluorouracil overdose or toxicity
  • Capecitabine overdose or toxicity

What type of medication is uridine triacetate?

  • Antidote
  • Endocrine-Metabolic Agent

What side effects can occur when taking uridine triacetate?

Not all of these side effects may occur. If any of these side effects do occur they may require medical attention. Check with your healthcare professional if any of the following side effects continue for longer than a few days or are severe.

More common side effects:

  • Vomiting

Less common side effects:

  • Diarrhea
  • Nausea

Call your doctor immediately if you experience any of these side effects:

  • Itching and/or hives
  • Swelling of the face and/or hands
  • Swelling and/or tingling of the mouth or throat
  • Feeling of tightness in the chest
  • Trouble breathing normally

Some side effects of uridine may not be reported, so always consult your doctor or healthcare professional for medical advice if you experience any other side effects. You or your doctor can report any severe side effects that you experience to the Food and Drug Administration's (FDA) Adverse Event Reporting website (http://www.fda.gov/Safety/MedWatch) or call at (1-800-332-1088).

What is the dosage for uridine triacetate?

Uridine triacetate comes in the form of an oral granule, which is usually taken four times a day (every six hours) for 20 doses. You should take uridine triacetate at around the same time every day. Unless your doctor tells you otherwise you can continue your normal diet while taking this medication. Do not take more or less of it or take it more often than has been prescribed to you by your doctor. Remember to wash your hands before and after using this medicine. Take uridine triacetate exactly as directed by your doctor. Once you have removed the measured dose from the packet, discard the unused portion of the oral granules. Do not use any granules that remain in the open packet, or that are left over from a previous packet.

Below, find the usual doses for reference. (4)

To take the usual adult dose for a fluorouracil or capecitabine overdose, mix 10 grams of the granules with 3-4 ounces of soft food (such as milk, pudding, applesauce or yogurt). Take a dose orally every 6 hours, for 20 doses. Make sure to ingest all of the dose within 30 minutes, and take it with at least 4 oz of water. Do not chew the granules.

This dosage can be used to treat adults suffering from:

  • Fluorouracil or capecitabine overdose
  • Early onset, life-threatening or severe capecitabine or fluorouracil toxicity that affects the cardiac and/or central nervous system
  • Early onset, abnormally severe and/or adverse reactions (such as gastrointestinal toxicity or neutropenia) arising in the 4 days following administration of fluorouracil or capecitabine.

To take the usual adult dose for treating orotic aciduria, first take a dose of 60 milligrams of the granules. Do not take more than 8 grams orally once a day. Do not chew the granules. You may need to increase the dosage to 120 milligrams orally once a day if the first dose shows signs of insufficient efficacy, or if any of the following arise:

  • The levels of orotic acid in urine stall above normal, or rise above a usual range
  • The laboratory values affected by hereditary orotic aciduria show evidence of becoming worse
  • Any other signs or symptoms become worse

This dosage can be used to treat adults suffering from:

  • Hereditary orotic aciduria

To take the usual pediatric dose for a fluorouracil or capecitabine overdose, mix 6.2/m2 of body surface area (BSA) of the granules with 3-4 ounces of soft food (such as milk, applesauce, pudding, or yogurt). Measure the dose with a scale accurate to at least 0.1 gram, or a teaspoon accurate to .25 of a teaspoon. Do not take more than 10 grams per dose. Take a dose orally every 6 hours, for 20 doses. Make sure to ingest all of the dose within 30 minutes, and take it with at least 4 oz of water. Do not chew the granules.

This dosage can be used to treat children suffering from:

  • Fluorouracil or capecitabine overdose
  • Early onset, life-threatening or severe capecitabine or fluorouracil toxicity that affects the cardiac or central nervous system
  • Early onset, abnormally severe adverse reactions (such as gastrointestinal toxicity or neutropenia) arising in the 4 days following the administration of fluorouracil or capecitabine

To take the usual pediatric dose for treating orotic aciduria, first take a dose of 60 milligrams of the granules. Do not take more than 8 grams orally once a day. Do not chew the granules. You may need to increase the dosage to 120 milligrams orally once a day if the first dose shows signs of insufficient efficacy, or if any of the following arise:

  • The levels of orotic acid in urine stay above normal, or climb above an expected range
  • The laboratory values affected by hereditary orotic aciduria show evidence of becoming worse
  • Any other signs or symptoms become worse

This dosage can be used to treat children suffering from:

  • Hereditary orotic aciduria

Uridine triacetate granules can also be given through certain types of feeding tubes. If you have a feeding tube, ask your doctor or healthcare professional how you should take the medication, and follow their directions carefully.

If you miss a dose:

Take the dose, as instructed by your doctor or pharmacist, as soon as you remember. If it is almost time for your next dose, wait until that time and take a regular dose. Do not take extra uridine triacetate to make up for the dose you missed. If you vomit within 2 hours of taking a dose of uridine triacetate, take another full dose immediately and take your next dose at your regularly scheduled time.

Always remember to read and follow the patient instructions that come with this medicine, and talk to your doctor or pharmacist if you have any further questions.

Interactions (4)

Some medicines are known to interact with uridine triacetate. Inform your doctor if you are taking any of the following medications before taking uridine triacetate:

  • aliskiren
  • aliskiren / amlodipine
  • aliskiren / amlodipine / hydrochlorothiazide
  • aliskiren / hydrochlorothiazide
  • aliskiren / valsartan
  • Amturnide (aliskiren / amlodipine / hydrochlorothiazide)
  • betrixaban
  • Bevyxxa (betrixaban)
  • naldemedine
  • Symproic (naldemedine)
  • Tekamlo (aliskiren / amlodipine)
  • Tekturna (aliskiren)
  • Tekturna HCT (aliskiren / hydrochlorothiazide)
  • Valturna (aliskiren / valsartan)

Warnings

This medicine may interact with other drugs or health problems. Before taking uridine triacetate, tell your doctor if you have an allergy to uridine triacetate or any part of this medication. Also tell your doctor and pharmacist about any other prescriptions or drugs or supplements you are taking (such as vitamins) and any other health concerns. Make sure that it is safe for you to take uridine triacetate with all other drugs or supplements you are taking, as well any other health problems you may be experiencing. Do not start, stop, or change the dose of any drug without checking with your doctor or pharmacist.

If you vomit within two hours of taking a dose of uridine triacetate, take another full dose as soon as possible and take your next dose at the regularly scheduled time. It is important that you take all doses of uridine triacetate prescribed to you, even if you feel well. Do not stop taking uridine triacetate without consulting your doctor or healthcare professional.

If you think you have overdosed on uridine triacetate, call your poison control center or get medical care immediately.

The safety of using uridine triacetate during pregnancy or breastfeeding has not been established.

Storage

Keep the uridine triacetate in the container it came in, tightly closed, and out of reach of children and pets. Do not share your medication with others or take anyone else's medication. Store uridine triacetate at room temperature and in a dry place away from moisture. Do not store uridine triacetate in a bathroom. Check with your pharmacist or healthcare professional about how to dispose of any unused medicine.

Summary

Uridine triacetate is a medication used for the treatment of hereditary orotic acuduria or for the emergency treatment of children and adults who have either received an overdose of medications such as capecitabine or fluorouracil, or who develop certain life-threatening or severe toxicities within four days of receiving capecitabine or fluorouracil. Uridine triacetate is in a class of medications called pyrimidine analogs. It works by blocking cell damage from certain medications.

This medicine is available only with a prescription from a doctor. There may be other brand names for this medicine.

Note: the numbers in parentheses within the text correspond to the sources below.

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Last Reviewed:
December 23, 2017
Last Updated:
April 05, 2018
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