European Medicines Agency recommendations on dihydropyrimidine dehydrogenase (DPD) testing prior to treatment with fluorouracil, capecitabine, tegafur and flucytosine

The EMA recommends that patients due to receive treatment with fluorouracil, capecitabine or tegafur be tested for lack of DPD before initiation. Treatment is contraindicated in cases of complete deficiency and a reduced starting dose should be considered in partial deficiency.

SPS commentary:


UKMI comment: The recommendations do not apply to fluorouracil medicines used on the skin, as only very low levels of the medicine are absorbed.

The EMA states that pre-treatment testing for DPD deficiency in patients receiving flucytosine is not required, in order to avoid delay in starting treatment for severe fungal infections.

Two direct healthcare professional communications will be sent in due course to healthcare professionals prescribing, dispensing or administering the medicines; these will be published on the EMA website in due course.


European Medicines Agency