Uridine triacetate

Uridine triacetate is a prescription medication used to treat hereditary orotic aciduria, a rare metabolic disorder in which the body can not make uridine. It is also used to treat overdose or toxicities of certain types of chemotherapy.

Uridine triacetate belongs to a group of drugs called pyrimidine analogs. When treating overdose or toxicities of certain types of chemotherapy, this medication works by blocking cell damage and cell death.

When treating hereditary orotic aciduria, this medication works by replacing uridine. 

Uridine triacetate is considered an orphan drug, because it treats a rare disease. 

It is available as oral granules that can be mixed with food and water. It can also be mixed in milk or infant formula when given to infants. Do not chew the granules.

Depending on what is being treated, uridine triacetate is typically taken once a day or every 6 hours. 

Common side effects include vomiting, nausea, and diarrhea.

Uridine triacetate is a prescription medication used to treat hereditary orotic aciduria, a rare metabolic disorder in which the body can not make uridine.

Uridine triacetate is also used in adults and children for the emergency treatment of the following:

• after an overdose of the cancer treatment fluorouracil or capecitabine
• who have early signs of severe or life-threatening side effects that affect the heart, or early signs of severe or life threatening neurologic (central nervous system) problems, or certain unusually severe side effects within four days of receiving fluorouracil or capecitabine

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Uridine triacetate may be found in some form under the following brand names:

• Vistogard

• Xuriden

Serious side effects have been reported with uridine triacetate. See the "Drug Precautions" section.

Common side effects include the following:

• vomiting
• nausea
• diarrhea

This is not a complete list of uridine triacetate side effects. Ask your doctor or pharmacist for more information.

Tell your doctor if you have any side effect that bothers you or that does not go away.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• medications that use the p-glycoprotein transporter such as digoxin (Lanoxin), loperamide (Imodium), quinidine, vinblastine (Velban), fexofenadine (Allegra), indinavir (Crixivan), colchicine (Colcrys),topotecan (Hycamtin), and paclitaxel (Abraxane, Onxol, Taxol)

This is not a complete list of uridine triacetate drug interactions. Ask your doctor or pharmacist for more information.

Do not take uridine triacetate if you are allergic to uridine triacetate or any of its ingredients. 

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of uridine triacetate, there are no specific foods that you must exclude from your diet when receiving this medication.

Before taking uridine triacetate, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

• are allergic to uridine triacetate or to any of its ingredients
• are pregnant or plan to become pregnant
• are breastfeeding or plan to breastfeed

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

Tell your doctor if you are breastfeeding or plan to breastfeed.

It is not known if uridine triacetate crosses into human milk. Because many medications can cross into human milk and because of the possibility for serious adverse reactions in nursing infants with use of this medication, a choice should be made whether to stop nursing or stop the use of this medication. Your doctor and you will decide if the benefits outweigh the risk of using uridine triacetate. Talk to your healthcare provider about the best way to feed your baby if you take uridine triacetate.

Take uridine triacetate exactly as prescribed.

Uridine triacetate comes as oral granules that can be mixed with food and water or in milk or infant formula.

Preparation

• Measure the dose using either a scale accurate to at least 0.1 gram, or a graduated teaspoon, accurate to the fraction of the dose to be administered.
• Once the measured dose has been removed from the uridine triacetate packet, discard the unused portion of granules.
• Do not use any granules left in the open packet.

Administration with Food

1. Place 3 to 4 ounces of applesauce, pudding or yogurt in a small clean container.

2. Mix the measured amount of granules in the applesauce, pudding or yogurt

3. Swallow applesauce/pudding/yogurt immediately. Do not chew the granules. Do not save the applesauce/pudding/yogurt for later use.

4. Drink at least 4 ounces of water.

Administration in Milk or Infant Formula

Uridine triacetate can be mixed with milk or infant formula instead of the soft foods described above for patients receiving up to 3/4 teaspoon (2 grams) of uridine triacetate. After weighing the dose of uridine triacetate: 

1. Pour 5 mL of milk or infant formula into a 30 mL medicine cup.

2. Insert the tip of the oral syringe into the medicine cup and draw up 5 mL of milk/infant formula into the syringe.

3. Hold the syringe with the tip pointing upward. Pull down on the plunger until the plunger reaches 10 mL. This will add air to the syringe.

4. Place the cap over the tip of the syringe. Then invert the syringe so the syringe tip is pointing down, and remove the plunger.

5. Pour the measured amount of granules into the syringe barrel and reinsert the syringe plunger. Do not push up on the plunger.

6. Gently swirl the syringe to mix the granules with the liquid.

7. Turn the syringe so the syringe tip is pointing up. Then remove the syringe cap and push up on the plunger until the plunger reaches the 5 mL mark. This will remove air from the syringe.

8. Place the tip of the syringe in the patient’s mouth between the cheek and gum at the back of the mouth. Gently push the plunger all the way down.

9. Refill the syringe with another 5 mL of milk/infant formula.

10. Gently swirl the syringe to rinse any remaining granules from the syringe barrel.

11. Place the tip of the syringe in the patient’s mouth between the cheek and gum at the back of the mouth. Gently push the plunger all the way down.

12. Follow with a bottle of milk or infant formula, if desired.

Take this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The dose your doctor recommends may be based on the following:

• the condition being treated
• how you respond to this medication
• your weight

Treating Hereditary orotic aciduria:

The starting dosage is 60 mg/kg once daily; the dose may be increased to 120 mg/kg (not to exceed 8 grams) once daily if needed. 

Treating overdose or toxicities of certain types of chemotherapy:

The recommended dose in adults is one packet (equal to 10 grams Vistogard) every 6 hours for 20 doses.

The recommended dose in a child is 6.2 grams/m2 of body surface area (not to exceed 10 grams per dose) every 6 hours for 20 doses. 

If you take too much uridine triacetate, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

• Store uridine triacetate at controlled room temperature, 25°C (77°F).
• Keep this and all medicines out of the reach of children.