Table 3.

Dose reductions for HAI FUDR

Liver blood testLower reference rangeUpper reference rangeFUDR dose
ASTRef*≤50 U/L>50 U/L
Current value0 to <3 × ref0 to <2 × ref100%
3 to <4 × ref2 to <3 × ref80%
4 to <5 × ref3 to <4 × ref50%
≥5 × ref≥4 × refHold
If held, restart when:<4 × ref<3 × ref50% off last dose
Alk PhosRef*≤90 U/L>90 U/L
Current value0 to <1.5 × ref0 to <1.2 × ref100%
1.5 to >2 × ref1.2-1.5 × ref80%
≥2 × ref≥1.5 × refHold
If held, restart when:<1.5 × ref<1.2 × ref25% off last dose
Total bilirubinRef*≤1.2 mg/dL>1.2 md/dL
Current value0 to <1.5 × ref0 to <1.2 × ref100%
1.5 to <2 × ref1.2 to <1.5 × ref50%
≥2 × ref≥1.5 × refHold
If held, restart when:<1.5 × ref<1.2 × ref25% off last dose

Abbreviations: AST, aspartate transaminase; Alk Phos, alkaline phosphatase; ref, reference value.

  • *Reference value is the value obtained on the day patient received the last FUDR dose.

  • Current value is that obtained at pump emptying or on the day of planned treatment (whichever is higher).