Uridine Dosage

Medically reviewed by Drugs.com. Last updated on Jun 14, 2023.

Applies to the following strengths: triacetate 10 g; 2 g

Usual Adult Dose for Fluorouracil/Capecitabine Overdose

10 grams (1 packet) orally every 6 hours for 20 doses

Comments:

This drug is not recommended for the non-emergent treatment of adverse reactions associated with fluorouracil or capecitabine because it may diminish the efficacy of these drugs.
The safety and efficacy of initiating treatment more than 96 hours following the end of a fluorouracil or capecitabine administration have not been established.

Uses:

For the emergency treatment of a fluorouracil or capecitabine overdose regardless of the presence of symptoms
For use in patients who exhibit early-onset, severe, or life-threatening toxicity affecting the cardiac or central nervous system, and/or early-onset, unusually severe adverse reactions (e.g., gastrointestinal toxicity and/or neutropenia) within 96 hours following the end of fluorouracil or capecitabine administration.

Usual Adult Dose for Orotic Aciduria

Initial Dose: 60 mg/kg orally once a day

Dose should be titrated for efficacy (i.e., orotic acid levels in urine); laboratory values (e.g., red blood cell or white blood cell indices) affected by hereditary orotic aciduria show evidence of worsening; or worsening of other signs or symptoms of the disease

Maintenance Dose: 60 to 120 mg/kg orally once a day
Maximum Dose: 8 grams orally once a day

Use: For the treatment of hereditary orotic aciduria.

Usual Pediatric Dose for Fluorouracil/Capecitabine Overdose

6.2 grams/m2 of body surface area (BSA) orally every 6 hours for 20 doses
Maximum Dose: 10 grams per dose

Comments:

This drug is not recommended for the non-emergent treatment of adverse reactions associated with fluorouracil or capecitabine because it may diminish the efficacy of these drugs.
The safety and efficacy of initiating treatment more than 96 hours following the end of a fluorouracil or capecitabine administration have not been established.

Uses:

For the emergency treatment of a fluorouracil or capecitabine overdose regardless of the presence of symptoms
For use in patients who exhibit early-onset, severe, or life-threatening toxicity affecting the cardiac or central nervous system, and/or early-onset, unusually severe adverse reactions (e.g., gastrointestinal toxicity and/or neutropenia) within 96 hours following the end of fluorouracil or capecitabine administration.

Usual Pediatric Dose for Orotic Aciduria

Initial Dose: 60 mg/kg orally once a day

Dose should be titrated for efficacy (i.e., orotic acid levels in urine); laboratory values (e.g., red blood cell or white blood cell indices) affected by hereditary orotic aciduria show evidence of worsening; or worsening of other signs or symptoms of the disease

Maintenance Dose: 60 to 120 mg/kg orally once a day
Maximum Dose: 8 grams orally once a day

Use: For the treatment of hereditary orotic aciduria.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Precautions

CONTRAINDICATIONS: None

Safety and effectiveness have been established in pediatric patients; however, data are limited.

Dialysis

Data not available

Other Comments

Administration Advice:
Uridine triacetate 10 g oral granules (Vistogard):

Take orally with or without food following preparation instructions below; do not chew granules
Begin administration as soon as possible after an overdose or early-onset toxicity; complete full course (20 doses)
If a patient vomits within 2 hours of a dose, give another complete dose as soon as possible after the vomiting episode; administer next dose at the regularly scheduled time
If a dose is missed, administer dose as soon as possible; administer next dose at the regularly scheduled time

Uridine triacetate 2 g oral granules (Xuriden):

Take orally mixed with soft food or in milk or infant formula following preparation instructions below; do not chew granules

Preparation techniques:

Measure dose using a scale accurate to at least 0.1 g OR a graduated teaspoon accurate to one-fourth teaspoon; discard any unused portion of granules; do not use granules left in the open packet for subsequent dosing
To administer with soft food: Mix the prescribed dose into 3 to 4 ounces of applesauce, pudding, or yogurt; consume immediately; do not store for later
To administer in milk or infant formula (for doses up to 2 g): Using an oral syringe, draw up 5 mL of milk/infant formula, add prescribed dose, swirl to mix, administer; refill syringe with another 5 mL of milk or infant formula and administer; may follow with a bottle of milk or infant formula
To administer via nasogastric tube or gastrostomy tube: Prepare approximately 100 mL of a food starch-based thickening product in water; stir briskly until thickener has dissolved; crush 10 g packet of granules to a fine powder and add crushed granules to thickening product; for pediatric patients requiring less than 10 g dose, prepare mixture at a ratio of no greater than 1 g/10 mL; after administration, flush tube with water

Manufacturer product labeling may be consulted for dosing tables:

Uridine triacetate 2 g oral granules (Xuriden): A 2 g packet contains approximately three-quarters of a teaspoon of uridine triacetate; manufacturer's product labeling displays a table with weight-based dosing in teaspoons and in grams
Uridine triacetate 10 g oral granules (Vistogard): Manufacturer's product labeling displays a table with pediatric doses based on BSA and doses in teaspoons and grams

General:

Two uridine triacetate products are available; the 2 g packets (Xuriden) are indicated for the treatment of hereditary orotic aciduria and the 10 g packets (Vistogard) for the emergency treatment of fluorouracil or capecitabine overdose or for those exhibiting early-onset, severe or life-threatening toxicity within 96 hours following administration.
Clinical studies did not include sufficient numbers of patients aged 65 and over to determine whether they respond differently than younger subjects.

Monitoring:

Urine levels of orotic acid to assess efficacy in the treatment of hereditary orotic aciduria
To monitor for worsening disease, follow laboratory values (e.g., red blood cell or white blood cell indices) affected by hereditary orotic aciduria

Patient Advice:

Patients should be instructed to read the US FDA-approved patient labeling (Patient Information and Instructions for Use).
Patients/caregivers should be advised on the preparation and administration of this drug and what to do in the event the patient vomits or misses a dose.