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| == '''What is Vistogard?''' ==
| | #REDIRECT [[Uridine triacetate]] |
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| * '''Vistogard''' ([[Uridine triacetate]]) is '''a pyrimidine analog''' used in the emergency treatment of patients who receive too much [[fluorouracil]] or [[capecitabine]] (types of anticancer drugs).
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| * It is also used in the emergency treatment of heart or [[central nervous system]] (CNS) toxicity or other serious side effects that occur within 4 days of ending treatment with fluorouracil or capecitabine.
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| [[File:Uridine triacetate.svg|thumb|Uridine triacetate]]
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| [[File:Uridine triacetate structure.svg|thumb|Uridine triacetate structure]]
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| <youtube>
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| title='''{{PAGENAME}}'''
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| movie_url=http://www.youtube.com/v/v=escAgiLAHW4
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| embed_source_url=http://www.youtube.com/v/v=escAgiLAHW4
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| &rel=1
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| wrap = yes
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| width=750
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| </youtube>
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| == '''What are the uses of this medicine?''' ==
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| Vistogard ([[Uridine triacetate]]) is a prescription medicine that contains [[uridine]], a substance that is normally found in your body.
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| Vistogard is used for emergency treatment of adults and children:
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| * after an overdose of [[fluorouracil]] or [[capecitabine]] with or without symptoms, or
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| * 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 4 days (96 hours)''' after receiving treatment with fluorouracil or capecitabine.
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| '''Limitations of use:'''
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| * Vistogard should only be used for the emergency treatment of side effects of [[fluorouracil]] or [[capecitabine]], because it may decrease the effectiveness of these medicines.
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| * It is not known if Vistogard is safe and effective if started more than 4 days (96 hours) after the end of a dose of fluorouracil or capecitabine.
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| == '''How does this medicine work?''' ==
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| <youtube>
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| title='''{{PAGENAME}}'''
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| movie_url=http://www.youtube.com/v=Xn5LOoK4sUw
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| embed_source_url=http://www.youtube.com/v=Xn5LOoK4sUw
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| &rel=1
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| wrap = yes
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| width=750
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| </youtube>
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| * Uridine triacetate is an acetylated pro-drug of [[uridine]].
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| * Following oral administration, '''uridine triacetate is deacetylated by nonspecific esterases present throughout the body, yielding uridine''' in the circulation.
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| * '''Uridine competitively inhibits cell damage and cell death caused by fluorouracil'''.
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| * Fluorouracil is a [[cytotoxic]] antimetabolite that interferes with nucleic acid metabolism in normal and cancer cells.
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| * Cells anabolize fluorouracil to the cytotoxic intermediates 5-fluoro-2'-deoxyuridine-5'-monophosphate (FdUMP) and 5-fluorouridine triphosphate (FUTP).
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| * FdUMP inhibits thymidylate synthase, blocking thymidine synthesis. Thymidine is required for DNA replication and repair.
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| * Uridine is not found in DNA.
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| * Fluorouracil cytotoxicity is the incorporation of its metabolite, FUTP, into RNA.
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| * This incorporation of FUTP into RNA is proportional to systemic fluorouracil exposure.
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| * '''Excess circulating uridine derived from Vistogard is converted into uridine triphosphate (UTP), which competes with FUTP for incorporation into RNA'''.
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| == '''Who Should Not Use this medicine ?''' ==
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| '''Limitations of use:'''
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| * Vistogard should only be used for the emergency treatment of side effects of fluorouracil or capecitabine, because it may decrease the effectiveness of these medicines.
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| * It is not known if Vistogard is safe and effective if started more than 4 days (96 hours) after the end of a dose of fluorouracil or capecitabine.
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| == '''What drug interactions can this medicine cause?''' ==
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| * Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
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| * Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
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| == '''Is this medicine FDA approved?''' ==
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| * Uridine triacetate was granted breakthrough therapy designation by the U.S. Food and Drug Administration (FDA) and approved for use in the United States in 2015.
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| == '''How should this medicine be used?''' ==
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| '''Recommended dosage:'''
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| '''In Adults:'''
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| * 10 grams (1 packet) orally every 6 hours for 20 doses, without regard to meals.
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| '''In Pediatric:'''
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| * 6.2 grams/m2 of body surface area (not to exceed 10 grams per dose) orally every 6 hours for 20 doses, without regard to meals.
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| '''Administration:'''
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| * Vistogard comes in single-dose packets that contain 10 grams of orange-flavored granules.
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| * It is important that you take all 20 doses of Vistogard even if you feel well.
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| * The usual adult dose of Vistogard is 1 packet taken by mouth every 6 hours for a total of 20 doses.
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| * If you vomit within 2 hours of taking a dose of Vistogard, take another full dose as soon as possible. Then take your next Vistogard dose at your next regularly scheduled time.
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| * If you miss a dose of Vistogard at the scheduled time, take the missed dose as soon as possible. Then take the next dose at the regularly scheduled time.
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| == '''What are the dosage forms and brand names of this medicine?''' ==
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| This medicine is available in fallowing doasage form:
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| * '''As Oral granules:''' 10 gram packets
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| This medicine is available in fallowing brand namesː
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| * '''Vistogard'''
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| =='''What side effects can this medication cause?'''==
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| The most common side effects of this medicine include:
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| * vomiting
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| * [[nausea]]
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| * [[diarrhea]]
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| * These are not all the possible side effects of Vistogard.
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| ==''' What special precautions should I follow?''' ==
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| Advise the patient or caregiver:
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| * The importance of taking all 20 doses, even if they feel well.
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| * That Vistogard can be taken mixed in food ([[applesauce]], [[pudding]] or [[yogurt]]).
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| * That the Vistogard granules should not be chewed.
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| * It is not known if Vistogard passes into your breast milk. Talk to your healthcare provider about the best way to feed your baby if you take Vistogard.
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| == '''What to do in case of emergency/overdose?''' ==
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| * {{overdose}}
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| == '''Can this medicine be used in pregnancy?''' ==
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| * It is not known if Vistogard will harm your unborn baby.
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| =='''Can this medicine be used in children?'''==
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| * The safety and effectiveness of Vistogard have been established in pediatric patients.
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| == '''What are the active and inactive ingredients in this medicine?''' ==
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| * '''Active Ingredient:''' uridine triacetate
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| * '''Inactive Ingredients:''' ethylcellulose, Opadry Clear [proprietary dispersion of hydroxypropylmethylcellulose and Macrogol], and natural orange juice flavor.
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| == '''Who manufactures and distributes this medicine?''' ==
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| * '''Manufactured for and distributed by''' [[Wellstat Therapeutics Corporation]], Rockville, MD
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| * Vistogard® is a registered trademark of Wellstat Therapeutics Corporation.
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| == '''What should I know about storage and disposal of this medication?''' ==
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| * Store Vistogard at room temperature between 68°F to 77°F (20°C to 25°C).
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| {{coststubd}}
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| {{Other alimentary tract and metabolism products}}
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| {{Portal bar | Medicine}}
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| [[Category:Acetate esters]]
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| [[Category:Antidotes]]
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| [[Category:Breakthrough therapy]]
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| [[Category:Prodrugs]]
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| {{gastrointestinal-drug-stub}}
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