Interaction between capecitabine and brivudin in a patient with breast cancer.

José M Baena-Cañada, María J Martínez, Obdulia García-Olmedo, Reyes Jiménez-Bárcenas, Pedro Muriel-Cueto

Index: Nat. Rev. Clin. Oncol. 7(1) , 55-8, (2010)

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Abstract

A 66-year-old woman with metastatic mammary carcinoma, who was being treated with capecitabine, contracted a herpes zoster infection that was treated with the antiviral drug brivudin. A drug-drug interaction between brivudin and capecitabine caused medullar aplasia, serious toxic effects to the intestinal mucous membrane, hand-foot syndrome, onycholysis and dental pigmentation.Physical examination, blood analysis, blood cultures, chest X-ray, bone marrow aspiration and biopsy.Serious adverse event secondary to inhibition of dihydropyrimidine dehydrogenase by a drug-drug interaction between capecitabine and brivudin.Intravenous hydration, imipenem, red blood cell and platelet transfusions, filgrastim, omeprazole, care of the mouth and feet, topical anesthetics, systemic analgesics and parenteral nutrition.