Fatal drug-drug interaction of brivudine and capecitabine

Figures & data

Figure 1.  Metabolism of capecitabine and interaction with brivudine ((E)-5-(2-bromovinyl)-2′-deoxyuridine; BVDU). The activation of capecitabine to 5-FU involves 3 steps. 5-FU is metabolized to dihydrofluorouracil by dihydropyrimidine-dehydrogenase (DPD). Brivudine is metabolized by pyrimidine-nucleosidphosphorylase to bromovinyluracil (BVU), an irreversible inhibitor of DPD.BVDU-MP: brivudine monophosphate; BVDU-BP: brivudine biphosphate; BVDU-TP: brivudine triphosphate. (Adapted according to De Clercq) [5]

De Clercq E. (E)-5-(2-bromovinyl)-2′-deoxyuridine (BVDU). Med Res Rev 2005; 25: 1–20

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