Carac Cream
Carac Cream
Fluorouracil
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Efudex Cream
Fluorouracil
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Carac Cream (Fluorouracil)

What is Carac Cream (Fluorouracil) ?

Carac is a topical cream with the active ingredient fluorouracil and is intended for dermatological use. This medication is classified as an antineoplastic metabolite. Carac cream is indicated for actinic or solar keratosis. These skin lesions come around after years of excessive exposure to the sun and display as scaly and dry patches of skin. Although not all solar keratotic lesions are harmful, some of these lesions could become skin cancer. Fluorouracil can also be used for superficial basal cell carcinoma, a type of skin cancer. Basal cell carcinoma lesions often come around skin areas exposed to the sun, like the face. Such lesions are characterized by a shiny, bumped, colored skin area. Carac cream is prescribed for basal cell carcinoma when other conventional methods have proved insufficient. In addition, carac cream could be prescribed in case of multiple basal cell carcinoma lesions or sites that are difficult to treat. If untreated, basal cell carcinoma can become invasive and grow, with aggressive cases spreading to other body parts other than the skin.

The location of basal cell carcinoma and solar keratotic lesions can vary from the scalp, face, hands, forearms, and chest, amongst many others.

How does Carac cream work?

Fluorouracil works on cancer cells by inhibiting the production of DNA in these cells. This inhibition prevents the cancer cell from multiplying and producing vital proteins for its growth. In addition, fluorouracil will mask itself as purine, a DNA building block. In this manner, these substances will not be incorporated into the cell’s DNA in the cell cycle. This will seize normal cell development and division. All this leads to the death of such cells.

Dosage

Carac cream comes in 0.5% of fluorouracil

For actinic keratosis, Carac cream is usually prescribed twice daily for 2 to 4 weeks.

Carac cream is usually prescribed twice daily for 3 to 6 weeks for superficial basal cell carcinoma.

How to Use Carac Cream

Carac cream is usually applied twice a day. However, the duration of the treatment depends on what your doctor deems fit and the condition for which it is being prescribed.

To help you remember, try applying Carac cream around the same each day.

Apply Carac cream as prescribed by your doctor and at the specified frequency.

Wash the area to be treated with water only and dry it. Wait 10 minutes before you apply the cream. Then, apply Carac cream with an applicator. Such applicator must not be made of metal. Suppose you are using your hands to apply; either wear a glove or wash your hands immediately after you are done. Leave the treated areas uncovered unless your doctor tells you otherwise. If you are advised to cover the treated area, be sure to use porous gauze dressings, allowing the site to breathe.

Carac cream should not be applied to the eyelids, eyes, mouth, nose, vagina, or mucous areas.

Apply sufficient amounts of cream that cover the area to be treated.

How to store Carac cream?

Store this cream in its original container, at room temperature, and out of reach for children or pets. Keep it away from excess heat or moisture. Carac cream can be fatal for pets. Seek veterinary care if your pet licks or ingests Carac cream. Avoid storing this medication in the bathroom.

Overdose

Since Carac cream requires topical application, topical overdose is less likely to cause acute problems. However, vomiting and gastric lavage may be necessary if Carac cream is ingested. In addition, if Carac cream comes in contact with the eyes, it is essential to flush with plenty of water. If you think you misused this medication as described above, feel like passing out, or experience difficulty breathing, it is crucial to call 911 or contact the poison control center.

Side Effects

If you have any of the following adverse effects, speak with a doctor:

Common side effects include:

  • Pain
  • Scaly skin
  • Redness
  • Mild skin discomfort
  • Erythema
  • Burning sensation
  • Pruritus
  • Dryness
  • Swelling and inflammation around the affected area
  • Discoloration of the skin
  • Increased sensitivity to sunlight
  • Erosion of the upper layer of the skin
  • Eye irritation includes burning sensation, watering, sensitivity, itching, and stinging.

Serious side effects include:

  • Stomach pain
  • Diarrhea
  • Blood in stools
  • Unresolved sore throat
  • Mouth sores
  • Unusual bruising and bleeding
  • Vomiting
  • Fever and chills
  • Signs of infection like yellowish skin, crusting, or a solid red color
  • Severe discomfort that is difficult to tolerate
  • Hives
  • Difficulty breathing
  • Swelling of the face, tongue, and throat
  • Open skin sores
  • Shedding of dead skin

If you experience severe side effects, consider discontinuing the treatment and speak to your doctor immediately.

Precautions

If you have a reaction to capecitabine or flucytosine, tell your doctor.

Avoid sunlight while using Carac cream. Direct exposure to sunlight between 10:00 am, and 2:00 pm should be avoided. Sun exposure increases side effects. Wear high SPF sunscreen, a hat, protective clothing, and sunglasses when sun-exposed, and use Carac cream.

Speak to your doctor if you get sunburned or develop skin blisters or redness.

Leave a 2-hour interval before applying sunscreen or any moisturizers.

Consult your doctor before using other topical creams or lotions while on Carac cream.

Avoid ultraviolet light like tanning booths and sunlamps while using Carac cream.

Ulcerated skin increases absorption and may result in inflamed skin and heightened side effects.

Avoid applying Carac cream at night before going to bed, as it may rub on your pillowcase and come in contact with your eyes.

Avoid applying Carac cream before any physical activity because sweat may cause the cream to come in contact with your eyes.

Warnings

Carac cream should not be used in children under the age of 18 years.

Do not breastfeed while using Carac cream. It is unknown if fluorouracil passes through breast milk.

Suppose you become pregnant or conceive while on this treatment; stop using Carac cream and speak to your doctor. Use effective birth control methods while on Carac cream.

Do not use Carac cream if you are allergic to fluorouracil and any of the excipients found in it.

Drug interactions

You must inform your doctor if you take any prescription medication, over-the-counter drugs, vitamins, and herbal medication.

Topical medication is less likely to interact with other medicines. However, you should always inform your doctor if you take any other medication before starting any new treatment.

Contraindications

Carac cream is contraindicated in:

  • Pregnant women or those planning to
  • Nursing women
  • Patients with dihydropyrimidine dehydrogenase enzyme deficiencies are also referred to as DPD deficiencies. This enzyme mostly catabolizes fluorouracil. Therefore, the lack of this enzyme can lead to fluorouracil toxicity. In addition, individuals with DPD deficiency could develop stomatitis, erythema, skin rash, neutropenia, thrombocytopaenia, inflamed esophagus, stomach, and small intestine.
  • Individuals who are allergic or have a hypersensitivity to fluorouracil or any of its excipients

Frequently Asked Questions

You may notice a difference in your skin lesions as early as two weeks after starting Carac cream. Fluorouracil cream can take up to 3 weeks to start working but may take as long as 12 weeks.

During the first few days and weeks of treatment, the treated area will display irritation and redness. This confirms that the medication is working. You should not stop the medicine as soon as you notice it is working. It is essential to stick to the treatment as prescribed by your doctor.

Carac cream could be prescribed for basal cell carcinoma if other treatments proved unsuccessful. You may be given this treatment for 3 to 6 weeks. Then, your doctor may ask you to continue such treatment for 10 to 12 weeks.

You can continue your regular diet unless your doctor tells you to do otherwise while using Carac cream.

Carac Cream is usually prescribed for up to 4 weeks. However, this depends on the conditions for which it is being given. Use Carac cream precisely as prescribed by your doctor.

Apply the missed dose as soon as you remember. If you recognize you missed a dose, and it is almost time for your next dose, skip the missed one and continue with your regular prescribed schedule. Do not double the dose to make up for the missed one. Do not apply excessive amounts of cream to compensate for the missed dose.

Side effects of Carac cream are likely to occur during its application and between 2 weeks to 3 months after treatment is stopped.

If you start experiencing irritated skin after applying Carac cream, know that this is one of the common side effects. Speak to your doctor to find the best soothing creams and use them as advised by your healthcare provider. Lotions contain alcohols that could irritate the skin; therefore, soothing creams are preferred. Wait 2 hours after applying Carac cream and before applying sunscreen or moisturizing cream.

This depends on the application and type of skin. However, Carac cream was found to reach its peak within an hour of application. Therefore, you should always leave 2 hours before applying sunscreen or a moisturizing screen.

Having your skin lesions checked once to twice a year is suggested, even after stopping the treatment. In addition, it is important to use sunscreen and wear protective clothing when exposed to sunlight to prevent re-occurrence.

You may need to repeat such treatment as referred to by your doctor. Do not re-start carac cream as soon as you notice a difference in your skin or a new skin lesion. Consult our doctor if you notice any skin changes at all. Make sure you avoid excessive exposure to sunlight without adequate sunscreen even after terminating the use of Carac cream as prescribed by your doctor, as this can increase your recurrence of skin lesions brought about by sun exposure.

The active ingredient in Carac cream is intended to act on sun-damaged skin and will not usually affect healthy skin. It is essential to apply a thin layer of cream on the affected area only and avoid contact with healthy skin during application. Wash your hands right after application or use a non-metal applicator.

Make sure you apply a thin layer enough to cover the affected area.

Carac cream is made of fluorouracil, a chemotherapy agent belonging to the class of anti-metabolites.

Moisturizing the treated area will affect how your skin heals after treatment. You can apply a moisturizing cream after every application of Carac cream, as long as you leave at least 2 hours in-between applications. The treated area can remain pink after cessation of Carac cream and could be more susceptible to sunburn. Avoiding direct and prolonged exposure to sunlight and applying a high SPF sunscreen will prevent it from burning.

Your doctor can prescribe different treatments as they deem fit. They will examine your skin lesions and prescribe the best treatment for you. Fluorouracil is not the only available treatment for basal cell carcinoma, but it is one of the treatments used for this.

After applying Carac cream, you do not need to cover your skin with a dressing. However, in some instances, your doctor may ask you to do so. You can protect your lesions after with a porous gauze dressing. This will allow your skin to breathe, despite being covered.