The following were adverse events considered to be drug-related and occurring
with a frequency of ≥ 1% with Carac (fluorouracil) : application site reaction (94.6%), and
eye irritation (5.4%). The signs and symptoms of facial irritation (application
site reaction) are presented below.
Summary of Facial Irritation Signs and Symptoms - Pooled
Phase 3 Studies
Clinical Sign or
Symptom |
Active One
Week |
Active Two
Week |
Active Four
Week |
ALL Active
Treatments |
Vehicle
Treatments |
| N=85 |
N=87 |
N=85 |
N=257 |
N=127 |
| n |
(%) |
n |
(%) |
n |
(%) |
n |
(%) |
n |
(%) |
| Erythema |
76 |
(89.4) |
82 |
(94.3) |
82 |
(96.5) |
240 |
(93.4) |
76 |
(59.8) |
| Dryness |
59 |
(69.4) |
76 |
(87.4) |
79 |
(92.9) |
214 |
(83.3) |
60 |
(47.2) |
| Burning |
51 |
(60.0) |
70 |
(80.5) |
71 |
(83.5) |
192 |
(74.7) |
28 |
(22.0) |
| Erosion |
21 |
(24.7) |
38 |
(43.7) |
54 |
(63.5) |
113 |
(44.0) |
17 |
(13.4) |
| Pain |
26 |
(30.6) |
34 |
(39.1) |
52 |
(61.2) |
112 |
(43.6) |
7 |
(5.5) |
| Edema |
12 |
(14.1) |
28 |
(32.2) |
51 |
(60.0) |
91 |
(35.4) |
6 |
(4.7) |
During clinical trials, irritation generally began on day 4 and persisted for
the remainder of treatment. Severity of facial irritation at the last treatment
visit was slightly below baseline for the vehicle group, mild to moderate for
the 1 week active treatment group, and moderate for the 2 and 4 week active
treatment groups. Mean severity declined rapidly for each active group after
completion of treatment and was below baseline for each group at the week 2
post-treatment follow-up visit.
Thirty-one patients (12% of those treated with Carac (fluorouracil) in the Phase 3 clinical
studies) discontinued study treatment early due to facial irritation. Except
for three patients, discontinuation of treatment occurred on or after day 11
of treatment.
Eye irritation adverse events, described as mild to moderate in intensity,
were characterized as burning, watering, sensitivity, stinging and itching.
These adverse events occurred across all treatment arms in one of the two Phase
3 studies.
Summary of All Adverse Events Reported in ≥ 1% of Patients
in the Combined Active Treatment and Vehicle Groups – Pooled Phase 3 Studies
| 9721 and 9722 Combined |
| Adverse Event |
Active One
Week |
Active Two
Week |
Active Four
Week |
ALL Active
Treatments |
Vehicle
Treatments |
| N=85 |
N=87 |
N=85 |
N=257 |
N=127 |
| n |
(%) |
n |
(%) |
n |
(%) |
n |
(%) |
n |
(%) |
| BODY AS A WHOLE |
7 |
(8.2) |
6 |
(6.9) |
12 |
(14.1) |
25 |
(9.7) |
15 |
(11.8) |
| Headache |
3 |
(3.5) |
2 |
(2.3) |
3 |
(3.5) |
8 |
(3.1) |
3 |
(2.4) |
| Common Cold |
4 |
(4.7) |
0 |
2 |
(2.4) |
6 |
(2.3) |
3 |
(2.4) |
| Allergy |
0 |
2 |
(2.3) |
1 |
(1.2) |
3 |
(1.2) |
2 |
(1.6) |
| Infection Upper Respiratory |
0 |
0 |
0 |
0 |
2 |
(1.6) |
| MUSCULOSKELETAL |
1 |
(1.2) |
1 |
(1.1) |
1 |
(1.2) |
3 |
(1.2) |
5 |
(3.9) |
| Muscle Soreness |
0 |
0 |
0 |
0 |
2 |
(1.6) |
| RESPIRATORY |
5 |
(5.9) |
0 |
1 |
(1.2) |
6 |
(2.3) |
6 |
(4.7) |
| Sinusitis |
4 |
(4.7) |
0 |
0 |
4 |
(1.6) |
2 |
(1.6) |
| SKIN & APPENDAGES |
78 |
(91.8) |
83 |
(95.4) |
82 |
(96.5) |
243 |
(94.6) |
85 |
(66.9) |
| Application Site |
78 |
(91.8) |
83 |
(95.4) |
82 |
(96.5) |
243 |
(94.6) |
83 |
(65.4) |
| Reaction |
|
|
|
|
|
|
|
|
|
|
| Irritation Skin |
1 |
(1.2) |
0 |
2 |
(2.4) |
3 |
(1.2) |
0 |
| SPECIAL SENSES |
6 |
(7.1) |
4 |
(4.6) |
6 |
(7.1) |
16 |
(6.2) |
6 |
(4.7) |
| Eye Irritation |
5 |
(5.9) |
3 |
(3.4) |
6 |
(7.1) |
14 |
(5.4) |
3 |
(2.4) |
Adverse Experiences Reported by Body System
In the Phase 3 studies, no serious adverse event was considered related to
study drug. A total of five patients, three in the active treatment groups and
two in the vehicle group, experienced at least one serious adverse event. Three
patients died as a result of adverse event(s) considered unrelated to study
drug (stomach cancer, myocardial infarction and cardiac failure).
Post-treatment clinical laboratory tests other than pregnancy tests were not
performed during the Phase 3 clinical studies. Clinical laboratory tests were
performed during conduct of a Phase 2 study of 104 patients and 21 patients
in a Phase 1 study. No abnormal serum chemistry, hematology, or urinalysis results
in these studies were considered clinically significant.