Uridine triacetate

    WARNING: This product is for research use only, not for human or veterinary use.

MedKoo CAT#: 203090

CAS#: 4105-38-8

Description: Uridine triacetate is a drug used in the treatment of hereditary orotic aciduria and to treat patients following an overdose of chemotherapy drugs 5-fluorouracil or capecitabine, or in patients exhibiting early-onset, severe or life-threatening toxicity affecting the cardiac or central nervous system, and/or early-onset, unusually severe adverse reactions (e.g., gastrointestinal toxicity and/or neutropenia) within 96 hours following the end of 5-fluorouracil or capecitabine administration. Uridine triacetate was granted breakthrough therapy designation by FDA in 2015. Uridine triacetate is a prodrug of uridine.

Chemical Structure

Uridine triacetate
CAS# 4105-38-8

Theoretical Analysis

MedKoo Cat#: 203090
Name: Uridine triacetate
CAS#: 4105-38-8
Chemical Formula: C15H18N2O9
Exact Mass: 370.10123
Molecular Weight: 370.31
Elemental Analysis: C, 48.65; H, 4.90; N, 7.56; O, 38.88

Price and Availability

Size Price Availability Quantity
500.0mg USD 150.0 Same day
1.0g USD 250.0 Same day
2.0g USD 350.0 Same day
5.0g USD 450.0 Same day
10.0g USD 650.0 Same day
20.0g USD 1050.0 Same day
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Synonym: PN401; PN 401; PN-401; RG 2133; RG2133; RG-2133; Tri-O-acetyluridine; Triacetyluridine; Vistogard; Vistonuridine; Xuriden;

IUPAC/Chemical Name: (2R,3R,4R,5R)-2-(acetoxymethyl)-5-(2,4-dioxo-3,4-dihydropyrimidin-1(2H)-yl)tetrahydrofuran-3,4-diyl diacetate


InChi Code: InChI=1S/C15H18N2O9/c1-7(18)23-6-10-12(24-8(2)19)13(25-9(3)20)14(26-10)17-5-4-11(21)16-15(17)22/h4-5,10,12-14H,6H2,1-3H3,(H,16,21,22)/t10-,12-,13-,14-/m1/s1

SMILES Code: O=C(C=CN1[C@H]2[C@H](OC(C)=O)[C@H](OC(C)=O)[C@@H](COC(C)=O)O2)NC1=O

Appearance: White solid powder

Purity: >98% (or refer to the Certificate of Analysis)

Shipping Condition: Shipped under ambient temperature as non-hazardous chemical. This product is stable enough for a few weeks during ordinary shipping and time spent in Customs.

Storage Condition: Shipped under ambient temperature as non-hazardous chemical. This product is stable enough for a few weeks during ordinary shipping and time spent in Customs.

Solubility: Soluble in DMSO, not in water

Shelf Life: >5 years if stored properly

Drug Formulation: This drug may be formulated in DMSO

Stock Solution Storage: 0 - 4 C for short term (days to weeks), or -20 C for long term (months).

HS Tariff Code: 2934.99.9001

Certificate of Analysis:

Safety Data Sheet (SDS):

Preparing Stock Solutions

The following data is based on the product molecular weight 370.31 Batch specific molecular weights may vary from batch to batch due to the degree of hydration, which will affect the solvent volumes required to prepare stock solutions.

Recalculate based on batch purity %
Concentration / Solvent Volume / Mass 1 mg 5 mg 10 mg
1 mM 1.15 mL 5.76 mL 11.51 mL
5 mM 0.23 mL 1.15 mL 2.3 mL
10 mM 0.12 mL 0.58 mL 1.15 mL
50 mM 0.02 mL 0.12 mL 0.23 mL

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1: Lampropoulou DI, Laschos K, Amylidi AL, Angelaki A, Soupos N, Boumpoucheropoulos S, Papadopoulou E, Nanou E, Zidianakis V, Nasioulas G, Fildissis G, Aravantinos G. Fluoropyrimidine-induced toxicity and DPD deficiency.. A case report of early onset, lethal capecitabine-induced toxicity and mini review of the literature. Uridine triacetate: Efficacy and safety as an antidote. Is it accessible outside USA? J Oncol Pharm Pract. 2019 Aug 5:1078155219865597. doi: 10.1177/1078155219865597. [Epub ahead of print] PubMed PMID: 31382864.

2: Baldeo C, Vishnu P, Mody K, Kasi PM. Uridine triacetate for severe 5-fluorouracil toxicity in a patient with thymidylate synthase gene variation: Potential pharmacogenomic implications. SAGE Open Med Case Rep. 2018 Jul 4;6:2050313X18786405. doi: 10.1177/2050313X18786405. eCollection 2018. PubMed PMID: 30013790; PubMed Central PMCID: PMC6041857.

3: Garcia RAG, Saydoff JA, Bamat MK, von Borstel RW. Prompt treatment with uridine triacetate improves survival and reduces toxicity due to fluorouracil and capecitabine overdose or dihydropyrimidine dehydrogenase deficiency. Toxicol Appl Pharmacol. 2018 Aug 15;353:67-73. doi: 10.1016/j.taap.2018.06.012. Epub 2018 Jun 13. PubMed PMID: 29908244.

4: Zurayk M, Keung YK, Yu D, Hu EH. Successful use of uridine triacetate (Vistogard) three weeks after capecitabine in a patient with homozygous dihydropyrimidine dehydrogenase mutation: A case report and review of the literature. J Oncol Pharm Pract. 2019 Jan;25(1):234-238. doi: 10.1177/1078155217732141. Epub 2017 Sep 26. Review. PubMed PMID: 28950804.

5: Oliver WD, Duffy AP, Hausner PF. Case report of capecitabine toxicity and use of uridine triacetate. J Oncol Pharm Pract. 2017 Jan 1:1078155217730662. doi: 10.1177/1078155217730662. [Epub ahead of print] PubMed PMID: 28942723.

6: Santos C, Morgan BW, Geller RJ. The successful treatment of 5-fluorouracil (5-FU) overdose in a patient with malignancy and HIV/AIDS with uridine triacetate. Am J Emerg Med. 2017 May;35(5):802.e7-802.e8. doi: 10.1016/j.ajem.2016.11.038. Epub 2016 Nov 15. PubMed PMID: 27884585.

7: Vaudo CE, Gil B, Galuski K, Zarwan C, Nugent FW. Early-Onset 5-Fluorouracil Toxicity in a Patient Negative for Dihydropyrimidine Dehydrogenase Mutations: The Clinical Course of Reversal with Uridine Triacetate. Pharmacotherapy. 2016 Nov;36(11):e178-e182. doi: 10.1002/phar.1841. Epub 2016 Nov 4. PubMed PMID: 27716991.

8: Ma WW, Saif MW, El-Rayes BF, Fakih MG, Cartwright TH, Posey JA, King TR, von Borstel RW, Bamat MK. Emergency use of uridine triacetate for the prevention and treatment of life-threatening 5-fluorouracil and capecitabine toxicity. Cancer. 2017 Jan 1;123(2):345-356. doi: 10.1002/cncr.30321. Epub 2016 Sep 13. PubMed PMID: 27622829; PubMed Central PMCID: PMC5248610.

9: Ison G, Beaver JA, McGuinn WD Jr, Palmby TR, Dinin J, Charlab R, Marathe A, Jin R, Liu Q, Chen XH, Ysern X, Stephens O, Bai G, Wang Y, Dorff SE, Cheng J, Tang S, Sridhara R, Pierce W, McKee AE, Ibrahim A, Kim G, Pazdur R. FDA Approval: Uridine Triacetate for the Treatment of Patients Following Fluorouracil or Capecitabine Overdose or Exhibiting Early-Onset Severe Toxicities Following Administration of These Drugs. Clin Cancer Res. 2016 Sep 15;22(18):4545-9. doi: 10.1158/1078-0432.CCR-16-0638. Epub 2016 Jul 11. Review. PubMed PMID: 27401247.

10: Cada DJ, Mbogu U, Bindler RJ, Baker DE. Uridine Triacetate. Hosp Pharm. 2016 Jun;51(6):484-8. doi: 10.1310/hpj5106-484. PubMed PMID: 27354750; PubMed Central PMCID: PMC4911989.

11: In brief: uridine triacetate (Vistogard) for fluorouracil overdose. Med Lett Drugs Ther. 2016 Jul 4;58(1498):90. PubMed PMID: 27348145.

12: Saif MW, Diasio RB. Benefit of uridine triacetate (Vistogard) in rescuing severe 5-fluorouracil toxicity in patients with dihydropyrimidine dehydrogenase (DPYD) deficiency. Cancer Chemother Pharmacol. 2016 Jul;78(1):151-6. doi: 10.1007/s00280-016-3063-1. Epub 2016 Jun 8. PubMed PMID: 27278667.

13: O'Malley PA. Vistogard (Uridine Triacetate): The First and Only Drug Approved for the Treatment of 5-Fluorouracil or Capecitabine Overdose: Implications for the Clinical Nurse Specialist. Clin Nurse Spec. 2016 May-Jun;30(3):145-7; quiz E11. doi: 10.1097/NUR.0000000000000198. PubMed PMID: 27055035.

14: In brief: Uridine triacetate (Xuriden) for hereditary orotic aciduria. Med Lett Drugs Ther. 2016 Mar 28;58(1491):e49. PubMed PMID: 27027693.

15: McEvilly M, Popelas C, Tremmel B. Use of uridine triacetate for the management of fluorouracil overdose. Am J Health Syst Pharm. 2011 Oct 1;68(19):1806-9. doi: 10.2146/ajhp100434. PubMed PMID: 21930638.

Additional Information

 According to news published in 21 May 2010, uridine triacetate has further demonstrated its life-saving potential in treating patients overexposed to the widely used cancer chemotherapy 5-fluorouracil (5-FU), according to clinical data to be presented June 7 at the annual meeting of the American Society of Clinical Oncology (ASCO) in Chicago. see http://www.medicalnewstoday.com/articles/189546.php.
Wellstat Releases Investigational Drug Uridine Triacetate Clinical Results By PBR Staff Writer Published 21 May 2010 Wellstat Therapeutics has released clinical results of its investigational drug Uridine triacetate for treating patients overexposed to the widely used cancer chemotherapy 5-fluorouracil (5-FU). Wellstat Therapeutics said that while no antidote for 5-FU overexposure has been approved by regulatory authorities, Uridine triacetate (formerly known as vistonuridine) has been made available to physicians for emergency use. Wellstat Therapeutics' trial was made on 37 cases of 5-FU overexposure, all of them treated with Uridine triacetate. In all of these cases, the patients recovered from the overexposure, even though a fatal outcome for at least 27 of them would have been predicted by the dose and rate of 5-FU administration. In one extreme case, the patient survived after receiving a 5-FU dose 10 times higher than intended (10,000mg in three hours instead of 1,000mg in one hour). Reportedly, in all cases, the emergency treatment commenced as rapidly as possible after 5-FU overexposure (within 8 to 96 hours), depending on the timing of the request to Wellstat and the location of the treatment site.  Michael Bamat, vice president of research and development at Wellstat, said: “Since our first report on uridine triacetate at ASCO in 2009, the number of patients treated with this investigational antidote has more than doubled.”