5-fluorouracil + allopurinol + dipyridamole + folinic acid

This is a combination regimen consisting of four agents: - **5-fluorouracil (5-FU):** A pyrimidine analog antimetabolite that inhibits thymidylate synthase, disrupting DNA synthesis and leading to cell death. It is widely used as a chemotherapeutic agent in various solid tumors. - **Allopurinol:** A xanthine oxidase inhibitor primarily used to reduce uric acid levels but also investigated for its ability to modulate the toxicity profile of 5-FU by reducing myelosuppression and gastrointestinal side effects[2][5]. - **Dipyridamole:** An antiplatelet agent and nucleoside transport inhibitor. In this context, it has been studied for its potential to modulate the cytotoxicity of 5-FU by inhibiting cellular uptake of nucleosides, potentially enhancing or altering the effect of chemotherapy[6][8]. - **Folinic acid (leucovorin):** A reduced form of folic acid that enhances the binding of 5-FU to thymidylate synthase, thereby increasing its cytotoxic efficacy. This combination has been explored in clinical trials for advanced refractory malignancies such as colorectal cancer. The rationale is based on preclinical evidence suggesting synergistic or modulatory effects among these agents; however, clinical studies have shown mixed results regarding efficacy and toxicity. Notably, adding dipyridamole did not significantly improve outcomes over standard regimens with 5-FU/folinic acid alone[6][8]. Allopurinol may provide some protection against high-dose 5-FU toxicity but does not necessarily improve response rates[2]. This regimen remains investigational and is not an established standard therapy.

Other names

5-FU + allopurinol + dipyridamole + folinic acidfluorouracil + allopurinol + dipyridamole + leucovorin