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Guidelines & Advice
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Fluoropyrimidine Treatment in Patients with Dihydropyrimidine Dehydrogenase (DPD) Deficiency: Guidance for Clinicians

Version: 2 Sep 2025
Type of Content: Guidelines & Advice, Clinical
Document Status: Current
Authors:
Sarah Salama, Leta Forbes, Daniela Gallo-Hershberg, The DPYD Expert Panel

Guideline Objective

To provide clinicians with guidance on implementation and interpretation of routine, pre-treatment DPYD testing and genotype-guided dosing for cancer patients with planned fluoropyrimidine treatment in Ontario.

Patient Population

Cancer patients who are candidates for systemic treatment with fluoropyrimidines (5-fluorouracil or capecitabine)

Intended Guideline Users

Health care providers involved in the care of cancer patients who have planned systemic treatment with fluoropyrimidines (medical oncologists, nurses, pharmacists etc.)

pdf download Full Report (PDF) (1.18 MB)

Guideline-Based Clinical Tools

Summary of Pre-treatment Dosing Recommendations (for providers)
Testing for people taking capecitabine or 5-fluorouracil (5-FU) (for patients)
Dépistage chez les personnes prenant de la capécitabine ou du 5-fluorouracile (5-FU)