Uridine triacetate

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Uridine triacetate
Uridine triacetate structure.svg
Trade namesVistogard, Xuriden
Other namesVistonuridine
  • [(2R,3R,4R,5R)-3,4-diacetyloxy-5-(2,4-dioxopyrimidin-1-yl)oxolan-2-yl]methyl acetate
Clinical data
Main usesHereditary orotic aciduria, poisoning due to fluorouracil or capecitabine[1]
  • US: N (Not classified yet)
Routes of
By mouth
Onset of actionTmax = 2–3 hours
External links
US NLMUridine triacetate
License data
Legal status
MetabolismPyrimidine catabolic pathway
Elimination half-life2–2.5 hours
Chemical and physical data
Molar mass370.314 g·mol−1
3D model (JSmol)
  • CC(=O)OCC1C(C(C(O1)N2C=CC(=O)NC2=O)OC(=O)C)OC(=O)C
  • 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

Uridine triacetate, formerly known as vistonuridine, is a medication used to treat hereditary orotic aciduria and poisoning due to fluorouracil or capecitabine.[1] For poisoning it should be used within 4 days and in an overdose may be used regardless of the presence of symptoms.[1] It is taken by mouth.[1][2]

Side effects may include nausea or diarrhea.[1] Use in pregnancy and breastfeeding is of unclear safety.[3] It is a prodrug of uridine; by which it acts.[2][1]

Uridine triacetate was approved for medical use in the United States in 2015.[1] It is not approved in Europe.[4] In the United States it costs about 4,200 USD per 10 gram dose as of 2021.[5] In the United States it is only available through specialty pharmacies.[1] In Canada approval is required from the Health Canada Special Access Programme.[6] Brand names include Vistogard and Xuriden.[1]

Medical uses


For poisoning a dose of 10 gm four times per day for 5 days is typically used.[1]

For hereditary orotic aciduria a dose of 60 mg/kg per day to a maximum of 8 gm per day is typically used.[1]

Society and culture


Uridine triacetate is the INN.[7] Brand names include Xuriden /ˈzʊərədɛn/ ZOOR-ə-den);[8] and Vistogard.[9][10][11]


The cost of the medication used to treat an overdose is about 84,000 USD in the United States as of 2021.[5]


  1. 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 "Uridine Triacetate Monograph for Professionals". Drugs.com. Retrieved 13 September 2021.
  2. 2.0 2.1 Saif, Muhammad Wasif (4 March 2019). "Uridine triacetate - an antidote in the treatment of 5-fluorouracil or capecitabine poisoning". Expert Opinion on Orphan Drugs. 7 (3): 95–103. doi:10.1080/21678707.2019.1591273.
  3. "Uridine Use During Pregnancy". Drugs.com. Retrieved 13 September 2021.
  4. "FDA approves drug for genetic condition that affects 20 patients worldwide". The Pharmaceutical Journal. 2015. doi:10.1211/PJ.2015.20069307.
  5. 5.0 5.1 "Vistogard Prices, Coupons & Patient Assistance Programs". Drugs.com. Retrieved 13 September 2021.
  6. "BC Cancer Agency Management Guidelines Management of 5-fluorouracil (5FU) infusion overdose" (PDF). Retrieved 13 September 2021.
  7. "International Nonproprietary Names for Pharmaceutical Substances (INN). Recommended International Nonproprietary Names: List 65" (PDF). World Health Organization. p. 92. Retrieved 12 March 2017.
  8. "Xuriden- uridine triacetate granule". DailyMed. 16 December 2019. Retrieved 20 October 2020.
  9. "Vistogard- uridine triacetate granule". DailyMed. 15 November 2018. Retrieved 20 October 2020.
  10. "BTG Announces FDA Approval of Vistogard (Uridine Triacetate) as Antidote to Overdose and Early Onset, Severe, or Life-Threatening Toxicities from Chemotherapy Drugs 5-Fluorouracil (5-FU) or Capecitabine". BTG International Ltd. 11 December 2015. Retrieved 12 March 2017.
  11. "Approved Drugs — Uridine Triacetate". U.S. Food and Drug Administration. Retrieved 12 March 2017.[dead link]

External links