How do you determine which patients you prescribe 5-fluorouracil vs 5-fluorouracil with calcipotriene for actinic field disease?

We tend to prescribe almost exclusively 5FU + calcipotriene as a compounded agent, the cost is reasonable usually around $50 for 30gms. Standard treatment is BID x 4 days, but many times use up to 7 days, and the response increases through 14 days with what patients experience.

Patient adherence is better and more patients are able to successfully complete treatment as the reaction 'peaks' slightly after the application so tolerability is better too.

Clearance rates are similar or superior to s...

Thank you Dr. @Dr. First Last for your answer.

I have mentioned 5-FU + Calcipotriene to multiple colleagues here in southern California, and was quite impressed with the speed of reaction and overall outcome when I first started utilizing it a few years ago.

Generally, I will start by discussing the need for "Field Therapy" due to the number of lesions, potential risk reduction based on history of NMSCs, and the risk of post-inflammatory dyspigmentation with Cryo.

The discussion will then move t...

I have used fluorouracil 8 times and imiquimod once personally, as well as extensive prescribing in a 30-year career. I can tell you unequivocally that fluorouracil+calcipotriene is much more painful than any other formulation. Time will tell if it is any more effective. 5-fluorouracil used to be dirt cheap, but now it’s rather more expensive. All other AK treatments compare themselves to fluorouracil - the benchmark. Give me the old classic - to quote an old medical axiom, the new broom doesn’t...