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5-Flurouracil (5-FU) Toxicity and Chemotherapeutic Response (DPYD) Test: Booking, Price, and Results

About 5-Flurouracil (5-FU) Toxicity and Chemotherapeutic Response (DPYD) Test: Booking, Price, and Results

Field	Value
Also Known As	DPYD Genotyping, DPD Deficiency Test, Dihydropyrimidine Dehydrogenase Test, 5-FU Pharmacogenetic Test
Sample Type	Peripheral blood (EDTA tube)
Fasting Required	No fasting required
Report Time	12 days
Recommended For	Adults of any gender scheduled for 5-fluorouracil or capecitabine chemotherapy
Price	Starting at ₹7,200

What Is a 5-Flurouracil (5-FU) Toxicity and Chemotherapeutic Response (DPYD) Test?

The 5-FU test is a pharmacogenetic test that analyses specific variants in the DPYD gene. This gene carries the instructions for making dihydropyrimidine dehydrogenase (DPD), an enzyme that breaks down the chemotherapy drug 5-fluorouracil (5-FU) in the body. The test is also known as DPYD Genotyping or the DPD Deficiency Test.

A small blood sample is drawn from a vein and analysed using Sanger sequencing, a method that reads the exact sequence of DNA in the DPYD gene. Oncologists order this test before starting fluoropyrimidine-based chemotherapy to understand how a patient's body will process the drug.

What Does a 5-Flurouracil (5-FU) Toxicity and Chemotherapeutic Response (DPYD) Test Measure?

This test examines the DPYD gene and reports three key pieces of information. The table below explains what each one means:

Parameter	What It Tells You
DPYD genotype	Identifies specific gene variants that affect how DPD enzyme is produced
Predicted phenotype (metaboliser status)	Classifies the patient as a normal, intermediate, or poor metaboliser of 5-FU
Activity score	A number from 0 to 2, reflecting how well the DPD enzyme is expected to function

Each allele (gene copy) contributes a score of 1.0 for normal function, 0.5 for partial function, or 0 for a non-functioning variant. The two scores are added together to give a final activity score.

Why Is a 5-Flurouracil (5-FU) Toxicity and Chemotherapeutic Response (DPYD) Test Done?

This test is ordered in specific clinical situations related to fluoropyrimidine chemotherapy. Your oncologist will advise whether it is appropriate for you.

Common Symptoms That May Require This Test

The following situations commonly lead a doctor to order this test before or during chemotherapy:

Planned treatment with 5-FU or capecitabine chemotherapy
Family history of severe reactions to fluoropyrimidine drugs
Unexplained severe side effects after an initial course of 5-FU
Personal or family history of known DPYD gene variants
A personalised medicine approach to cancer treatment planning

Conditions This Test Can Help Detect

This test identifies genetic conditions that affect how 5-FU is processed in the body:

Partial DPD deficiency, present in approximately 3 to 8% of the population, which increases the risk of severe drug toxicity
Complete DPD deficiency, a rarer condition caused by two non-functioning gene copies, associated with a high risk of serious adverse reactions, including mucositis, diarrhoea, neutropenia, and neurotoxicity

5-FU is used to treat several cancers, including colorectal cancer, gastric cancer, pancreatic cancer, breast cancer, and head and neck cancers. This test is relevant for patients receiving treatment for any of these conditions.

How to Prepare and What to Expect

The 5-FU test procedure is straightforward and requires no special preparation beforehand.

Do You Need to Fast?

No, fasting is not required. This test analyses DNA extracted from blood cells, so food or drink intake does not affect the result.

Practical Tips Before Your Test

Here are a few practical steps to ensure your test goes smoothly:

Bring a detailed clinical history, including your symptoms, previous test results, and family history, as this is required for the test.
Inform your doctor if you have had a recent blood transfusion, particularly a non-leukocyte-reduced transfusion, as this can affect results.
Tell your doctor if you have received an allogeneic (donor) haematopoietic stem cell transplant or a liver transplant, as these can interfere with genotyping.
Carry your doctor's prescription and a valid government-issued photo ID.
Wear a short-sleeved or loose-sleeved top to allow easy access to your arm for blood collection.
Stay well hydrated before the appointment to make the blood draw easier.

Step-by-Step Procedure

The 5-FU test procedure involves a simple blood collection. Here is what to expect:

A trained phlebotomist will verify your identity, review your clinical history, and confirm your sample requirements.
A tourniquet is placed on your upper arm, and a suitable vein, usually in the inner elbow, is identified.
A small amount of blood (approximately 2 mL) is drawn into a lavender-top EDTA tube via a standard venepuncture (needle blood draw).
The sample is labelled and stored at 2 to 8 degrees Celsius before being dispatched to the laboratory.
In the laboratory, genomic DNA is extracted from the blood cells. The DPYD gene is then amplified and sequenced using Sanger sequencing to identify relevant variants.
A detailed report covering your genotype, activity score, and predicted metaboliser status is prepared and delivered within 12 days.

Factors That Can Affect Accuracy

Certain factors may reduce the reliability of the test result:

Recent non-leukocyte-reduced blood transfusions (wait at least 6 weeks after such a transfusion before testing)
A prior allogeneic haematopoietic stem cell transplant or liver transplant from a donor, which can introduce donor DNA into the sample
Poor sample quality or compromised DNA integrity
Other genetic or non-genetic factors not covered by this test that may also influence 5-FU metabolism

Understanding Your 5-Flurouracil (5-FU) Toxicity and Chemotherapeutic Response (DPYD) Test Results

Results from this test are reported as a genotype, an activity score, and a predicted metaboliser status. Your oncologist will use these findings alongside your overall health profile to guide chemotherapy decisions.

Metaboliser Status	Activity Score	Interpretation
Normal metaboliser	2.0	Normal DPD enzyme activity; standard dosing is generally appropriate
Intermediate metaboliser	1.0 to 1.5	Reduced DPD activity; dose reduction is typically recommended
Poor metaboliser	0 to 0.5	Severely reduced or absent DPD activity; fluoropyrimidine drugs are generally avoided

Disclaimer: These ranges are general guidelines. Your doctor will interpret your results based on your age, health history, and other factors. Always consult a qualified healthcare professional for personalised medical advice.

Results During Special Conditions

Certain medical situations can affect how results should be interpreted:

Patients who have received a liver transplant from a different donor may have results that do not accurately reflect their own DPD status.
Patients who received a non-leukocyte-reduced blood transfusion should wait approximately 6 weeks before testing, as donor DNA in the sample can temporarily alter the genotype result.

How to Maintain Healthy Levels

Because the DPYD gene result reflects your inherited DNA, it does not change over time and cannot be altered by diet or lifestyle. However, there are practical steps you can take:

Share your DPYD result with your oncologist before starting any fluoropyrimidine-based treatment.
Consider genetic counselling if a variant is identified, as biological family members may carry the same variant.
Keep a copy of your result for future medical consultations, as this information may be relevant throughout your lifetime.

Lupin Diagnostics 5-Flurouracil (5-FU) Toxicity and Chemotherapeutic Response (DPYD) Test Price and Home Collection

The 5-FU test cost at Lupin Diagnostics starts at ₹7,200, and home sample collection is available across cities. The table below shows city-wise indicative pricing:

City	Approximate Price (₹)
Mumbai	7200
Pune	7200
Bangalore	7200
Chennai	7200

Disclaimer: Prices are indicative and may vary by location. Please confirm the current price at the time of booking.

How to Book

5-FU test online booking is simple and takes only a few minutes:

Select the test on the Lupin Diagnostics website.
Choose your city and preferred time slot.
Opt for home sample collection by a certified phlebotomist, or visit your nearest Lupin Diagnostics centre.
Receive your report via email or WhatsApp within the stipulated turnaround time.

Home Collection

5-FU test home collection is available across cities through Lupin Diagnostics. A certified phlebotomist visits your home at a scheduled time to collect the blood sample. All samples are processed in NABL-accredited laboratories, and your digital report is made accessible once ready.

Frequently Asked Questions

Severe toxic reactions to 5-FU affect a significant proportion of patients and are a common reason for stopping treatment early. DPYD testing identifies patients at higher risk, allowing their oncologist to adjust the dose or consider an alternative treatment plan before therapy begins.

A poor metaboliser has two copies of a non-functioning DPYD gene variant, meaning their body has very limited ability to break down 5-FU. This significantly raises the risk of serious adverse effects. In most cases, oncologists recommend avoiding fluoropyrimidine drugs entirely for these patients.

Partial DPD deficiency affects approximately 3 to 5% of the general population. Complete deficiency, where enzyme activity is almost entirely absent, is rarer and affects around 0.2% of people.

No fasting is needed before the 5-FU test. The test analyses DNA from your blood cells, and what you eat or drink has no effect on the genetic result.

No. Your DPYD gene variants are part of your inherited genetic makeup and do not change over time. This is a one-time test, and the result remains valid for your lifetime.

If a DPYD variant is detected, your oncologist will use the activity score and metaboliser status to decide on the safest course of action. This may include a dose reduction or an alternative treatment. Genetic counselling is also worth considering, as your biological relatives may carry the same variant.