An 85-year-old woman, with known stable angina pectoris, was prescribe
d 5-fluorouracil cream to treat a small basal cell carcinoma on the fo
rehead. Half an hour after application the patient developed her typic
al ischemic pain which persisted for 2 hours. Rechallenge, during hosp
italization, resulted in recurrence of symptoms that were effectively
controlled with sublingual isosorbide dinitrate. Prophylactic therapy
with nitroglycerin patch enabled further use of the 5-fluorouracil cre
am for the next month.