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Formation of a false nucleotide inhibits an enzyme necessary for DNA synthesis. This is similar to the mode of action of the antifungal drug, flucytosine. Fluorouracil is used to treat gastrointestinal and breast cancers, often together with synthetic folinates. Adverse effects of fluorouracil are less likely, but similar to methotrexate. Cytarabine is a pyrimidine analogue, which is incorporated into both RNA and DNA and interferes with the action of DNA polymerase. Cytarabine is used to treat leukaemia.

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They should be used with caution in people with diabetes because the β-blocking effect can mask warning signs of hypoglycaemia. The original β-blockers did not discriminate between β drugs have been developed that are more cardio-selective and there are others that also cause vasodilation. First generation β-blockers are non-cardio-selective and they can produce bronchoconstriction as an adverse effect. They exacerbate congestive heart failure, adversely affect plasma lipid profiles and reduce exercise tolerance. An example is propranolol.

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