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Lonsurf

Generic Name: tipiracil and trifluridine (tye PIR a sil and trye FLURE i deen)
Brand Names: Lonsurf

Medically reviewed by P. Thornton, DipPharm Last updated on Apr 4, 2019.

What is Lonsurf?

See also: Xeloda

Lonsurf contains a combination of tipiracil and trifluridine. Tipiracil and trifluridine are anti-cancer medicines that interfer with the growth and spread of cancer cells in the body.

Lonsurf is used to treat colorectal cancer that has spread to other parts of the body (metastatic).

Lonsurf is also used to treat a type of stomach cancer called gastric cancer, including adenocarcinoma of the gastroesophageal junction, that has spread to other parts of the body (metastatic).

Lonsurf is usually given after other cancer medicines have been tried without success.

Important Information

Lonsurf affects your immune system. You may get infections more easily, even serious or fatal infections. Call your doctor if you have a fever, chills, body aches, or unusual bleeding or bruising.

You will need blood tests before and during treatment with Lonsurf. Call your doctor at once if you develop signs of infection (fever, chills, body aches).

Before taking this medicine

To make sure Lonsurf is safe for you, tell your doctor if you have ever had:

You may need to have a negative pregnancy test before starting this treatment.

Tipiracil and trifluridine can harm an unborn baby if the mother or the father is using this medicine.

  • If you are a woman, do not use Lonsurf if you are pregnant. Use effective birth control to prevent pregnancy while you are using this medicine and for at least 6 months after your last dose.

  • If you are a man, use effective birth control if your sex partner is able to get pregnant. Keep using birth control for at least 3 months after your last dose.

  • Tell your doctor right away if a pregnancy occurs while either the mother or the father is using Lonsurf.

You should not breast-feed while using this medicine, and for at least 24 hours after your last dose.

How should I take Lonsurf?

Take Lonsurf exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.

Before and during treatment with this medicine, you will need blood tests. The timing of these tests is very important.

Take with food.

Lonsurf is given in a 28-day treatment cycle. You may need to use the medicine only on certain days of each cycle. Your doctor will determine how long to treat you with this medicine.

Swallow the tablet whole and do not crush, chew, or break it.

To get the correct dose, you may need to take 2 or more tablets that are different strengths and colors. Follow your doctor's dosing instructions very carefully.

Wash your hands after handling Lonsurf tablets. Caregivers who touch or handle the tablets should wear rubber gloves.

If you vomit shortly after taking Lonsurf, do not take another dose. Wait until your next scheduled dose time to take the medicine again.

Tipiracil and trifluridine doses are based on body surface area (height and weight). Your dose needs may change if you gain or lose weight.

Store tablets in their original container at room temperature, away from moisture and heat. Throw away any unused tablets after 30 days if you do not store them in the original container.

Ask your pharmacist how to safely dispose of tablets you no longer need.

Lonsurf dosing information

Usual Adult Dose for Colorectal Cancer:

-Initial dose: 35 mg/m2 orally twice a day on Days 1 through 5 and Days 8 through 12 of each 28-day cycle (based on trifluridine component)
-Maximum dose: 80 mg per dose (based on trifluridine component)
-Duration of therapy: Until disease progression or unacceptable toxicity

Comments:
-Dose should be taken within 1 hour of completion of morning and evening meals.
-The dose should be rounded to the nearest 5 mg increment.
-Do not initiate a cycle of this drug until absolute neutrophil count (ANC) is 1,500/mm3 or greater or febrile neutropenia is resolved; platelets are 75,000/mm3 or greater; and Grade 3 or 4 non-hematological adverse reactions are resolved to Grade 0 or 1.

Use: Treatment of patients with metastatic colorectal cancer who have been previously treated with fluoropyrimidine-, oxaliplatin-, and irinotecan-based chemotherapy, an anti-VEGF biological therapy, and an anti-EGFR therapy (if RAS wild-type).

What happens if I miss a dose?

Call your doctor for instructions if you miss a dose.

Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking Lonsurf?

This medicine can pass into body fluids (urine, feces, vomit). Caregivers should wear rubber gloves while cleaning up a patient's body fluids, handling contaminated trash or laundry or changing diapers. Wash hands before and after removing gloves. Wash soiled clothing and linens separately from other laundry.

Lonsurf side effects

Get emergency medical help if you have signs of an allergic reaction to Lonsurf: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • low levels of platelets in your blood - easy bruising, unusual bleeding, purple or red spots under your skin;

  • low red blood cells (anemia) - pale skin, unusual tiredness, feeling light-headed or short of breath, cold hands and feet; or

  • low white blood cell counts - fever, mouth sores, skin sores, sore throat, cough, trouble breathing.

Your cancer treatments may be delayed or permanently discontinued if you have certain side effects.

Serious side effects may be more likely in older adults.

Common Lonsurf side effects may include:

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Lonsurf?

Other drugs may interact with tipiracil and trifluridine, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Lonsurf only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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