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

Medically reviewed on Jul 25, 2017

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

Important information

Before and during your treatment with Lonsurf, you will need blood tests.

Call your doctor at once if you develop signs of infection (fever, chills, body aches).

Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

Before taking this medicine

You should not use Lonsurf if you are allergic to tipiracil or trifluridine.

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

  • kidney disease;

  • liver disease; or

  • if you are pregnant or may become pregnant.

Lonsurf can harm an unborn baby. Use effective birth control to prevent pregnancy while you are using this medicine, whether you are a man or a woman. Men should use condoms. The use of Lonsurf by either parent may cause birth defects.

If you are a man, keep using condoms 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 this medicine.

It is not known whether tipiracil and trifluridine passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using Lonsurf, 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. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Before and during your treatment with Lonsurf, you will need blood tests. The timing of these tests is very important. Do not miss any scheduled appointments.

Lonsurf should be taken within 1 hour after your morning and evening meals.

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.

Wash your hands after handling the tablets.

Caregivers who touch or handle the tablets should wear rubber gloves.

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.

Lonsurf can lower blood cells that help your body fight infections and help your blood to clot. Your blood will need to be tested often. Your cancer treatments may be delayed based on the results of these tests.

Store tablets in their original container at room temperature, away from moisture and heat.

Do not put the tablets into a daily pill box. If you do not store this medicine in the original container, you will need to throw away any unused tablets after 30 days.

Lonsurf dosing information

Usual Adult Dose of Lonsurf 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

-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?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

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?

Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.

Trifluridine and tipiracil 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:

  • fever, chills, flu-like symptoms, swollen gums, painful mouth sores;

  • pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating; or

  • easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin.

Serious side effects may be more likely in older adults.

Common Lonsurf side effects may include:

  • stomach pain, loss of appetite;

  • nausea, vomiting, diarrhea;

  • fever; or

  • feeling weak or tired.

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 each of your health care providers about all medicines you use now 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.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

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