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Tipiracil and trifluridine

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

Medically reviewed on July 25, 2017

What is tipiracil and trifluridine?

Tipiracil and trifluridine is a combination cancer medicine that interferes with the growth and spread of cancer cells in the body.

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

Tipiracil and trifluridine is usually given after other cancer medicines have been tried without success.

Tipiracil and trifluridine may also be used for purposes not listed in this medication guide.

Important Information

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

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

Before taking this medicine

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

To make sure tipiracil and trifluridine 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.

Tipiracil and trifluridine 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 tipiracil and trifluridine 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 tipiracil and trifluridine.

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 this medicine, and for at least 24 hours after your last dose.

How should I take tipiracil and trifluridine?

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

Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.

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

Tipiracil and trifluridine 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 tipiracil and trifluridine 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.

Tipiracil and trifluridine 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.

If you do not store this medicine in the original container, you will need to throw away any unused tablets after 30 days.

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 tipiracil and trifluridine?

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

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.

Tipiracil and trifluridine side effects

Get emergency medical help if you have signs of an allergic reaction: 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 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.

See also: Side effects (in more detail)

Tipiracil and trifluridine 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 other drugs will affect tipiracil and trifluridine?

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 this medication 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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