Why is this medication prescribed?

Trifluridine and Tipiracil, commonly known by the brand name “Lonsurf,” is a medication used in the treatment of metastatic colorectal cancer (cancer that has spread to other parts of the body) when other treatments have failed.

Trifluridine is a nucleoside analog, while tipiracil is a thymidine phosphorylase inhibitor. Together, they work by inhibiting thymidine phosphorylase, which can lead to increased levels of trifluridine in the body. Trifluridine can then interfere with the DNA synthesis process in cancer cells, ultimately leading to their destruction.

This medication is typically prescribed for patients who have already undergone treatment with certain chemotherapy drugs and biologic therapies. It’s used as a last-line option when other treatments have been ineffective.

How should this medicine be used?

Trifluridine and Tipiracil, commonly known as Lonsurf, is typically used orally in the form of tablets. Here’s a general guideline on how it’s used:

• Dosage: The dosage of Trifluridine and Tipiracil can vary depending on factors such as the patient’s body surface area and overall health. The prescribing doctor will determine the appropriate dosage for the individual patient.
• Administration: The medication is usually taken orally with food to help minimize gastrointestinal side effects. It’s essential to swallow the tablets whole and not crush, break, or chew them.
• Schedule: Trifluridine and Tipiracil is typically taken twice daily, usually in the morning and evening. The specific schedule may vary depending on the treatment plan outlined by the doctor.
• Treatment Cycle: Trifluridine and Tipiracil treatment is usually given in cycles, with each cycle consisting of a certain number of days of treatment followed by a rest period. The treatment cycle typically lasts for 28 days, followed by a 14-day rest period before starting the next cycle. The exact duration and number of cycles will be determined by the doctor based on the patient’s response to treatment and overall health.
• Monitoring: Patients taking Trifluridine and Tipiracil should be closely monitored by their healthcare provider for any side effects or complications. Blood tests may be performed regularly to monitor blood cell counts and liver function.
• Adherence: It’s crucial for patients to adhere to the prescribed dosage and schedule for taking Trifluridine and Tipiracil. Missing doses or taking the medication differently than prescribed can affect its effectiveness and may increase the risk of side effects.
• Side Effects: Patients should be aware of potential side effects associated with Trifluridine and Tipiracil, such as nausea, vomiting, diarrhea, fatigue, decreased appetite, and anemia. Any concerning side effects should be reported to the healthcare provider promptly.

It’s important for patients to discuss any questions or concerns about the use of Trifluridine and Tipiracil with their healthcare provider. They should also inform their doctor about any other medications, supplements, or medical conditions they have before starting treatment.

Other uses for this medicine

Trifluridine and Tipiracil, marketed under the brand name Lonsurf, is primarily indicated for the treatment of metastatic colorectal cancer in patients who have previously received chemotherapy. However, it may also have other off-label uses or be investigated for use in other types of cancer or conditions. It’s important to note that using medications for off-label purposes should only be done under the guidance and supervision of a healthcare professional.

What special precautions should I follow?

As for special precautions to follow when taking Trifluridine and Tipiracil:

• Medical History: Inform your healthcare provider about your medical history, including any allergies, previous treatments, surgeries, or current medical conditions, especially kidney or liver problems.
• Pregnancy and Breastfeeding: Trifluridine and Tipiracil may cause harm to a developing fetus, so it’s essential to discuss the risks and benefits with your doctor if you are pregnant or planning to become pregnant. It is also not recommended for use during breastfeeding.
• Blood Cell Counts: Trifluridine and Tipiracil can cause a decrease in blood cell counts, including white blood cells, red blood cells, and platelets. Regular blood tests will likely be required to monitor these levels during treatment.
• Liver Function: Trifluridine and Tipiracil can affect liver function, so it’s essential to monitor liver function tests regularly during treatment.
• Interactions: Inform your doctor about all medications, supplements, and herbal products you are taking, as they may interact with Trifluridine and Tipiracil and affect its effectiveness or increase the risk of side effects.
• Gastrointestinal Issues: Trifluridine and Tipiracil can cause gastrointestinal side effects such as nausea, vomiting, diarrhea, and decreased appetite. Your doctor may prescribe medications to help manage these symptoms.
• Handling Precautions: Since Trifluridine and Tipiracil is an oral chemotherapy medication, it’s important to handle the tablets with care and follow proper disposal guidelines. Wash hands thoroughly after handling the medication.
• Driving and Operating Machinery: Trifluridine and Tipiracil may cause fatigue or dizziness, which can affect your ability to drive or operate machinery. Use caution until you know how the medication affects you.

Always follow your doctor’s instructions and advice regarding the use of Trifluridine and Tipiracil, and report any concerning symptoms or side effects promptly.

What special dietary instructions should I follow?

There are no specific dietary restrictions associated with Trifluridine and Tipiracil. However, taking the medication with food may help minimize gastrointestinal side effects.

What should I do if I forget a dose?

If you forget to take a dose of Trifluridine and Tipiracil, take it as soon as you remember, unless it is almost time for your next scheduled dose. In that case, skip the missed dose and take your next dose at the regular time. Do not take a double dose to make up for a missed one. If you have any concerns or questions about missed doses, consult your healthcare provider or pharmacist for guidance.

What side effects can this medication cause?

Trifluridine and Tipiracil (Lonsurf) can cause various side effects, which can vary in severity from person to person. Common side effects of Trifluridine and Tipiracil include:

• Gastrointestinal Issues: Nausea, vomiting, diarrhea, and abdominal pain are common side effects. Taking the medication with food and using anti-nausea medications as prescribed by your doctor can help alleviate these symptoms.
• Fatigue: Feeling tired or weak is a common side effect of Trifluridine and Tipiracil. It’s important to get plenty of rest and avoid strenuous activities if you experience fatigue.
• Decreased Appetite: Some individuals may experience a loss of appetite while taking Trifluridine and Tipiracil. Eating small, frequent meals and staying hydrated can help manage this side effect.
• Anemia: Trifluridine and Tipiracil can cause a decrease in red blood cell count, leading to anemia. Symptoms of anemia may include fatigue, weakness, and shortness of breath.
• Decreased White Blood Cell Count: Trifluridine and Tipiracil may reduce the number of white blood cells in the body, increasing the risk of infections. Contact your healthcare provider if you develop signs of infection such as fever, chills, or sore throat.
• Decreased Platelet Count: Trifluridine and Tipiracil can lower platelet levels, which may lead to an increased risk of bleeding or bruising.
• Liver Function Changes: Trifluridine and Tipiracil may affect liver function, leading to elevated liver enzymes. Your doctor may monitor your liver function with blood tests during treatment.
• Other Side Effects: Other less common side effects may include headache, dizziness, hair loss, changes in taste, and skin reactions.

It’s essential to discuss any side effects you experience with your healthcare provider. They can provide guidance on managing side effects and may adjust your treatment regimen if necessary. Additionally, seek medical attention if you experience severe or persistent side effects or signs of allergic reactions such as rash, itching, swelling, or difficulty breathing.

What should I know about storage and disposal of this medication?

When it comes to the storage and disposal of Trifluridine and Tipiracil, here’s what you should know:

• Storage: Store Trifluridine and Tipiracil tablets at room temperature, away from moisture and heat. Keep the medication in its original packaging, and be sure to store it out of reach of children and pets.
• Disposal: Dispose of any unused or expired Trifluridine and Tipiracil tablets properly. Do not flush them down the toilet or throw them in the trash. Instead, follow any specific disposal instructions provided by your healthcare provider or local pharmacy. You may also inquire about community drug take-back programs for safe disposal.

In case of emergency/overdose

In case of an emergency or overdose with Trifluridine and Tipiracil, seek immediate medical attention or contact your local poison control center at 1-800-222-1222. Be prepared to provide information about the amount of medication ingested, as well as any symptoms experienced.

What other information should I know?

• Keep all appointments with your healthcare provider for monitoring and follow-up during treatment.
• Inform all healthcare providers involved in your care that you are taking Trifluridine and Tipiracil, as it may interact with other medications or treatments.
• Avoid drinking alcohol while taking Trifluridine and Tipiracil, as it may worsen certain side effects such as dizziness or liver problems.
• Be cautious when handling sharp objects or participating in activities that may cause injury, as Trifluridine and Tipiracil can increase the risk of bleeding due to decreased platelet count.
• Carry a medical alert card or wear a medical alert bracelet indicating that you are taking Trifluridine and Tipiracil in case of emergencies.
• Do not share Trifluridine and Tipiracil with others, even if they have similar symptoms or conditions.

It’s important to follow all instructions provided by your healthcare provider regarding the use, storage, and disposal of Trifluridine and Tipiracil. If you have any questions or concerns, don’t hesitate to discuss them with your doctor or pharmacist.