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Trifluridine Tipiracil: Treatment, Dosage & Side Effects Explained
Summary of Key Points
Trifluridine/tipiracil is a combination medication used to treat certain cancers, including colorectal and gastric cancers. It works by slowing the growth of cancer cells and is typically prescribed when other treatments have not been successful. It is essential to follow your doctor’s instructions closely when taking this medication. Always consult your healthcare provider before making any changes to your treatment plan.
Names of Medication
US Brand Name: Lonsurf
Generic Name: Trifluridine/tipiracil
The generic name refers to the chemical components of the active ingredients and is listed in parentheses next to the brand name.
Pharmacologic Category
Antineoplastic Agent
Nucleoside Metabolic Inhibitor
Trifluridine Tipiracil Dosage
Trifluridine/tipiracil is used to treat various cancers in adults. The dosing schedule may vary depending on the type of cancer being treated. Always follow your doctor’s instructions and consult with one of our providers through telemedicine before making any adjustments to your dose.
Trifluridine Tipiracil for Colorectal Cancer
Dose: 35 mg/m² orally twice daily on Days 1-5 and Days 8-12 of each 28-day cycle.
Frequency: Twice daily.
Length of Treatment: Continue until disease progression or unacceptable toxicity.
Trifluridine Tipiracil for Gastric Cancer
Dose: 35 mg/m² orally twice daily on Days 1-5 and Days 8-12 of each 28-day cycle.
Frequency: Twice daily.
Length of Treatment: Continue until disease progression or unacceptable toxicity.
Trifluridine Tipiracil for Pancreatic Cancer
Dose: 35 mg/m² orally twice daily on Days 1-5 and Days 8-12 of each 28-day cycle.
Frequency: Twice daily.
Length of Treatment: Continue until disease progression or unacceptable toxicity.
Trifluridine Tipiracil for Esophageal Cancer
Dose: 35 mg/m² orally twice daily on Days 1-5 and Days 8-12 of each 28-day cycle.
Frequency: Twice daily.
Length of Treatment: Continue until disease progression or unacceptable toxicity.
Trifluridine Tipiracil for Small Intestine Cancer
Dose: 35 mg/m² orally twice daily on Days 1-5 and Days 8-12 of each 28-day cycle.
Frequency: Twice daily.
Length of Treatment: Continue until disease progression or unacceptable toxicity.
Trifluridine Tipiracil for Anal Cancer
Dose: 35 mg/m² orally twice daily on Days 1-5 and Days 8-12 of each 28-day cycle.
Frequency: Twice daily.
Length of Treatment: Continue until disease progression or unacceptable toxicity.
Trifluridine Tipiracil for Biliary Tract Cancer
Dose: 35 mg/m² orally twice daily on Days 1-5 and Days 8-12 of each 28-day cycle.
Frequency: Twice daily.
Length of Treatment: Continue until disease progression or unacceptable toxicity.
Trifluridine Tipiracil for Head and Neck Cancer
Dose: 35 mg/m² orally twice daily on Days 1-5 and Days 8-12 of each 28-day cycle.
Frequency: Twice daily.
Length of Treatment: Continue until disease progression or unacceptable toxicity.
Trifluridine Tipiracil for Non-Small Cell Lung Cancer
Dose: 35 mg/m² orally twice daily on Days 1-5 and Days 8-12 of each 28-day cycle.
Frequency: Twice daily.
Length of Treatment: Continue until disease progression or unacceptable toxicity.
Trifluridine Tipiracil for Ovarian Cancer
Dose: 35 mg/m² orally twice daily on Days 1-5 and Days 8-12 of each 28-day cycle.
Frequency: Twice daily.
Length of Treatment: Continue until disease progression or unacceptable toxicity.
Dosage Forms and Strengths
Tablet: 15 mg trifluridine/6.14 mg tipiracil
Tablet: 20 mg trifluridine/8.19 mg tipiracil
Administration Instructions for Trifluridine Tipiracil
Take trifluridine/tipiracil exactly as prescribed by your doctor. It is usually taken twice daily with food. Swallow the tablets whole with water. Do not crush, chew, or split the tablets. If you miss a dose, take it as soon as you remember, but skip it if it’s almost time for your next dose. Never take two doses at once.
Contraindications for Trifluridine Tipiracil Treatment
A contraindication is a condition where a specific medication should not be used due to potential harm. If you have any of the following conditions, you should not take trifluridine/tipiracil or should discuss it with your healthcare provider:
- Severe kidney disease: Trifluridine/tipiracil is processed by the kidneys. Impaired kidney function may cause the medication to accumulate, leading to toxicity.
- Severe liver disease: The liver helps process this medication. If your liver is compromised, it may not break down the drug properly, increasing the risk of side effects.
- Low blood cell counts (bone marrow suppression): Trifluridine/tipiracil can reduce white blood cell, red blood cell, and platelet counts. If you already have low counts, this medication could worsen the condition, increasing the risk of infections, anemia, or bleeding.
- Allergic reaction to trifluridine, tipiracil, or any ingredients: If you have had an allergic reaction to this medication or its components, taking it again could result in a severe, potentially life-threatening allergic reaction.
Drug to Drug Interactions
Trifluridine/tipiracil can interact with other medications, potentially increasing side effects or reducing the effectiveness of either the cancer treatment or the other drugs. It’s important to inform your healthcare provider about all medications you are taking, including over-the-counter drugs and supplements. Some known drug interactions include:
- Warfarin (Coumadin): This blood thinner may interact with Trifluridine/tipiracil, increasing the risk of bleeding.
- Fluorouracil (Adrucil): Both drugs are used to treat cancer, but using them together may heighten the risk of severe side effects, such as bone marrow suppression.
- Capecitabine (Xeloda): Another cancer medication that, when combined with Trifluridine/tipiracil, may increase the risk of gastrointestinal side effects and bone marrow suppression.
- Live vaccines: Since Trifluridine/tipiracil can weaken your immune system, receiving live vaccines (such as the measles, mumps, and rubella vaccine) while on this medication can increase your risk of contracting the infection the vaccine is meant to prevent.
Trifluridine/tipiracil in Pregnancy
Is it Safe to Take Trifluridine/tipiracil During Pregnancy?
No, Trifluridine/tipiracil is not considered safe during pregnancy. This medication can harm an unborn baby, potentially causing birth defects or miscarriage. If you are pregnant or planning to become pregnant, it’s crucial to discuss this with your healthcare provider. You should use effective contraception while taking this medication and for at least six months after your last dose. If you become pregnant while taking Trifluridine/tipiracil, contact your healthcare provider immediately.
Trifluridine/tipiracil While Breastfeeding
Is it Safe to Take Trifluridine/tipiracil While Breastfeeding?
No, it is not recommended to take Trifluridine/tipiracil while breastfeeding. Although it is unknown whether the drug passes into breast milk, the potential for serious harm to a nursing infant means breastfeeding should be avoided during treatment and for at least one day after the last dose. If you are breastfeeding or planning to breastfeed, talk to your healthcare provider about your options.
Estimated Cost of Trifluridine/tipiracil
The cost of Trifluridine/tipiracil can vary depending on your location and pharmacy. Without insurance, a 30-day supply (60 tablets of 15 mg/6.14 mg) is estimated to cost around $15,000. However, using a GoodRX coupon may reduce the price to approximately $12,000. Be sure to check with your pharmacy for the most accurate pricing and inquire about any available financial assistance programs.
Possible Alternatives to Trifluridine/tipiracil Treatment
Depending on your diagnosis, alternative treatments or lifestyle changes may help manage your condition. Always discuss any changes to your treatment plan with your healthcare provider. You can also schedule a telemedicine appointment with one of our providers to explore your options.
- Colorectal cancer: Alternatives may include other chemotherapy drugs like capecitabine (Xeloda) or irinotecan (Camptosar). Targeted therapies such as bevacizumab (Avastin) or cetuximab (Erbitux) may also be considered. In some cases, surgery or radiation therapy may be an option.
- Gastric cancer: Other chemotherapy options include cisplatin (Platinol) or oxaliplatin (Eloxatin). Targeted therapies like trastuzumab (Herceptin) may be used for certain types of gastric cancer. Surgery and radiation are also potential treatments.
- Pancreatic cancer: Alternatives include gemcitabine (Gemzar) or nab-paclitaxel (Abraxane). Surgery and radiation therapy may also be part of the treatment plan.
- Esophageal cancer: Chemotherapy options include cisplatin or fluorouracil (Adrucil). Radiation therapy and surgery are also common treatments.
- Small intestine cancer: Treatment may involve surgery, chemotherapy (such as capecitabine or oxaliplatin), or radiation therapy.
- Anal cancer: Chemotherapy options include fluorouracil and mitomycin. Radiation therapy is often used in combination with chemotherapy.
- Biliary tract cancer: Chemotherapy options include gemcitabine and cisplatin. Surgery and radiation therapy may also be considered.
- Head and neck cancer: Alternatives include cisplatin or carboplatin (Paraplatin). Radiation therapy and surgery are also common treatments.
- Non-small cell lung cancer: Alternatives include chemotherapy with drugs like pemetrexed (Alimta) or targeted therapies such as erlotinib (Tarceva). Immunotherapy may also be an option.
- Ovarian cancer: Chemotherapy options include paclitaxel (Taxol) and carboplatin. Targeted therapies like bevacizumab may also be considered, along with surgery.
Recent Updates on Trifluridine/tipiracil Research
Recent studies show that Trifluridine/tipiracil remains an effective treatment for patients with metastatic colorectal and gastric cancer who have not responded to other therapies. Ongoing research is exploring its use in combination with other treatments, such as immunotherapy, to enhance its effectiveness. Additionally, studies are investigating its potential use in other cancers, such as pancreatic and esophageal cancers. As research progresses, new treatment protocols may emerge, offering more options for patients. Stay in touch with your healthcare provider to learn about the latest developments in cancer treatment.
