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Overview: Trifluridine/tipiracil is an oral tablet. It is used to treat colorectal cancer and cancers of the stomach or esophagus. It works by entering cancer cells, where it disrupts DNA and stops the cells from multiplying. Common side effects include tiredness, weakness, nausea, and stomach issues. Serious side effects can include severe allergic reactions or blood disorders that may cause infections or unusual bleeding.

Uses

What is trifluridine/tipiracil used for?

Trifluridine/tipiracil is commonly used to treat colorectal cancer. It is also used to treat cancers of the stomach or esophagus, which is the tube connecting the mouth and stomach.

Trifluridine/tipiracil may also be used for other conditions as determined by your healthcare provider.

How does trifluridine/tipiracil work (mechanism of action)?

This medicine has two active ingredients: trifluridine and tipiracil. Trifluridine acts like a part of DNA. When it enters a cancer cell, it mixes into the DNA and stops the cell from multiplying. This slows the growth of cancer. Tipiracil works by preventing trifluridine from breaking down too quickly. This keeps trifluridine active longer in the body, helping it work better.  

How is trifluridine/tipiracil supplied (dosage forms)?

Brands and other names

  • Lonsurf

Dosage forms and strengths

  • 15 mg/6.14 mg oral tablets
  • 20 mg/8.19 mg oral tablets

How should I store trifluridine/tipiracil?

Trifluridine/tipiracil should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place. 

If you store trifluridine/tipiracil tablets outside of the original bottle, throw them out after 30 days. Your healthcare provider can tell you how to safely throw away this medicine.

Side Effects

What are the most common side effects of trifluridine/tipiracil?

The most common side effects of trifluridine/tipiracil are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

  • Blood disorders (see below)
  • Tiredness
  • Weakness
  • Nausea and vomiting
  • Poor appetite
  • Diarrhea
  • Stomach pain
  • Fever

There may be other side effects of trifluridine/tipiracil that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of trifluridine/tipiracil?

While less common, the most serious side effects of trifluridine/tipiracil are described below, along with what to do if they happen.

Severe Allergic Reactions. Trifluridine/tipiracil may cause allergic reactions, which can be serious. Stop taking trifluridine/tipiracil and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Blood Disorders. Trifluridine/tipiracil can cause blood disorders, such as low levels of white blood cells (neutropenia), red blood cells (anemia), and platelets (thrombocytopenia). This may increase your risk of infection, which could be serious or even life-threatening. Keep all appointments to have your bloodwork checked. Tell your healthcare provider right away if you have any of the following symptoms of an infection or blood disorders.

  • Fever, chills, or sweats
  • Unusual weakness or tiredness
  • Sore throat, cough, or shortness of breath
  • Mouth or throat sores
  • Swollen lymph nodes
  • Shortness of breath
  • Pale or yellowish skin
  • Easy bruising or bleeding
  • Dizziness, lightheadedness, or feeling like you are about to pass out
  • Headache
  • Fast or abnormal heartbeat

Warnings & Precautions

Who should not use trifluridine/tipiracil?

Allergies to Ingredients. People who are allergic to any of the following should not take trifluridine/tipiracil.

  • Trifluridine
  • Tipiracil 
  • Lonsurf
  • Viroptic
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific trifluridine/tipiracil products they stock.

What should I know about trifluridine/tipiracil before taking it?

Do not take trifluridine/tipiracil unless it has been prescribed to you by a healthcare provider. Take it as prescribed.

Do not share trifluridine/tipiracil with other people, even if they have the same condition as you. It may harm them.

Keep trifluridine/tipiracil out of the reach of children.

Wash your hands after touching trifluridine/tipiracil tablets. Caregivers should wear gloves when handling this medicine.

Take trifluridine/tipiracil with food. Contact your healthcare provider if you have severe or prolonged stomach side effects, such as nausea, vomiting, diarrhea, or belly pain.

People who are 65 and older can be at greater risk for some side effects from trifluridine/tipiracil. Talk to your healthcare provider about your risks if you are in this age group.

If you can become pregnant, you should use birth control while taking trifluridine/tipiracil and for at least six months after your last dose. If you can get your partner pregnant, you should use a condom while taking trifluridine/tipiracil and for three months after your last dose. Talk to your healthcare provider about effective birth control options.

What should I tell my healthcare provider before taking trifluridine/tipiracil?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if trifluridine/tipiracil is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.

  • Liver problems
  • Kidney problems

Pregnancy. Trifluridine/tipiracil may cause harm to an unborn baby. You will need a pregnancy test to make sure you are not pregnant before starting this medicine. Tell your healthcare provider if you are or plan to become pregnant. If you become pregnant while taking trifluridine/tipiracil, contact your healthcare provider right away. 

Breastfeeding. It is not known if trifluridine/tipiracil passes into breast milk. Do not breastfeed while taking trifluridine/tipiracil and for one day after your last dose. Tell your healthcare provider if you are breastfeeding or plan to breastfeed.

Interactions

Does trifluridine/tipiracil interact with foods or drinks?

There are no known interactions between trifluridine/tipiracil and foods or drinks.

It is unknown if drinking alcohol will affect trifluridine/tipiracil.

Does trifluridine/tipiracil interact with other medicines (drug interactions)?

There are no known interactions between trifluridine/tipiracil and other medicines. Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much trifluridine/tipiracil?

If you or someone else has used too much trifluridine/tipiracil, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of trifluridine/tipiracil?

If you miss a dose, skip the missed dose and only take the next dose as scheduled. If you vomit right after you take a dose, do not take another dose to make up for it. Instead, take the next dose as scheduled. Do not take double or extra doses. If you are unsure what to do after missing or vomiting doses, contact your healthcare provider for next steps.