tipiracil hydrochloride + trifluridine at a glance
Medicine class
Antineoplastic antimetabolite
Usual role
Treatment of previously treated metastatic colorectal, gastric or gastro-oesophageal junction cancer
Administration
Swallow tablets whole with water within one hour after finishing a meal.
Key monitoring
Regular blood-cell counts are essential because bone-marrow suppression is common.
What is tipiracil hydrochloride + trifluridine used for?
Licensed UK uses in adults include:
Metastatic colorectal cancer as monotherapy after previous established therapies, or when those therapies are unsuitable.
Metastatic colorectal cancer with bevacizumab after two previous anticancer treatment regimens containing relevant established therapies.
Metastatic gastric cancer, including gastro-oesophageal junction adenocarcinoma, after at least two previous systemic regimens for advanced disease.
How does tipiracil hydrochloride + trifluridine work?
Trifluridine is activated inside cells and incorporated into DNA, disrupting its function and limiting cancer-cell proliferation. Tipiracil blocks an enzyme that would otherwise rapidly break down trifluridine.
How to take tipiracil hydrochloride + trifluridine
Follow the personalised instructions from the specialist cancer team.
Swallow tablets whole with a glass of water.
Take each prescribed dose within one hour after finishing a meal.
Wash your hands after handling the tablets.
Do not alter or restart treatment after an interruption unless instructed by the oncology team.
tipiracil hydrochloride + trifluridine side effects
Common or expected effects
- Reduced neutrophils, red blood cells, platelets or other white blood cells
- Nausea, vomiting or diarrhoea
- Fatigue
- Reduced appetite
- Mouth inflammation or soreness
- Abdominal pain or constipation
- Taste changes
- Hair loss, dry skin or rash
Get urgent medical advice
- Fever or other infection symptoms associated with low neutrophils
- Unusual bleeding or bruising from low platelets
- Severe or persistent vomiting or diarrhoea causing dehydration
- Severe abdominal pain, possible bowel obstruction, colitis or pancreatitis
- Sudden breathlessness or chest pain suggesting pulmonary embolism
- New breathlessness, cough or fever suggesting interstitial lung disease
tipiracil hydrochloride + trifluridine in pregnancy
Human pregnancy data are unavailable, but the mechanism and animal evidence indicate potential fetal harm. It should generally be avoided during pregnancy unless specialist assessment finds it clinically necessary. Effective contraception is required during treatment and for six months afterwards; hormonal contraception should be supplemented with a barrier method.
tipiracil hydrochloride + trifluridine while breastfeeding
Breastfeeding must stop during treatment because transfer into human milk is unknown and harm to the child cannot be excluded.
tipiracil hydrochloride + trifluridine interactions
Tell the oncology team about all prescribed, non-prescribed and herbal products. Relevant interactions include:
Zidovudine and other human thymidine-kinase substrates
Competition for activation may reduce antiviral effectiveness; monitoring or an alternative antiviral may be needed.
OCT2 or MATE1 inhibitors
These may increase tipiracil exposure, so concomitant use requires caution.
Medicines affecting CNT1, ENT1 or ENT2 transporters
They could alter trifluridine transport, so concomitant use requires caution.
Common questions about tipiracil hydrochloride + trifluridine
Answers are fully visible for fast scanning and source review.
Why are blood tests needed?
Treatment can reduce white cells, red cells and platelets, increasing the risks of infection, anaemia and bleeding.
Can it be used with kidney problems?
Kidney impairment can increase exposure and toxicity. Specialist assessment and closer monitoring are required, and use is not recommended in end-stage renal disease.
Can it be used with liver problems?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.