From the Guidelines
Lonsurf (trifluridine/tipiracil) is given orally in tablet form, typically administered twice daily on days 1-5 and 8-12 of a 28-day cycle, with a standard dosage of 35 mg/m² per dose, up to a maximum single dose of 80mg, as recommended by the most recent guidelines 1.
Administration and Dosage
The administration of Lonsurf involves taking the tablets orally, twice a day, within 1 hour after completing morning and evening meals with water, and swallowing the tablets whole.
- The dosage is calculated based on body surface area, usually 35 mg/m² per dose, with a maximum single dose of 80mg.
- The treatment cycle consists of days 1-5 and 8-12 of a 28-day cycle.
Mechanism of Action and Monitoring
Lonsurf works through a dual mechanism:
- Trifluridine incorporates into DNA, disrupting cancer cell function.
- Tipiracil prevents rapid breakdown of trifluridine, maintaining therapeutic levels in the body. Regular blood tests are essential during treatment to monitor for potential side effects like neutropenia and anemia, as indicated in the guidelines 1.
Handling and Safety
The medication should be handled with care as it's cytotoxic. Dose adjustments may be necessary based on blood counts and side effects, with treatment continued until disease progression or unacceptable toxicity occurs, as supported by the evidence 1.
From the FDA Drug Label
For oral administration For oral administraion The main method of administration for Lonsurf is orally. 2
From the Research
Administration of Lonsurf
- Lonsurf, also known as trifluridine/tipiracil, is administered orally, twice daily, on days 1-5 and 8-12 of each 28-day cycle 3, 4, 5, 6.
- The recommended dose is 35 mg/m2, taken twice daily 3, 4, 5, 6.
- The treatment is typically given in combination with best supportive care 3, 4, 5.
Special Considerations
- In patients with hepatic impairment, trifluridine/tipiracil can be safely administered in those with normal hepatic function and mild hepatic impairment, with no initial dose adjustment 6.
- However, trifluridine/tipiracil is not recommended for use in patients with moderate or severe hepatic impairment due to increased risk of adverse events 6.
- The efficacy and safety of trifluridine/tipiracil have been evaluated in various patient subgroups, including those with metastatic colorectal cancer and metastatic gastric cancer 3, 4, 5, 7.