Is urine analysis required before administering Lonsurf (Trifluridine/Tipiracil)?

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Last updated: May 2, 2025View editorial policy

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From the Guidelines

A urine analysis is not specifically required before administering Lonsurf (trifluridine/tipiracil). The standard pre-treatment assessments for Lonsurf focus primarily on complete blood counts, as myelosuppression is a common side effect. Before starting Lonsurf, healthcare providers should obtain baseline complete blood counts and monitor them throughout treatment, with dose modifications based on hematological toxicities. Renal function should be assessed through serum creatinine or calculated creatinine clearance, but routine urinalysis is not mandated in the prescribing information, as supported by the most recent guideline update 1.

According to the latest evidence, routine urinalysis is not necessary unless there is a suspicion of urinary tract infections or other specific conditions 1. The primary concern with Lonsurf administration is monitoring for myelosuppression and adjusting the dose accordingly, rather than renal function through urinalysis.

Key points to consider when administering Lonsurf include:

  • Baseline complete blood counts and ongoing monitoring
  • Dose modifications based on hematological toxicities
  • Assessment of renal function through serum creatinine or calculated creatinine clearance
  • No routine urinalysis required unless specific conditions are suspected, as per the latest guideline update 1.

It is essential to prioritize the patient's overall health and adjust the treatment plan according to their individual needs, focusing on minimizing morbidity, mortality, and improving quality of life. In the context of Lonsurf administration, the emphasis is on managing myelosuppression and monitoring renal function through serum creatinine levels, rather than routine urinalysis, as supported by the highest quality and most recent evidence 1.

From the Research

Urine Analysis Before Administering Lonsurf

  • There is no direct evidence in the provided studies that specifically requires urine analysis before administering Lonsurf (trifluridine/tipiracil) 2, 3, 4, 5.
  • However, studies suggest that renal impairment can be a risk factor for trifluridine/tipiracil-induced adverse events, such as severe neutropenia 2, 3.
  • Baseline renal function screening is important to assess the risk of contrast-induced nephropathy (CIN) in patients receiving iodinated contrast media, and it is recommended to use an estimated glomerular filtration rate (eGFR) calculated from the serum creatinine as an index of renal function 6.
  • While urine analysis is not explicitly mentioned as a requirement before administering Lonsurf, assessing renal function through serum creatinine or eGFR is crucial to identify patients at higher risk for adverse events 2, 3, 6.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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