II. Indications

  1. Colorectal Cancer (metastatic)
  2. Gastric or gastroesophageal junction adenocarcinoma (metastatic, refractory)

III. Mechanism

  1. Trifluridine
    1. Fluorinated thymidine analog with both antineoplastic and antiviral activity
    2. As a thymidine analog, Trifluridine is incorporated into DNA
      1. Inhibits thymidylate synthase
      2. Inhibits DNA synthesis and Protein synthesis
  2. Tipiracil
    1. Thymidine phosphorylase inhibitor
    2. Thymidine is added to Trifluridine, to slow its metabolism, and potentiate its activity

IV. Medications

  1. Trifluridine/Tipiracil Tablets: 15 mg/6.14 mg and 20 mg/8.19 mg

V. Dosing

  1. See other references for disease specific dosing protocols

VI. Pharmacokinetics

  1. Trifluridine is metabolized by Thymidine phosphorylase

VII. Adverse Effects

  1. Myelosuppression (severe)

VIII. Safety

  1. Avoid in Lactation
  2. Avoid in pregnancy (all trimesters)
    1. Use reliable Contraception
  3. Monitoring
    1. Complete Blood Count (CBC)
      1. Obtain prior to dosing and again on Day 15 of Chemotherapy cycle

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Related Studies

Cost: Medications

trifluridine (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
TRIFLURIDINE 1% EYE DROPS Generic $19.43 per ml