lonsurf 20 mg

lonsurf 20 mg is a combination oral chemotherapy medication containing trifluridine and tipiracil hydrochloride. LONSURF is approved for use with or without bevacizumab for patients with previously treated metastatic colorectal cancer. LONSURF is a prescription medicine for patients with colorectal cancer that has spread to other parts of the body and who have previously been treated with chemotherapy medicines.

Active Ingredients and Formulation

LONSURF comes in 2 strengths: 15mg and 20mg tablets. Your healthcare provider may prescribe both strengths for your prescribed dose. The medication combines:

Trifluridine – A nucleoside analog that gets incorporated into DNA, causing DNA damage

Tipiracil – A thymidine phosphorylase inhibitor that prevents the breakdown of trifluridine

Indications

The primary indication is for metastatic colorectal cancer in patients who have been previously treated with standard chemotherapy regimens. This represents a third-line or later treatment option for advanced disease.

lonsurf 20 mg Dosing and Administration

Standard Dosing:

The recommended dose of trifluridine and tipiracil is 35 mg/m2, rounded up to the nearest 5-mg increment. It is dosed orally twice daily on days 1 through 5 and on days 8 through 12 of each 28-day cycle.

Administration Guidelines:

You take Lonsurf as tablets. Your doctor will tell you how many tablets to take. You take them twice a day with a glass of water. You need to take them within an hour after your morning and evening meals.

Trifluridine plus tipiracil should be taken within 1 hour after the morning and the evening meals to optimize absorption.

Treatment Schedule:

If your blood results are okay, the pharmacist team will prepare your chemotherapy. You have Lonsurf as cycles of treatment. A cycle lasts 28 days (4 weeks). You usually take the tablets on set days during each cycle: Weeks 1 and 2 – you take Lonsurf tablets twice a day for 5 days.

You will take LONSURF twice a day (with morning and evening meals) for 5 days, and then rest for the next 2 days. This goes on for 2 weeks. Then there’s a 2-week rest period before the next cycle.

Dose Modifications:

A maximum of 3 dose reductions are permitted to a minimum dose 20mg/m² BID. based on toxicity and patient tolerance.

Common Side Effects

Most Frequent Adverse Reactions:

The most frequently observed adverse drug reactions (≥ 30%) in patients receiving Lonsurf are neutropenia (53% [34% ≥ Grade 3]), nausea (34% [1% ≥ Grade 3]), fatigue (32% [4% ≥ Grade 3]) and anaemia (32% [12% ≥ Grade 3]).

lonsurf 20 mg Other Common Side Effects:

Nausea, diarrhea, vomiting, change in taste, or hair loss may occur.

eye problems such as changes to your sight, or red, sticky eyes that feel gritty and may water (conjunctivitis) or dry eyes – call your advice line about any eye problems · pain, including in your muscles, joints, bones or tumour.

Serious Safety Concerns

Bone Marrow Suppression:

Lonsurf affects your immune system and can cause serious bone marrow suppression. You may get infections more easily, even serious or fatal infections. Call your doctor if you have a fever, chills, body aches, or unusual bleeding or bruising.

The combination severely suppresses bone marrow function, resulting in fewer red blood cells, white blood cells, and platelets, so many people taking it are at risk for infections, anemia, and blood loss from lack of clotting.

Most Serious Adverse Reactions:

The most serious observed adverse reactions in patients receiving Lonsurf are bone marrow suppression and gastrointestinal toxicity.

Special Populations

Elderly Patients:

Older adults may be more sensitive to the side effects of this drug, especially decreased bone marrow function.

Pregnancy Considerations:

Tell your doctor if you are pregnant or plan to become pregnant. You should not become pregnant while using trifluridine/tipiracil. Trifluridine/tipiracil may harm an unborn baby.

Contraindications

There are no contraindications to the use of Lonsurf. However, careful monitoring and dose adjustments are essential based on patient tolerance and laboratory values.

Hepatic Impairment:

Mild (total bilirubin [TB] ≤ULN and AST >ULN, or TB <1-1.5x ULN and any AST): No dosage adjustment required.

Supportive Care

Antiemetic Therapy:

Associated with a moderate emetic potential; antiemetics to prevent nausea and vomiting recommended.

Additional Considerations:

Fatigue, dizziness or malaise may occur during treatment.

Monitoring Requirements

Regular monitoring should include:

Complete blood count with differential

Comprehensive metabolic panel

Liver function tests

Performance status assessment

Assessment for signs of infection

Mechanism of Action

Trifluridine is a nucleoside analog that gets incorporated into DNA during replication, leading to DNA strand breaks and cell death. Tipiracil prevents the degradation of trifluridine, allowing for sustained therapeutic levels.

Clinical Considerations

Requires careful patient selection based on performance status

Regular laboratory monitoring is essential

Patient education about infection precautions is critical

Dose modifications based on toxicity are common

Consider prophylactic supportive care measures

lonsurf 20 mg Storage and Handling

Store at room temperature, protect from moisture, and keep in original packaging. This is a cytotoxic medication requiring appropriate handling precautions.

Lonsurf represents an important treatment option for patients with refractory metastatic colorectal cancer, but requires careful monitoring and management of its significant hematologic and gastrointestinal toxicities. lonsurf 20 mg