INDICATION: LONSURF® (trifluridine and tipiracil) tablets are a prescription medicine used to treat people with colon or rectal cancer that has spread to other parts of the body and who have previously been treated with or cannot receive certain chemotherapy medicines. It is not known if LONSURF is safe and effective in children.
INDICATION: LONSURF® (trifluridine and tipiracil) tablets are a prescription medicine used to treat people with colon or rectal cancer that has spread to other parts of the body and who have previously been treated with or cannot receive certain chemotherapy medicines. It is not known if LONSURF is safe and effective in children.
Living with mCRC
Considering LONSURF
Living with metastatic colon or rectal cancer

Taking LONSURF: Helpful reminders

LONSURF® (trifluridine and tipiracil) tablets are oral chemotherapy tablets you swallow:

  • Twice a day
  • After you eat breakfast and dinner (immediately after or up to 1 hour after)
    • LONSURF may cause a decrease in white blood cells. Taking LONSURF after morning and evening meals may help lessen this effect. This is important because a low white blood cell count can make you more prone to infection
    • The type of food does not matter

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

*Tablet strength of LONSURF is based on 1 active part of the medicine.
LONSURF® (trifluridine and tipiracil) 15 mg and 20 mg tablets Tablets shown are not actual size.

LONSURF 28‑day treatment schedule

LONSURF® (trifluridine and tipiracil) tablets Treatment Schedule

You will take LONSURF after morning and evening meals for 5 days a week, and then rest for 2 days. This goes on for 2 weeks.

Then you will not take LONSURF for 2 weeks (14 days).

This is repeated for as long as your healthcare provider says. Always follow all of your healthcare provider's directions carefully.

Watch Mollie Reed, Oncology Nurse, outline six important tips for taking your medicine as prescribed to help you stick to your treatment plan.

See more dosage directions

Other things to keep in mind about taking LONSURF

  • Store LONSURF at room temperature between 68°F and 77°F (20°C to 25°C)
  • Don't store LONSURF with other medicines. Keep LONSURF in its own container
  • If you store your tablets outside of the original container, any unused LONSURF tablets should be disposed of after 30 days
  • Wash your hands after handling LONSURF. Even though it is a pill, it is still chemotherapy
  • Make sure your caregiver wears gloves when handling LONSURF
  • Note that there is a packet inside the bottle that helps absorb moisture. Do not swallow this material
  • Keep LONSURF out of the reach of children

Contact your healthcare provider if:

  • You miss a dose. Do not take additional doses to make up for the missed dose. Call your healthcare provider for instructions about what to do for a missed dose
  • You have leftover tablets. Your healthcare provider or pharmacist will tell you how to dispose of them properly

Interested in receiving a LONSURF Starter Kit? The Kit contains useful tools to help you learn more about LONSURF and stay on track.

Create your treatment calendar

With this simple tool, you can create and print a personalized LONSURF treatment calendar where you can track your doses, temperature, and any side effects you experience. Make sure to share your calendar with your healthcare provider at your next appointment. 

Note: If your doctor changes your LONSURF dosage, be sure to create a new treatment calendar.

Steps for entering your doses into your calendar

STEP 1: Select your start date.

Start Date:

STEP 2: To enter your morning dose, select the number of 15‑mg and/or 20‑mg tablets you take in the morning.

Morning Dose:

NOTE: If your dose is made up of 15‑mg and 20‑mg tablets, make sure to include both in the appropriate boxes.

STEP 3: To enter your evening dose, select the number of 15‑mg and/or 20‑mg tablets you take in the evening.

Evening Dose:

NOTE: If your dose is made up of 15‑mg and 20‑mg tablets, make sure to include both in the appropriate boxes.

LONSURF (trifluridine and tipiracil) tablets come in 2 strengths: 15-mg and 20-mg tablets. Your healthcare provider may prescribe both strengths for your prescribed dose. Tablet strength of LONSURF is based on 1 active part of the medicine.
STEP 4: Select “Print”, check your calendar to make sure your doses have been entered correctly, and print.
STEP 4: Select “Download”, check your calendar to make sure your doses have been entered correctly.
Download

Potential treatment changes

During your treatment with LONSURF, your healthcare provider (HCP) may need to change your treatment plan. These changes are often made to help address certain side effects.

The following are questions that patients commonly ask about potential treatment plan changes.

Click on any of the questions below to learn more:

Why would my HCP change my LONSURF treatment plan?

  • Your HCP may change your LONSURF treatment plan if you have a decrease in your white blood cells, red blood cells, or platelets, or if you experience other certain serious side effects.
  • Your HCP should do blood tests before you receive LONSURF, at day 15 during treatment with LONSURF, and as needed to check your blood cell counts.
  • Keep track of any side effects you may experience in the Treatment Calendar included in your LONSURF Starter Kit and bring it with you to your doctor’s appointment. Or, create a personalized Treatment Calendar where you can note how you are feeling. Tell your HCP right away if you have nausea, vomiting, or diarrhea that is severe or that does not go away.

How could my HCP change my LONSURF treatment plan?

There are 3 ways your HCP may change your treatment plan. In each case, your HCP may first stop your treatment. Stopping your treatment is an important step your HCP may take before deciding whether to:

  1. Restart your LONSURF treatment at the same dose
  2. Restart your LONSURF treatment at a lower dose
  3. Stop your LONSURF treatment permanently

How common is it to experience a change in my treatment plan?

The rates below represent how common each type of treatment change was in the clinical trial in which LONSURF was studied. Treatment changes were used to help address certain side effects.

  • 53% of patients had their treatment stopped and then restarted at the same dose.
  • 14% of patients had their treatment stopped and then restarted at a lower dose.
  • 4% of patients had their treatment stopped permanently.

How could low white blood cell counts affect me?

  • Low white blood cell counts can make you more likely to get serious infections. Serious infections could be fatal. Your HCP may change your treatment to prevent blood cell counts from lowering to a dangerous level.
  • Tell your HCP right away if you develop any signs of infection such as fever, chills, or body aches. You can use the thermometer in the Starter Kit to check your temperature each day.

Can I lessen the chance of having low white blood cell counts while taking LONSURF?

  • Taking LONSURF after morning and evening meals may help lessen the effect of LONSURF on your white blood cell counts.
  • The kind of food you eat does not matter. Just be sure to take LONSURF immediately after or up to 1 hour after your meals.

Although experiencing a change in your treatment plan may feel overwhelming, remember that it is not uncommon.

If you receive a change in your treatment plan and would like to know more, don’t hesitate to ask your HCP or nurse about it. Always follow their instruction carefully.


Managing side effects: Some tips to try

Your healthcare provider may have ways to help manage some of the side effects of LONSURF. This could include adjusting your treatment plan by changing your dosage or stopping treatment.

The following information may also be helpful to you in managing some of the side effects of LONSURF while under your healthcare provider's care; however, these tips may not always work.

This information is not meant to replace your healthcare provider's advice. Always discuss any side effects with your healthcare provider.

Choose one or more to get helpful ideas:

Tiredness

Some tips for managing tiredness

  • Plan time to rest or to take a short nap (less than 1 hour). Keeping naps short will help you sleep better at night
  • Talk with your healthcare provider about exercise that can help, like going for a 15‑minute walk, doing yoga, or riding on an exercise bike
  • Don't overdo it
  • Try to sleep at least 8 hours each night
  • Make a bedtime routine. Bathing or listening to music before you go to bed may help you relax

Nausea and vomiting

Some tips for managing nausea and vomiting

  • Eat 5 or 6 small meals a day, instead of 3 big ones (this does not change your dosage schedule)
  • Have food and drinks that are warm or cool instead of hot or cold
  • Choose foods that are easy on the stomach, like saltine crackers or angel food cake
  • Avoid certain foods. Don't eat greasy, fried, sweet, or spicy foods if you feel sick after eating them
  • Remember to take any medicine that your healthcare provider has prescribed to you to help with nausea

Decreased appetite

Some tips for managing decreased appetite

  • Eat 5 or 6 small meals a day, instead of 3 big ones (this does not change your dosage schedule)
  • Drink milkshakes, smoothies, juice, or soup if you do not feel like eating solid foods
  • Choose foods that are high in calories and/or protein
  • Being active may help you feel hungrier. Talk with your healthcare provider about exercises that can help, like going for a 15‑minute walk

Diarrhea/abdominal pain

Some tips for managing diarrhea/abdominal pain

For diarrhea:

  • Eat 5 or 6 small meals a day, instead of 3 big ones (this does not change your dosage schedule)
  • Eat low‑fiber foods. Foods that are high in fiber can make diarrhea worse. Low‑fiber foods include bananas, white rice, white toast, and plain or vanilla yogurt
  • Have food and drinks that are warm or cool instead of hot or cold
  • Eat bland foods instead of greasy, fried, salty, sweet, or spicy foods
  • Avoid dairy products, such as milk, cheese, and sour cream
  • Avoid alcohol and caffeine
  • Drink plenty of liquids to replace the fluids being lost
  • If the rectal area becomes sore, use warm water and a towelette. Keep the area dry. Ask your healthcare provider about creams that can help

For abdominal pain:

  • Eat plenty of foods that are high in fiber such as fruits and vegetables
  • Avoid foods that produce gas
  • Exercise regularly

Fever

Some tips for managing fever

  • Drink plenty of liquids, like water, juice, and broth
  • Rest
  • Keep cool by dressing in light clothing and sleeping with only a sheet
  • Call a healthcare provider immediately if you have a fever, or other signs of infection such as chills or body aches. Remember to check your temperature each day

Tell your healthcare provider if you have nausea, vomiting, or diarrhea that is severe or that does not go away.

You can call the Taiho Oncology 24/7 hotline with questions about side effects with LONSURF at 1‑844‑US‑TAIHO1‑844‑US‑TAIHO (1‑844‑878‑24461‑844‑878‑2446). You may report side effects to the FDA at 1‑800‑FDA‑10881‑800‑FDA‑1088.


How to stay on track

Tips for Taking your Medicine as Prescribed

In this video, Nurse Reed outlines six specific tips to help you stick to your treatment plan.

Find out about services that may help with medication costs
Important Safety Information +

LONSURF may cause serious side effects, including:

  • Low blood counts. Low blood counts are common with LONSURF and can sometimes be severe and life‑threatening. LONSURF can cause a decrease in your white blood cells, red blood cells, and platelets. Low white blood cells can make you more likely to get serious infections that could lead to death. Your healthcare provider should do blood tests before you receive LONSURF, at day 15 during treatment with LONSURF, and as needed to check your blood cell counts. Your healthcare provider may lower your dose of LONSURF or stop LONSURF if you have low white blood cell or platelet counts

Tell your healthcare provider right away if you get any of the following signs and symptoms of infection during treatment with LONSURF: fever, chills, or body aches.

Before taking LONSURF, tell your healthcare provider about all of your medical conditions, including if you:

  • Have kidney or liver problems
  • Are pregnant or plan to become pregnant. LONSURF can harm your unborn baby
    • Females who can become pregnant should use effective birth control during treatment with LONSURF. Tell your healthcare provider immediately if you become pregnant
    • Males, while on treatment and for 3 months after your last dose of LONSURF, you should use a condom during sex with female partners who are able to become pregnant. Tell your healthcare provider right away if your partner becomes pregnant while you are taking LONSURF
  • Are breast‑feeding or plan to breast‑feed. It is not known if LONSURF passes into your breast milk. Do not breast‑feed during treatment with LONSURF and for 1 day after your last dose of LONSURF

Tell your healthcare provider about all the prescription and over‑the‑counter medicines, vitamins, and herbal supplements you take.

The most common side effects with LONSURF include tiredness, nausea, decreased appetite, diarrhea, vomiting, abdominal pain, and fever.

Tell your doctor if you have nausea, vomiting, or diarrhea that is severe or that does not go away.

These are not all of the possible side effects of LONSURF. For more information, ask your healthcare provider. Call your doctor for medical advice about side effects.