Trifluridine and tipiracil
Say it: try-FLOOR-ih-deen and tih-PEER-uh-sill · Brand names: Lonsurf
Trifluridine and tipiracil is a chemotherapy pill that gets into the DNA of cancer cells and stops them from growing.
What it is
Trifluridine looks like one of the building blocks of DNA. Cancer cells use it by mistake, which damages their DNA. Tipiracil keeps trifluridine from breaking down too fast, so it can work longer.
Often used for
- colorectal cancer that has spread, alone or with bevacizumab
- stomach cancer or cancer where the stomach meets the esophagus, that has spread
How you get it
This medicine is a tablet you take at home twice a day. A common plan is to take it on days 1 to 5 and days 8 to 12, then rest until the next 28-day cycle. Your schedule may be different.
Common side effects and what helps
- Low blood counts, which raise your risk of infection and tiredness. Wash your hands often.
- Feeling tired. Rest and short walks can help.
- Nausea and vomiting. Take your anti-nausea medicine as your team tells you.
- Poor appetite. Try small meals and snacks.
- Diarrhea. Drink fluids and tell your team if it is frequent.
- Belly pain. Tell your team if it is strong or does not go away.
- Fever. Check your temperature if you feel unwell.
Call your care team right away if you have
- A fever of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher, or chills
- Vomiting or diarrhea so bad you cannot keep fluids down
- Bleeding or bruising that will not stop, black or bloody stools, or blood in your urine
- Feeling very weak, short of breath, or pale
- Severe belly pain
Before you start, tell your team
- If you are pregnant, may become pregnant, or are breastfeeding
- If you have kidney or liver problems
- All the medicines, vitamins, and herbal products you take
Good to know
- You will have blood tests before each cycle and in the middle of each cycle to check your blood counts.
- Your team may delay or lower doses if your counts are low.
- It can harm an unborn baby. Women and men should use birth control during treatment and for a time after.
At home
- Take the tablets within 1 hour after finishing your morning and evening meals.
- Swallow them whole with water.
- If you miss a dose, ask your team what to do. Do not take extra tablets to make up for it.
- Store at room temperature in the original bottle.
- Wash your hands after handling the tablets. Caregivers should wear gloves.
Questions to ask
- Which days do I take the pills each month?
- How often will I need blood tests?
- When should I call you about diarrhea or fever?
Side effect guides
- Fatigue (tiredness)
- Nausea and vomiting
- Diarrhea
- Appetite loss and weight loss
- Low white blood cells and infection risk
- Pain
Sources
Quick answers
- What is Trifluridine and tipiracil?
- Trifluridine and tipiracil is a chemotherapy pill that gets into the DNA of cancer cells and stops them from growing. Brand names: Lonsurf.
- What is Trifluridine and tipiracil used for?
- colorectal cancer that has spread, alone or with bevacizumab; stomach cancer or cancer where the stomach meets the esophagus, that has spread.
- How is Trifluridine and tipiracil given?
- This medicine is a tablet you take at home twice a day. A common plan is to take it on days 1 to 5 and days 8 to 12, then rest until the next 28-day cycle. Your schedule may be different.
- What are the common side effects of Trifluridine and tipiracil?
- Low blood counts, which raise your risk of infection and tiredness. Feeling tired. Nausea and vomiting. Poor appetite. Diarrhea. Belly pain. Fever.
- When should I call my care team while taking Trifluridine and tipiracil?
- A fever of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher, or chills; Vomiting or diarrhea so bad you cannot keep fluids down; Bleeding or bruising that will not stop, black or bloody stools, or blood in your urine; Feeling very weak, short of breath, or pale; Severe belly pain.
Last updated: 2026-10-27. Medically reviewed by Veli Bakalov, MD, medical oncologist (October 2026). General education from Step by Step, the patient portal of HemeOncBuddy.