What are the precautions for Trifluridine Tipiracil Tablets (Lonsurf)?

Patients should pay attention to the occurrence of adverse events such as severe bone marrow suppression and embryo-fetal toxicity during treatment with Trifluridine Tipiracil Tablets (Lonsurf).

1. Severe myelosuppression: In clinical studies of trifluridine tipiracil tablets as monotherapy and in combination with bevacizumab, caused severe or life-threatening myelosuppression (grade 3-4), including neutropenia, anemia, thrombocytopenia and febrile neutropenia, and some patients received granulocyte colony-stimulating factor therapy. A complete blood count should be obtained before and on Day 15 of each trifluridine-tipiracil cycle and more frequently as clinically indicated. For severe myelosuppression, use of trifluridine and tipiracil tablets should be suspended and continued at the next lower dose.

2. Embryo-Fetal Toxicity: Based on animal studies and its mechanism of action, trifluridine and tipiracil tablets can cause fetal damage when administered to pregnant women. Oral administration of trifluridine and tipiracil tablets during pregnancy resulted in embryonic-fetal death and embryo-fetal toxicity in pregnant rats at doses lower than the recommended dose of 35 mg/m2 twice daily. Doctors need to inform pregnant women of potential risks to the fetus. It is recommended that females of reproductive potential use effective contraception during treatment with trifluridine and for at least 6 months after the last dose.

The original drug of trifluridinetipiracil tablets has been marketed in China under the trade name Langsif, but it has not yet entered the scope of medical insurance. The price per box may be around RMB 6,000, and the price per box of the Hong Kong version may be more than RMB 10,000 (the price may fluctuate due to exchange rates). The Japanese version of trifluridine tipiracil tablets sold overseas may cost around more than 5,000 yuan per box (the price may fluctuate due to exchange rates). There are also cheaper generic versions of trifluridine and tipiracil tablets available overseas. Their pharmaceutical ingredients are basically the same as those of the original drugs sold domestically and abroad. For example, the price of each box produced by an Indian pharmaceutical factory may be around more than 1,000 yuan (the price may fluctuate due to exchange rates).