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Lonsurf (trifluridine and tipiracil)
Starting Lonsurf can bring up a lot of questions, for you and for the people who love you. Here you'll find what to expect, how to feel your best day to day and where to get help, so you can focus on your life and time together.
ℹ️ General information to help you and your loved ones talk with your care team, not medical advice. Read our disclaimer.
Chemotherapy pill · Used for: Colorectal cancer
Types and tests it may fit: HER2-positive (HER2-amplified) colorectal cancer, KRAS G12C colorectal cancer (RAS-mutant), RAS wild-type colorectal cancer (KRAS/NRAS normal), BRAF V600E colorectal cancer
💊 Taken by mouth · Chemotherapy pill
The quick guide
What it is: Chemotherapy pill.
How it's given: Tablets by mouth twice a day after meals on days 1–5 and 8–12 of a 28-day cycle, often with Avastin (bevacizumab).
How it works: Lonsurf is an oral chemo. Trifluridine gets built into cancer cell DNA and damages it; tipiracil keeps trifluridine from breaking down too fast. It's used for metastatic colorectal cancer after earlier chemo.
Side effects you may notice, and what helps at home
| Side effect | What can help |
|---|---|
| Neutropenia (low blood counts and infection risk) | Wash hands often; check your temperature if you feel unwell. |
| Nausea and vomiting (CINV) | Small bland meals; take anti-nausea medicine as prescribed. |
| Fatigue (extreme tiredness) | Short walks and planned rest. |
| Dysgeusia (taste changes and appetite loss) (Decreased appetite) | Small, frequent meals; try tart or seasoned foods. |
| Diarrhea (loose, watery stools) | Fluids, bland food; ask your team about anti-diarrhea medicine early. |
Not everyone gets these. Your team may suggest other ways to manage them.
Call your care team now if you have:
- Fever of 100.4°F (38°C) or higher or chills
- Unusual bleeding or bruising
- Severe vomiting or diarrhea
Call 911 for trouble breathing, chest pain or signs of stroke.
🗓 What to expect
1️⃣ Before you start
- Ask your team for a written schedule and an after-hours phone number.
- Bring a list of all your medicines and supplements.
2️⃣ Each day on treatment
- Take it exactly as prescribed, at about the same time each day.
- Don't crush or split pills unless your team says it's OK.
- If you miss a dose, follow the label instructions or call your pharmacist.
3️⃣ Between doses
- Watch for the side effects below and use the checklist.
- Keep up with blood tests and visits.
- Call your team for anything in the red box.
✅ Side-effect checklist
Print this and check off what you notice so you can tell your team.
| Side effect | Noticed? | Notes for my team |
|---|---|---|
| Neutropenia (low blood counts and infection risk) | ☐ | |
| Nausea and vomiting (CINV) | ☐ | |
| Fatigue (extreme tiredness) | ☐ | |
| Dysgeusia (taste changes and appetite loss) | ☐ | |
| Diarrhea (loose, watery stools) | ☐ |
Help paying for Lonsurf (trifluridine and tipiracil)
Lonsurf (trifluridine and tipiracil) is made by Taiho Oncology.
Official manufacturer program:
- Taiho Oncology Patient Support: Copay help and patient assistance from Taiho.
Copay cards are usually only for people with commercial (job or marketplace) insurance. If you have Medicare or Medicaid, look at free-drug programs and these independent foundations:
- PAN Foundation: Copays and coinsurance, including for people with Medicare, when a disease fund is open.
- HealthWell Foundation: Grants for copays, deductibles and premiums when a fund is open.
- CancerCare Co-Payment Assistance Foundation: Help with treatment copays for insured people under income limits.
- Good Days: Copay help and some travel costs.
- NeedyMeds: Free database of assistance programs, open to anyone.
📋 Medicare: Pills you take at home are usually covered by Medicare drug coverage (Part D). Part B covers some cancer drugs taken by mouth if the same drug comes in an injectable form. See Medicare and your cancer drugs.
More: Help from drug makers · Our guide to paying for cancer treatment.
❓ Questions you and your loved ones can ask
- What is the goal of this treatment for me?
- How will we know if it's working?
- Which side effects should I call about right away, and what number do I call after hours?
- Which medicines, vitamins or supplements should I avoid?
- Will this affect my ability to work, drive or care for my family?
- What will this cost me, and who can help me with coverage?
Support for you and your family
- Fight Colorectal Cancer: Patient guides, advocacy and community
- Colorectal Cancer Alliance: Helpline (877-422-2030) and patient navigation
- CancerCare: Free counseling, support groups and financial help
- Cancer Support Community: Support groups, a helpline and the MyLifeLine online community
Questions people often ask
How does Lonsurf work?
Lonsurf is an oral chemo.
How is Lonsurf given?
Tablets by mouth twice a day after meals on days 1–5 and 8–12 of a 28-day cycle, often with Avastin (bevacizumab).
How is Lonsurf (trifluridine and tipiracil) given?
Tablets by mouth twice a day after meals on days 1–5 and 8–12 of a 28-day cycle, often with Avastin (bevacizumab).
How does Lonsurf (trifluridine and tipiracil) work?
Lonsurf is an oral chemo. Trifluridine gets built into cancer cell DNA and damages it; tipiracil keeps trifluridine from breaking down too fast. It's used for metastatic colorectal cancer after earlier chemo.
What side effects are common with Lonsurf (trifluridine and tipiracil)?
Side effects people often notice include Neutropenia (low blood counts and infection risk), Nausea and vomiting (CINV), Fatigue (extreme tiredness), Dysgeusia (taste changes and appetite loss), and Diarrhea (loose, watery stools). Not everyone gets them, and our table above shares tips that may help at home.
When should I call my care team while on Lonsurf (trifluridine and tipiracil)?
Call right away if you notice any of these: fever of 100.4°F (38°C) or higher or chills; unusual bleeding or bruising; severe vomiting or diarrhea. If you're ever unsure, it's always OK to call.
What cancers is Lonsurf (trifluridine and tipiracil) used for?
On this site, we cover Lonsurf (trifluridine and tipiracil) for colorectal cancer. Your care team decides whether it fits your situation.
📄 The official FDA label for Lonsurf (trifluridine and tipiracil), including its patient information section, is on DailyMed.
Written by the Cancer Side Effects Guide team from FDA labels and leading cancer centers. Not medical advice. · Last updated: October 15, 2026 · How we write
Sources
Last updated: October 15, 2026. We summarize these sources in our own words.