Trifluridine: Difference between revisions

Trifluridine
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Latest revision as of 01:43, 20 February 2025

Overview of the use of Trifluridine in medicine

Trifluridine is an antiviral medication primarily used in the treatment of herpes simplex virus (HSV) infections of the eye, such as herpes simplex keratitis. It is also used in combination with tipiracil as an oral anticancer agent for the treatment of metastatic colorectal cancer.

Mechanism of Action[edit]

Trifluridine is a nucleoside analog that interferes with viral DNA synthesis. It is incorporated into viral DNA in place of thymidine, leading to the formation of defective DNA strands that inhibit viral replication. This mechanism is effective against both HSV-1 and HSV-2.

Medical Uses[edit]

Ophthalmic Use[edit]

Trifluridine is available as an ophthalmic solution for the treatment of primary keratoconjunctivitis and recurrent epithelial keratitis due to HSV. It is applied topically to the eye, and its use is typically limited to a short duration to prevent corneal toxicity.

Oncological Use[edit]

In combination with tipiracil, trifluridine is used in the treatment of metastatic colorectal cancer. The combination, known as trifluridine/tipiracil (brand name Lonsurf), works by inhibiting cancer cell proliferation. Tipiracil enhances the bioavailability of trifluridine by inhibiting its degradation.

Side Effects[edit]

Common side effects of trifluridine when used ophthalmically include eye irritation, burning sensation, and increased tear production. When used in combination with tipiracil for cancer treatment, side effects may include fatigue, nausea, decreased appetite, and hematological abnormalities such as neutropenia and anemia.

History[edit]

Trifluridine was first synthesized in the 1960s and was initially developed for the treatment of viral infections. Its use in oncology was later discovered, leading to the development of the combination therapy with tipiracil.

References[edit]

Trifluridine[edit]

Trifluridine structure
Trifluoromethyl pyrimidinedione

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-{{intro}}
+{{Short description|Overview of the use of Trifluridine in medicine}}
-Trifluridine/tipiracil is the combination of an antineoplastic pyrimidine analogue (trifluridine) with an inhibitor of its metabolism (tipiracil) that is used in the therapy of refractory, metastatic colorectal cancer.
+{{Drugbox
+| Verifiedfields = changed
+| verifiedrevid = 477002648
+| IUPAC_name = 5-Trifluoromethyl-2'-deoxyuridine
+| image = Trifluridine structure.svg
+| width = 200
+}}
-{{livtox}}
+'''Trifluridine''' is an antiviral medication primarily used in the treatment of [[herpes simplex virus]] (HSV) infections of the eye, such as [[herpes simplex keratitis]]. It is also used in combination with [[tipiracil]] as an oral anticancer agent for the treatment of [[metastatic colorectal cancer]].
-Trifluridine/tipiracil is associated with a low rate of transient serum enzyme elevations during therapy, but has not been implicated in cases of clinically apparent acute liver injury with jaundice.
-{{moa}}
+==Mechanism of Action==
-Trifluridine (trye flure' i deen)/tipiracil (tye pir’ a sil) combines an antineoplastic pyrimidine analogue (2-deoxy-5-trifluoromethyl uridine) with a thymidine phosphorylase inhibitor that blocks its rapid metabolism, thus increasing the bioavailability of trifluridine.  Trifluridine is absorbed orally and converted intracellularly to a triphosphate which becomes incorporated into DNA causing inhibition of DNA synthesis, a decrease in cellular growth and proliferation and triggering apoptosis.  Trifluridine triphosphate is metabolized by thymidine phosphorylase which is inhibited by tipiracil, thus providing a longer half-life and increased intracellular concentrations of active phosphorylated trifluridine.  Trifluridine/tipiracil was shown to have potent activity in vitro in cellular and in vivo in animal models of colon cancer.  In clinical trials, this combination led to prolongation of progression-free as well as overall survival in patients with previously treated, refractory metastatic colorectal cancer.
+Trifluridine is a nucleoside analog that interferes with viral DNA synthesis. It is incorporated into viral DNA in place of thymidine, leading to the formation of defective DNA strands that inhibit viral replication. This mechanism is effective against both HSV-1 and HSV-2.
-{{fda}}
+==Medical Uses==
-Trifluridine/tipiracil was approved for use in the United States in 2015 and is available in tablets of 15 mg/14 mg and 20 mg/19 mg under the commercial name Lonsurf.  Current indications are for refractory, metastatic colorectal cancer after previous treatment with other agents.  The recommended dose regimen is 35 mg/m2 (based upon the trifluridine component) orally twice daily on days 1 through 5 and days 8 through 12 of each 28-day cycle.
-{{se}}
+===Ophthalmic Use===
-Common side effects include bone marrow suppression, weakness, fatigue, nausea, anorexia, diarrhea, abdominal pain and fever.  Less common, but potentially severe adverse events include severe myelosuppression, febrile neutropenia, infections, sepsis and embryo-fetal toxicity.
+Trifluridine is available as an ophthalmic solution for the treatment of primary keratoconjunctivitis and recurrent epithelial keratitis due to HSV. It is applied topically to the eye, and its use is typically limited to a short duration to prevent corneal toxicity.
-{{coststubd}}
+===Oncological Use===
+In combination with tipiracil, trifluridine is used in the treatment of metastatic colorectal cancer. The combination, known as [[trifluridine/tipiracil]] (brand name Lonsurf), works by inhibiting cancer cell proliferation. Tipiracil enhances the bioavailability of trifluridine by inhibiting its degradation.
+==Side Effects==
+Common side effects of trifluridine when used ophthalmically include eye irritation, burning sensation, and increased tear production. When used in combination with tipiracil for cancer treatment, side effects may include fatigue, nausea, decreased appetite, and hematological abnormalities such as neutropenia and anemia.
+==History==
+Trifluridine was first synthesized in the 1960s and was initially developed for the treatment of viral infections. Its use in oncology was later discovered, leading to the development of the combination therapy with tipiracil.
+==See Also==
+* [[Herpes simplex virus]]
+* [[Antiviral drug]]
+* [[Metastatic colorectal cancer]]
+* [[Nucleoside analog]]
+==References==
+<references />
+[[Category:Antiviral drugs]]
+[[Category:Ophthalmology]]
+[[Category:Oncology]]
+== Trifluridine ==
+<gallery>
+File:Trifluridine structure.svg|Trifluridine structure
+File:Trifluoromethyl-pyrimidinedione.svg|Trifluoromethyl pyrimidinedione
+</gallery>