TEGAFUR,GIMERACIL,OTERACIL
Background and Date of Approval
Tegafur, gimeracil, and oteracil is a combination chemotherapy medication containing the active constituents tegafur, gimeracil, and oteracil. This capsule is not recommended for adolescents and children under 18 years of age and may be given alone or in combination with other anticancer drugs. Tegafur, gimeracil, and oteracil, marketed under the brand name S-1, received approval from the U.S. Food and Drug Administration (FDA) on 1 November 2019, for treating metastatic gastric or gastroesophageal junction adenocarcinoma in adult patients, in combination with the chemotherapy drug cisplatin.
Uses
The combination chemotherapy Tegafur, Gimeracil, and Oteracil treatment known as S-1 is used to treat various types of cancer, including gastric, colorectal, breast, and pancreatic cancer.
How is it administered?
Tegafur, Gimeracil, and Oteracil are typically taken orally, with or without food. The capsule should be swallowed whole, not crushed, chewed, or broken. The recommended dosage can vary depending on the type of cancer being treated and other factors such as your overall health and response to treatment. Do not take a double dose to make up for a missed dose.
Side Effects
Common side effects may include nausea, vomiting, diarrhea, loss of appetite, fatigue, and hand-foot syndrome (painful swelling and redness of the hands and feet). Serious side effects may include bone marrow suppression, which can lead to anemia, infection, or bleeding disorders, as well as cardiovascular events such as irregular heartbeat or heart attack.
Warnings
The medication may cause bone marrow suppression, increasing the risk of infection, bleeding, and anemia. It may also cause cardiovascular events such as heart attack or irregular heartbeat, particularly in patients with heart problems. In addition, there have been reports of serious skin reactions, neurological effects, and immune system disorders in patients taking tegafur, gimeracil, and oteracil.
Precautions
Patients should avoid contact with sick people and use caution when performing activities that may increase the risk of injury or bleeding while taking Tegafur, Gimeracil, and Oteracil. Patients should also monitor their blood counts regularly to ensure they are not experiencing any complications. Patients should also avoid alcohol while taking this medication, as it may increase the risk of liver damage.
Word of Advice
If you have been prescribed Tegafur, Gimeracil, and Oteracil, it is important to carefully read and understand the warnings and precautions associated with this medication. The combination increases the risk of infection, so patients should avoid close contact with individuals who have infectious illness. If you have an intolerance to sugars, you must inform your physician. Avoid consumption of grapefruit during treatment. Use effective contraceptive measures during therapy and for at least 6 months after the last dose. Patients with diabetes require close monitoring during treatment. Maintain a healthy and balanced diet to support your overall health and wellbeing.
References
Nordic Group BV, European Medicines Agency, [Revised on 19/11/2015], [Accessed on 06/05/2023], https://www.ema.europa.eu/en/documents/product-information/teysuno-epar-product-information_en.pdf Masao Kobayakawa, Yasushi Kojima; Tegafur/gimeracil/oteracil (S-1) approved for the treatment of advanced gastric cancer in adults when given in combination with cisplatin: a review comparing it with other fluoropyrimidine-based therapies; OncoTargets and Therapy; [Published on 2011]; [Accessed on 06/05/2023]; https://pubmed.ncbi.nlm.nih.gov/22162925/ Mahlberg R et al; New Perspectives in the Treatment of Advanced Gastric Cancer: S-1 as a Novel Oral 5-FU Therapy in Combination with Cisplatin; Chemotherapy; [Published on 2017]; [Accessed on 06/05/2023]; https://www.karger.com/Article/Abstract/443984
Frequently Asked Questions
Can Tegafur, Gimeracil, and Oteracil be used in children?
Tegafur, gimeracil, and oteracil are generally not recommended for use in children. There is limited information on the safety and effectiveness of these medications in pediatric patients, and other treatments may be more appropriate.
Can Tegafur, Gimeracil, and Oteracil be used in elderly patients?
Elderly patients may be more susceptible to the side effects of tegafur, gimeracil, and oteracil, particularly bone marrow suppression and liver toxicity. Your healthcare provider may adjust the dosage or monitor you more closely during the treatment.
Can Tegafur, Gimeracil, and Oteracil be used in patients with kidney disease?
Tegafur, gimeracil, and oteracil are primarily eliminated from the body through the liver so they may be appropriate for use in patients with mild to moderate kidney disease. However, patients with severe kidney disease may require dose adjustments or close monitoring.
Can Tegafur, Gimeracil, and Oteracil affect my mental health?
Tegafur, gimeracil, and oteracil are not commonly associated with effects on mental health. However, like many cancer treatments, they can cause fatigue, contributing to feelings of low mood or depression.
How will Tegafur, Gimeracil, and Oteracil affect my blood?
Tegafur, gimeracil, and oteracil can affect your blood cell counts, particularly your white blood cell count, which can increase your risk of infections. It can also cause anemia (low red blood cell count) and thrombocytopenia (low platelet count). These effects are usually temporary and reversible when treatment is stopped.
How will Tegafur, Gimeracil, and Oteracil affect my heart?
Tegafur, gimeracil, and oteracil may affect your heart in certain ways. While not a common side effect, these medications have been associated with cardiac events such as irregular heartbeat (arrhythmia) and heart attack.