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Prescription only medicine

Lonsurf 20 mg Tablets

Tipiracil, Trifluridine

Lonsurf 20 mg Tablets is a trusted medication containing Trifluridine & Tipiracil, designed for personal use under the guidance of a healthcare professional. Available for prescription-based international supply with discreet worldwide delivery.

Active ingredients
Tipiracil, Trifluridine
Strength
20 mg / 8.19 mg
Form
Tablet
Manufacturer
Taiho Oncology
Made in
India
Prescription
Required
Commonly used forCancer
$250.00 per pack of 60 tablets

Prescription required — upload it at checkout.

Verified pharmacy Genuine medication Tracked shipping Medically reviewed by Simran Jha
Licensed Pharmacy Trust & safety
Licensed Manufacturers Every medicine from a licensed manufacturer
Dedicated Oncology Team Doctor + pharmacist review every order before dispatch
Worldwide Delivery UK · US · AU · EU · NZ — tracked and insured
About this medicine

What is Lonsurf 20 mg Tablets?

This medicine combines two ingredients in one tablet: trifluridine, a chemotherapy drug, and tipiracil, which stops the body breaking trifluridine down so that enough of it reaches the tumour. It is used for bowel (colorectal) cancer that has spread and has already been treated with the standard chemotherapy and targeted drugs, and for stomach (gastric) cancer after at least two earlier lines of treatment. In bowel cancer it is often given together with bevacizumab.

Tablets come in two strengths (15 mg and 20 mg of trifluridine) and your dose is worked out from your body surface area, so you may be prescribed a mix of both. It is taken twice a day, after meals, on days 1–5 and 8–12 of each 28-day cycle.

Low blood counts are the main side effect and are checked before every cycle. This is a prescription-only medicine; a valid prescription must be provided at checkout.

How it works

How does Trifluridine + Tipiracil work?

Trifluridine looks like thymidine, one of the four building blocks of DNA. Rapidly dividing cancer cells take it up and build it into their DNA, where it causes damage the cell cannot repair, so the cell stops dividing. On its own trifluridine would be broken down almost immediately by an enzyme called thymidine phosphorylase; tipiracil blocks that enzyme, so trifluridine stays in the blood long enough to work. Because trifluridine acts on DNA in a different way from 5-fluorouracil, it can still work in tumours that have stopped responding to earlier fluoropyrimidine chemotherapy.

Protection

Tipiracil inhibits thymidine phosphorylase, the enzyme that would otherwise destroy trifluridine within minutes of absorption.

Incorporation

Trifluridine is taken up by dividing cells, activated, and built into their DNA in place of thymidine.

DNA dysfunction

DNA containing trifluridine cannot function or be repaired properly, so the tumour cell stops dividing and dies.

Uses

What is Trifluridine + Tipiracil used for?

Metastatic colorectal cancer

After fluoropyrimidine-, oxaliplatin- and irinotecan-based chemotherapy, an anti-VEGF agent and, if RAS wild-type, an anti-EGFR agent. Alone or with bevacizumab.

FDA EMA CDSCO
Metastatic gastric or gastro-oesophageal junction cancer

After at least two prior lines of chemotherapy including a fluoropyrimidine, a platinum and either a taxane or irinotecan, and HER2-targeted therapy if appropriate.

FDA EMA

Only your oncologist can determine whether this medicine is right for your diagnosis. The above is for information only.

Dosage

How to take Lonsurf 20 mg Tablets

Your oncologist will prescribe your exact dose. The right dose for you depends on your weight, kidney and liver function, and — for some medicines — your genetic test results.

Always take exactly as prescribed. Do not change your dose or stop taking this medicine without speaking to your doctor first, even if you feel well.

Missed a dose? Skip a missed or vomited dose and take the next one at the usual time. Do not make up doses. Any tablets left at the end of the cycle should not be taken — tell your team.

With food? Take within one hour after your morning and evening meals with a glass of water. Swallow whole. Taking it on an empty stomach changes absorption.

Important safety information

Safety & warnings

Please read this section before taking Lonsurf 20 mg Tablets and discuss any concerns with your oncologist.

Common side effects

Side effects affect some people, not everyone. Most are manageable — let your treatment team know about anything that concerns you.

  • Low white blood cells (neutropenia)
  • Anaemia (low red cells)
  • Low platelets
  • Tiredness (fatigue)
  • Nausea, reduced appetite
  • Diarrhoea
  • Vomiting, abdominal pain
  • Fever
  • Hair thinning

Contact your doctor immediately if you notice:

  • Fever of 38°C or higher, chills, sore throat or other signs of infection Go to the emergency department at once — neutropenic infection is a medical emergency.
  • Unusual bruising, bleeding, or tiny red spots on the skin Contact your team the same day — possible very low platelets.
  • Severe tiredness, breathlessness, pale skin Contact your team; severe anaemia may need treatment.
  • Persistent vomiting or diarrhoea with signs of dehydration Contact your team the same day.
  • New breathlessness or dry cough Seek urgent review — lung inflammation has been reported rarely.

Important: tell your doctor about these medicines

Taking Trifluridine + Tipiracil with certain other medicines can be dangerous. Always tell every doctor, dentist, and pharmacist about all medicines you are taking.

  • Other bone-marrow-suppressing medicines or radiotherapy Major

    Additive lowering of blood counts.

  • Live vaccines Major

    Risk of serious infection while immunosuppressed.

Pregnancy & breastfeeding

Trifluridine/tipiracil can harm an unborn baby. It should not be used in pregnancy, and women who could become pregnant should use effective contraception during treatment and for at least six months after the last dose.

Do not breastfeed during treatment or for one day after the last dose.

Effects on human fertility are not established; discuss fertility preservation before starting if relevant.

For full prescribing information see: FDA prescribing information: Lonsurf (trifluridine and tipiracil) — DailyMed

Storage

How to store Lonsurf 20 mg Tablets

Temperature

Store below 30°C (86°F) in the original blister or bottle.

Light & moisture

Protect from moisture; keep the container closed.

Keep away from children

Keep out of the sight and reach of children.

Safe handling

This is a cytotoxic medicine. Swallow tablets whole; do not crush or split. Wash hands after handling. Carers should avoid direct contact with tablets. Return unused tablets to a pharmacy.

Travelling

Carry the tablets in their original packaging with your prescription and a letter from your oncologist. Keep a written note of which days of the cycle are dosing days.

Reviewed for accuracy

Medically reviewed content

Simran Jha

Simran Jha

B.Pharm, M.Pharm

Simran Jha is a licensed clinical pharmacist with 17 years of experience. She holds a B.Pharm and M.Pharm from Dr. YSR University of Health Sciences. At OnlineMeds, she reviews medicine and health content to help ensure it is accurate, evidence-based, and easy to understand.

Our commitment to you

How we support oncology patients

We understand that accessing the right cancer medicine can feel overwhelming. Here is what you can expect from us.

Personal oncology support

Every enquiry is reviewed by our oncology doctor and pharmacist team — not an automated system.

Genuine, verified medicine

Sourced exclusively from licensed pharmaceutical manufacturers. Every batch is traceable from origin to your door.

Prescription checked before dispatch

We verify every prescription with our internal medical team. No shortcuts, no exceptions.

Cold-chain logistics

Temperature-sensitive medicines shipped with appropriate packaging to maintain integrity.

Discreet, plain packaging

No pharmacy branding or product name on the outer packaging.

FAQ

Frequently asked questions

Why are there two ingredients in Lonsurf 20 mg Tablets?

Trifluridine is the anticancer drug; tipiracil is there only to stop your body destroying trifluridine before it can act. Without tipiracil, trifluridine would be broken down within minutes of being absorbed.

[2] Cancer Research UK: Trifluridine and tipiracil (Lonsurf)

Why do I take it for five days, then stop, then five more?

The days 1–5 and 8–12 schedule within a 28-day cycle gives the bone marrow time to recover. Follow the written calendar your oncologist gives you and do not take tablets on rest days even if some are left over.

[1] FDA prescribing information: Lonsurf (trifluridine and tipiracil) — DailyMed

Why must Lonsurf 20 mg Tablets be taken after food?

Taking the dose within an hour after a meal is how it was studied and approved; an empty stomach changes the balance of the two ingredients in the blood. Morning and evening meals are the usual anchors.

[1] FDA prescribing information: Lonsurf (trifluridine and tipiracil) — DailyMed

Why might I be prescribed both 15 mg and 20 mg tablets?

Your dose is calculated from your body surface area and rounded to the nearest 5 mg, so many people need a combination of the two strengths to make up each dose. Your pharmacist will label exactly how many of each to take.

[1] FDA prescribing information: Lonsurf (trifluridine and tipiracil) — DailyMed

How often will my blood be tested?

A full blood count is checked before every cycle and usually on day 15 as well, because low white cells and platelets are the most common side effects. A cycle may be delayed until counts recover; that is normal and expected.

[1] FDA prescribing information: Lonsurf (trifluridine and tipiracil) — DailyMed

Can I take Lonsurf 20 mg Tablets if 5-FU or capecitabine stopped working?

It is designed for exactly that situation. Trifluridine damages DNA in a different way from 5-fluorouracil and capecitabine, so it can still act on tumours that have become resistant to them. Your oncologist decides whether it is appropriate for you.

[2] Cancer Research UK: Trifluridine and tipiracil (Lonsurf)

Do I need a prescription to order Lonsurf 20 mg Tablets?

Yes. Trifluridine/tipiracil is prescription-only. Upload your oncologist's prescription at checkout; our pharmacist team reviews it before dispatch. Used as prescribed by a licensed medical professional.

Sources

References

  1. 1. FDA prescribing information: Lonsurf (trifluridine and tipiracil) — DailyMed. https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=lonsurf U.S. National Library of Medicine. Accessed 12 Sep 2026.
  2. 2. Cancer Research UK: Trifluridine and tipiracil (Lonsurf). https://www.cancerresearchuk.org/about-cancer/treatment/drugs/trifluridine-and-tipiracil Accessed 12 Sep 2026.
  3. 3. EMA: Lonsurf — European public assessment report. https://www.ema.europa.eu/en/medicines/human/EPAR/lonsurf European Medicines Agency. Accessed 12 Sep 2026.
  4. 4. Macmillan Cancer Support: Trifluridine-tipiracil hydrochloride (Lonsurf). https://www.macmillan.org.uk/cancer-information-and-support/treatments-and-drugs/trifluridine-tipiracil-hydrochloride Accessed 12 Sep 2026.
Medical disclaimer: This content is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a licensed healthcare professional — specifically your oncologist — before starting, changing, or stopping any medication. Information is based on NDA #207981, NCI Drug Information, and NHS patient information.
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