S-1 is an oral chemotherapy capsule that combines three ingredients. Tegafur is converted in the body into 5-fluorouracil (5-FU), one of the most widely used chemotherapy drugs. Gimeracil slows the breakdown of 5-FU so that steady levels are reached from a tablet rather than an infusion, and oteracil stays in the gut to reduce the diarrhoea and mouth soreness 5-FU can cause.
It is approved in Europe (as Teysuno) for advanced stomach cancer, taken together with cisplatin, and is used in Japan, India and other countries for stomach, pancreatic, bowel, head-and-neck and some lung cancers under specialist protocols. It is not approved in the United States.
The strength on the pack (15 mg or 20 mg) refers to the tegafur component. S-1 is taken twice a day after meals, typically for 21 days followed by a 7-day break, with the dose calculated from your body surface area. It is a prescription-only medicine; a valid prescription must be provided at checkout.