Tegafur-uracil is a chemotherapy drug that is given as a treatment for some types of cancer, especially BOWEL CANCER. It is also sometimes called Uftoral. This information describes tegafur-uracil, how it is given and some of the possible side effects.
How tegafur-uracil is given
Tegafur-uracil is taken as white capsules three times a day at regular intervals. It should be taken either an hour before or an hour after food. It is usually taken for four weeks, followed by a seven day break. The cycle is then repeated.
A tablet called calcium folinate (folinic acid) is given with tegafur-uracil. This helps to make tegafur-uracil work more effectively.
Chemotherapy is usually given as a course of several sessions (or cycles) of treatment over a few months. The length of your treatment and the number of cycles you have will depend on the type of cancer for which you are being treated.
How it works
Tegafur-uracil is a combination of two chemotherapy drugs: tegafur and uracil. After the capsules are taken, tegafur is absorbed into the blood stream, and converted into the active drug 5FU (fluorouracil) in the liver and then absorbed by tumour cells. Within the cells is an enzyme that breaks down the 5FU. The uracil slows the breakdown of 5FU, which means that the 5FU stays in the cancer cells for longer.
Combining these two drugs means that there is also a higher concentration of 5FU in the tumour cells than when tegafur is given alone, or when the same dose of 5FU is given into a vein. 5FU itself has been used as a valuable treatment for bowel cancer for almost 50 years.
Possible side effects
Each person’s reaction to chemotherapy is different. Some people have very few side effects, while others may experience more. The side effects described in this information will not affect everyone who is given tegafur-uracil, and may be different if you are having more than one chemotherapy drug.
We have outlined the most common side effects and rarer ones so that you can be aware of them if they occur. However, we have not included those that are very rare and therefore extremely unlikely to affect you. If you notice any effects which you think may be due to the drug, but which are not listed in this information, please discuss them with your doctor or chemotherapy nurse.
The known side effects of tegafur-uracil are not usually severe. The following are the most common:
Diarrhoea
This can usually be easily controlled with medicines such as imodium (loperamide) or codeine, but let your doctor know if it is severe or if it continues. If you have diarrhoea it is important to drink plenty of fluids to replace the fluid that you lose.
Feeling sick (nausea) and being sick (vomiting)
If you do feel sick this may begin a few hours after you have taken the drug. This is usually mild, and your doctor can prescribe very effective anti-sickness (anti-emetic) drugs to prevent, or greatly reduce, nausea. If the sickness is not controlled, or continues, tell your doctor; they can prescribe other anti-sickness drugs which may be more effective.
Tiredness and feeling weak
You may feel very tired. It is important to allow yourself plenty of time to rest.
Lowered resistance to infection
Tegafur-uracil can reduce the production of white blood cells by the bone marrow, making you more prone to infection. The extent to which your bone marrow is affected depends on the dose of chemotherapy you are given and whether you are being given other chemotherapy drugs at the same time. Your blood cells will usually have returned to normal before your next course of chemotherapy is due.
Contact your doctor or the hospital straightaway if:
- your temperature goes above 38ºC (100.5ºF)
- you suddenly feel unwell (even with a normal temperature).
- You will have a blood test before having more chemotherapy to make sure that your cells have recovered. Occasionally it may be necessary to delay your treatment if the number of blood cells (the blood count) is still low.
Bruising or bleeding
Tegafur-uracil can reduce the production of platelets (which help the blood to clot). Let your doctor know if you have any unexplained bruising or bleeding, such as nosebleeds, blood spots or rashes on the skin, or bleeding gums.
Anaemia (low number of red blood cells)
While having treatment with tegafur-uracil you may become anaemic. This may make you feel tired and breathless on exertion. Let your doctor or nurse know if these side effects are a problem.
Changes to the nails
Your nails may become brittle, chipped and ridged. These changes grow out slowly over a few months once treatment has ended.
Rashes and dry skin
The treatment may cause a rash or dry skin, which may be itchy. Your doctor can prescribe treatment to help reduce this.
Watery and sore eyes
Tegafur-uracil may make your eyes produce more tears than normal. You may also develop ‘pink-eye’ (conjunctivitis) which can be sore and itchy. Your doctor can prescribe treatment to soothe your eyes, or you can get eye drops from your pharmacist.
Less common side effects
Hair loss
This is rare but your hair may thin, or occasionally fall out completely. If hair loss does happen, it usually begins about 3–4 weeks after starting treatment, although it may occur earlier. It is temporary and your hair will regrow once the treatment ends.
Sore mouth and ulcers
Your mouth may become sore, or you may notice small ulcers during this treatment. Drinking plenty of fluids, and cleaning your teeth regularly and gently with a soft toothbrush, can help to reduce the risk of this happening. Tell your nurse or doctor if you have any of these problems, as special mouthwashes and medicines to prevent or clear any mouth infection can be prescribed.
Taste changes
You may notice that your food tastes different. Normal taste will usually come back after the treatment finishes.
Alterations in liver function
Tegafur-uracil may cause changes in the way that your liver works. Your doctor may take blood to check your liver is working properly before each dose of tegafur-uracil.
Additional information
Risk of blood clots
Cancer can increase your risk of developing a blood clot (thrombosis), and having chemotherapy may increase this risk further. A blood clot may cause symptoms such as pain, redness and swelling in a leg, or breathlessness and chest pain. Blood clots can be very serious so it is important to tell your doctor straightaway if you have any of these symptoms. However, most clots can usually be successfully treated with drugs to thin the blood. Your doctor or nurse can give you more information.
Other medicines
Some medicines can be harmful to take when you are having chemotherapy. Let your doctor know about any medications you are taking, including non-prescribed drugs such as complementary therapies and herbal drugs.
Fertility
Your ability to become pregnant or father a child may be affected by taking this drug. It is important to discuss fertility with your doctor before starting treatment.
Contraception
It is not advisable to become pregnant or father a child while taking tegafur-uracil, as the developing foetus may be harmed. It is important to use effective contraception while taking this drug, and for at least a few months afterwards. Again, discuss this with your doctor.
Things to remember about taking tegafur-uracil capsules
- It is important to take your capsules at the right times. You must take them as directed by your doctor.
- Remember to take your folinic acid tablets at the same time as you take the tegafur-uracil tablets.
- Keep the tablets in the original packaging and store them at room temperature, away from heat and direct sunlight.
- Keep the capsules in a safe place where children cannot reach them, as tegafur-uracil could harm them.
- If your doctor decides to stop treatment return the remaining capsules to the pharmacist. Do not flush them down the toilet or throw them away.
- If you are sick or forget to take your capsule, do not take a double dose. Tell your doctor and keep to your regular dose schedule.
- As far as possible, take tegafur-uracil on an empty stomach, i.e one hour before or after meals.