Teysuno is a cancer medicine. It belongs to a group of cancer medicines called fluoropyrimidines and is used to treat advanced gastric (stomach) cancer together with cisplatin (another cancer medicine).
Teysuno Capsules 20 mg is a cancer medicine. It belongs to a group of cancer medicines called fluoropyrimidines and is used to treat advanced gastric (stomach) cancer together with cisplatin (another cancer medicine).
It is also used to treat metastatic colorectal cancer (cancer of the colon and rectum that has spread elsewhere in the body) in patients who can no longer be treated with other fluoropyrimidines because of unacceptable side effects.For this it may be used alone or with the cancer medicines oxaliplatin or irinotecan, with or without another medicine, bevacizumab.
Teysuno should only be prescribed by a doctor who is experienced in the use of cancer medicines.
Before starting treatment, it is recommended that patients are tested to check whether they have a working dihydropyrimidine dehydrogenase (DPD) enzyme.
Teysuno is available as capsules containing 15 mg tegafur with 4.35 mg gimeracil and 11.8 mg oteracil, and as capsules containing 20 mg tegafur with 5.8 mg gimeracil and 15.8 mg oteracil. The recommended initial dose depends on the patient’s height and weight. Teysuno capsules should be taken at least one hour before or after a meal.
For the treatment of advanced gastric cancer, Teysuno is used in a four-week cycle starting on the day of cisplatin administration. The capsules are given twice daily for 21 days followed by a 7-day gap before the next course. Cisplatin treatment stops after six cycles, but Teysuno treatment is continued unless the disease gets worse or the side effects are unacceptable.
For the treatment of metastatic colorectal cancer, Teysuno is used in a three-week cycle, with capsules given twice daily for 14 days, followed by a 7-day gap before starting the next cycle. Bevacizumab can be given on day 1 of each cycle. If Teysuno is given in combination with oxaliplatin and irinotecan, a lower dose is recommended.
Doses need to be adjusted for patients with kidney disease and for patients who develop certain side effects. For patients with partial DPD deficiency, a lower starting dose may be considered.
For more information about using Teysuno, see the package leaflet or contact your doctor or pharmacist.
How Does It Work?
The main active substance in Teysuno, tegafur, is a cytotoxic medicine (a medicine that kills rapidly dividing cells, such as cancer cells). Tegafur is converted to the medicine fluorouracil in the body, but more is converted in tumour cells than in normal tissues.
Fluorouracil is very similar to pyrimidine. Pyrimidine is part of the genetic material of cells (DNA and RNA). In the body, fluorouracil takes the place of pyrimidine and interferes with the enzymes involved in making new DNA. As a result, it prevents the growth of tumour cells and eventually kills them.
The two other active substances in Teysuno allow tegafur to be effective at lower doses and with fewer side effects: gimeracil by preventing the breakdown of fluorouracil and oteracil by reducing the activity of fluorouracil in normal, non-cancerous tissue in the gut.
Teysuno, in combination with cisplatin, has been shown to be effective in treating gastric cancer, and analysis of the literature has shown Teysuno-based treatments to be effective for metastatic colorectal cancer in patients for whom other fluoropyrimidine-based regimens are not an option because of side effects.
The safety profile of the medicine is considered acceptable. The European Medicines Agency therefore decided that Teysuno’s benefits are greater than its risks and it can be authorised for use in the EU.
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