Dosage calculator and personalized treatment calendar

Calculate the appropriate LONSURF dosage and create a personalized treatment calendar for your patients using the tool below. In addition to calculating the standard starting dose, you can calculate the dose for patients who require dose reductions as well as for those who have severe renal impairment. Ensure you select the option to Create a Calendar to generate a personalized treatment calendar for your patients to help them stay on therapy as prescribed. You can also choose to include bevacizumab on the treatment calendar.

For more information on how to appropriately modify the dose of LONSURF for adverse reactions, visit the Dosage Modifications page or see full Prescribing Information.

Step 1: Calculate your patient's BSA by entering his/her height and weight in metric or imperial units, or select the BSA tab to enter BSA directly.
cm

Please enter your patient's height

Please enter a height below 300 cm

ft
in

Please enter your patient's height

Please enter a value for feet between 0 and 10 and a value for inches between 0 and 12

kg

Please enter your patient's weight

Please enter a weight below 1000 kg

lb

Please enter your patient's weight

Please enter a weight below 2000 lb

Step 2: Select appropriate dose type, then select Calculate Dosage. The tablets comprising the recommended morning and evening doses will be displayed.
Dose Type

Standard dose

Standard Starting Dose (35 mg/m2) 1st Standard Dose Reduction (30 mg/m2)* 2nd Standard Dose Reduction (25 mg/m2)* 3rd & Final Standard Dose Reduction (20 mg/m2)*

Severe Renal Impairment

Severe Renal Impairment Starting Dose (20 mg/m2) 1st & Final Severe Renal Impairment Dose Reduction (15 mg/m2)

*Not a starting dose. See Dosage Modifications for more information about how to make appropriate dose modifications.

Not a standard dose. See Prescribing Information for recommended starting dose and dose modification in patients with severe renal impairment.

Please select a dose type

Please calculate dosage

Contact an Oncology Account Manager to learn more about dosing and dose modifications.
Step 1: Enter your patient's BSA directly, or select the Height and Weight tab to calculate BSA.
m2

Please enter your patient's BSA

Please enter a BSA between 0 and 10 m2

Step 2: Select appropriate dose type, then select Calculate Dosage. The tablets comprising the recommended morning and evening doses will be displayed.
Dose Type

Standard dose

Standard Starting Dose (35 mg/m2) 1st Standard Dose Reduction (30 mg/m2)* 2nd Standard Dose Reduction (25 mg/m2)* 3rd & Final Standard Dose Reduction (20 mg/m2)*

Severe Renal Impairment

Severe Renal Impairment Starting Dose (20 mg/m2) 1st & Final Severe Renal Impairment Dose Reduction (15 mg/m2)

*Not a starting dose. See Dosage Modifications for more information about how to make appropriate dose modifications.

Not a standard dose. See Prescribing Information for recommended starting dose and dose modification in patients with severe renal impairment.

Please select a dose type

Please calculate dosage

Contact an Oncology Account Manager to learn more about dosing and dose modifications

Results

Dosage is rounded up to the nearest 5 mg increment.
BSA
m2
Dosage (per formula)
mg
(2x Daily)
Recommended dosage (rounded per PI)
mg
(2x Daily)
Tablet strength of LONSURF is based on the trifluridine component.
Morning
x 15‑mg tablets
x 20‑mg tablets
Evening
x 15‑mg tablets
x 20‑mg tablets
Step 3: Create a personalized treatment calendar for your patient.

Please select a treatment start date

Contact an Oncology Account Manager to learn more about dosing and dose modifications

BSA calculated using the DuBois formula1

BSA=Body Surface Area.

Reference: 1. Data on file. Taiho Oncology, Inc., Princeton, NJ.

INDICATIONS

LONSURF is indicated as a single agent or in combination with bevacizumab for the treatment of adult patients with metastatic colorectal cancer previously treated with fluoropyrimidine‑, oxaliplatin‑ and irinotecan‑based chemotherapy, an anti‑VEGF biological therapy, and if RAS wild‑type, an anti‑EGFR therapy.

LONSURF is indicated for the treatment of adult patients with metastatic gastric or gastroesophageal junction adenocarcinoma previously treated with at least two prior lines of chemotherapy that included a fluoropyrimidine, a platinum, either a taxane or irinotecan, and if appropriate, HER2/neu‑targeted therapy.

Indications and Important Safety Information

Important Safety Information

INDICATIONS

LONSURF is indicated as a single agent or in combination with bevacizumab for the treatment of adult patients with metastatic colorectal cancer previously treated with fluoropyrimidine‑, oxaliplatin‑ and irinotecan‑based chemotherapy, an anti‑VEGF biological therapy, and if RAS wild‑type, an anti‑EGFR therapy.

LONSURF is indicated for the treatment of adult patients with metastatic gastric or gastroesophageal junction adenocarcinoma previously treated with at least two prior lines of chemotherapy that included a fluoropyrimidine, a platinum, either a taxane or irinotecan, and if appropriate, HER2/neu‑targeted therapy.

IMPORTANT SAFETY INFORMATION

WARNINGS AND PRECAUTIONS

Severe Myelosuppression: In the 1114 patients who received LONSURF as a single agent, LONSURF caused severe or life‑threatening myelosuppression (Grade 3‑4) consisting of neutropenia (38%), anemia (17%), thrombocytopenia (4%) and febrile neutropenia (3%). Three patients (0.3%) died due to neutropenic infection/sepsis; four other patients (0.5%) died due to septic shock. A total of 14% of patients received granulocyte‑colony stimulating factors. In the 246 patients who received LONSURF in combination with bevacizumab, LONSURF caused severe or life-threatening myelosuppression (Grade 3‑4) consisting of neutropenia (52%), anemia (5%), thrombocytopenia (4%) and febrile neutropenia (0.4%). One patient (0.4%) died due to abdominal sepsis and two other patients (0.8%) died due to septic shock. A total of 29% of patients received granulocyte-colony stimulating factors. Obtain complete blood counts prior to and on Day 15 of each cycle of LONSURF and more frequently as clinically indicated. Withhold LONSURF for severe myelosuppression and resume at the next lower dosage.

Embryo‑Fetal Toxicity: LONSURF can cause fetal harm when administered to a pregnant woman. Advise pregnant women of the potential risk to the fetus. Advise females of reproductive potential to use effective contraception during treatment and for at least 6 months after the final dose.

USE IN SPECIFIC POPULATIONS

Lactation: It is not known whether LONSURF or its metabolites are present in human milk. There are no data to assess the effects of LONSURF or its metabolites on the breastfed child or the effects on milk production. Because of the potential for serious adverse reactions in breastfed children, advise women not to breastfeed during treatment with LONSURF and for 1 day following the final dose.

Male Contraception: Because of the potential for genotoxicity, advise males with female partners of reproductive potential to use condoms during treatment with LONSURF and for at least 3 months after the final dose.

Geriatric Use: Patients 65 years of age or older who received LONSURF as a single agent had a higher incidence of the following hematologic laboratory abnormalities compared to patients younger than 65 years: Grade 3 or 4 neutropenia (46% vs 32%), Grade 3 anemia (20% vs 14%), and Grade 3 or 4 thrombocytopenia (6% vs 3%). Patients 65 years of age or older who received LONSURF in combination with bevacizumab had a higher incidence of the following hematologic laboratory abnormalities compared to patients younger than 65 years: Grade 3 or 4 neutropenia (60% vs 46%) and Grade 3 or 4 thrombocytopenia (5% vs 4%).

Renal Impairment: No adjustment to the starting dosage of LONSURF is recommended in patients with mild or moderate renal impairment (CLcr of 30 to 89 mL/min). Reduce the starting dose of LONSURF for patients with severe renal impairment (CLcr of 15 to 29 mL/min) to a recommended dosage of 20 mg/m2.

Hepatic Impairment: Do not initiate LONSURF in patients with baseline moderate or severe (total bilirubin > 1.5 times ULN and any AST) hepatic impairment. Patients with severe hepatic impairment (total bilirubin > 3 times ULN and any AST) were not studied. No adjustment to the starting dosage of LONSURF is recommended for patients with mild hepatic impairment.

ADVERSE REACTIONS

Serious adverse reactions occurred in 25% of patients. The most frequent serious adverse reactions (≥2%) were intestinal obstruction (2.8%), and COVID-19 (2%). Fatal adverse reactions occurred in 1.2% of patients who received LONSURF in combination with bevacizumab, including rectal fistula (0.4%), bowel perforation (0.4%) and atrial fibrillation (0.4%).

The most common adverse reactions or laboratory abnormalities (≥10% in incidence) in patients treated with single‑agent LONSURF at a rate that exceeds the rate in patients receiving placebo in mCRC: anemia (77% vs 33%), neutropenia (67% vs 0.8%), asthenia/fatigue (52% vs 35%), nausea (48% vs 24%), thrombocytopenia (42% vs 8%), decreased appetite (39% vs 29%), diarrhea (32% vs 12%), vomiting (28% vs 14%), abdominal pain (21% vs 19%), and pyrexia (19% vs 14%). In metastatic gastric cancer or gastroesophageal junction (GEJ): neutropenia (66% vs 4%), anemia (63% vs 38%), nausea (37% vs 32%), thrombocytopenia (34% vs 9%), decreased appetite (34% vs 31%), vomiting (25% vs 20%), infections (23% vs 16%) and diarrhea (23% vs 14%).

Pulmonary emboli occurred more frequently in LONSURF‑treated patients compared to placebo: in mCRC (2% vs 0%) and in metastatic gastric cancer and GEJ (3% vs 2%).

Interstitial lung disease (0.2%), including fatalities, has been reported in clinical studies and clinical practice settings in Asia.

The most common adverse reactions or laboratory abnormalities (≥20% in incidence) in patients treated with LONSURF in combination with bevacizumab vs LONSURF alone were neutropenia (80% vs 68%), anemia (68% vs 73%), thrombocytopenia (54% vs 29%), fatigue (45% vs 37%), nausea (37% vs 27%), increased aspartate aminotransferase (34% vs 28%), increased alanine aminotransferase (33% vs 23%), increased alkaline phosphate (31% vs 36%), decreased sodium (25% vs 20%), diarrhea (21% vs 19%), abdominal pain (20% vs 18%), and decreased appetite (20% vs 15%).

Please see accompanying full Prescribing Information.