Description

Tegonat 15 mg (Tegafur + Gimeracil + Oteracil): Oral S‑1 Chemotherapy for Gastric & Colorectal Cancers

Tegonat 15 mg capsule contains the fixed‑dose combination of tegafur, gimeracil, and oteracil, commonly known as S‑1. Tegafur acts as a prodrug to fluorouracil (5‑FU), while gimeracil inhibits its metabolizing enzyme DPD, and oteracil reduces GI toxicity by limiting gut 5‑FU activation. This joint action enhances tolerability without compromising anticancer efficacy. 

📌 Approved Indications

• Advanced or metastatic gastric cancer, in combination with cisplatin, for patients unsuitable for standard regimens. 
• Second‑line metastatic colorectal cancer—with or without oxaliplatin/irinotecan where intravenous fluoropyrimidines pose toxicity risks. 

🗓️ Dosage & Administration (Adults)

• To calculate the dose based on body surface area (BSA): standard is **25 mg/m² (as tegafur)** twice daily for 21 days followed by 7 days rest. 
• Each Tegonat 15 mg capsule contains **15 mg tegafur, 4.35 mg gimeracil, & 11.8 mg oteracil**—modifications as per SmPC. 
• Most patients with BSA ~1.6–1.9 m² require **two capsules per dose, 12 hours apart**, reflecting 30–40 mg tegafur per dose. Adjust based on serial BSA measurements. 
• Take on an **empty stomach** with water—**≥1 hour before or after a meal**. Do not crush or chew. 

⚠️ Safety Profile & Adverse Effects

• Main toxicity: Bone marrow suppression—neutropenia, anemia, thrombocytopenia—dose-limiting & requiring regular CBC monitoring.
• Other common effects: diarrhea, nausea, anorexia, dehydration, electrolyte imbalances, cardiac irregularities, lacrimation. 
• Severe events (>10%): fatigue, acute renal failure, infection, hand-foot syndrome may occur with or without cisplatin. 

⛑️ Monitoring & Contraindications

• Baseline and ongoing labs: CBC, renal and hepatic panels, electrolytes. Monitor hydration level especially during diarrhea. 
• Do not use in patients with known DPD deficiency or concurrent capecitabine/5-FU therapy. 
• Pregnancy and breastfeeding are contraindicated due to teratogenic risk. Effective contraception is required. 
• Avoid live vaccines during and several months post-treatment due to immunosuppression.

✅ Why Choose Tegonat 15 mg?

• Generic equivalent to Teysuno—**India-approved oral S‑1**, delivering identical efficacy at a more affordable price. 
• Fixed 15 mg strength allows fine tuning per BSA, reducing overexposure in smaller patients. 
• Simple twice-daily oral dosing increases outpatient convenience and adherence compared to IV fluoropyrimidines. 

❓ Frequently Asked Questions (FAQs)

1. Can Tegonat be used alone?

Yes—in metastatic colorectal cancer, Tegonat monotherapy is permitted. In gastric cancer it is combined with cisplatin. Always consult your oncologist.

2. What if I vomit a dose?

If vomiting occurs within 15 minutes, take the dose again; otherwise, skip until the next scheduled time. Do not double up. 

3. Is hair loss common?

Minor hair thinning can occur, but complete alopecia is rare with S‑1. Ask about topical care during therapy. 

4. How long does it take to work?

Response assessments are usually done after two to three cycles (~2–3 months). Benefits depend on tumor type and stage. 

5. What about vaccine timing?

Avoid live vaccines during treatment and for at least three months post-therapy. Inactivated vaccines may have reduced efficacy.