Description

Luporal 100 mg (Tegafur / Uracil UFT): Oral Antimetabolite for Colon & Rectal Cancer

Luporal 100 mg capsule combines tegafur (100 mg) and uracil (224 mg) in a fixed molar ratio (tegafur:uracil ≈ 1:4), branded as UFT. Manufactured by Lupin Ltd. in India, it’s used for adjuvant and palliative treatment of colon and rectal carcinoma. (Luporal data) 

📌 Mechanism of Action

Tegafur is a prodrug of 5‑fluorouracil (5‑FU) that requires hepatic conversion, while uracil competitively inhibits dihydropyrimidine dehydrogenase (DPD), the enzyme that breaks down 5‑FU. This enhances intratumoral 5‑FU concentration and systemic exposure with fewer gastrointestinal metabolites. (UFT pharmacology) 

🩺 Dosing & Administration (Adults)

• Standard dosing: **300 mg/m²/day** of tegafur, typically given in **three divided doses every 8 hours**, with or without food, in a **21-day treatment followed by 7-day rest** cycles. 
• For BSA ~1.6 m², this equals around **3 capsules (300 mg tegafur) taken TID**; for larger BSA or higher dose regimens, that may increase to **4–6 capsules/day**. Dosage must be tailored under oncologist supervision.
• A daily regimen of **300–600 mg tegafur/day** may be used based on indication (e.g., high-risk rectal or advanced colorectal cancer).
• Take Luporal at a **fixed time each day**; if using TID regimen, maintain 8-hour intervals for steady levels. 
• In pancreatic or lung off‑label cases the regimen is similar but modified per protocol.

⚠️ Side Effects & Safety Profile

• **Myelosuppression**: neutropenia, anemia, thrombocytopenia are common and dose-limiting—monitor CBC regularly. 
• **Gastrointestinal toxicity**: nausea, diarrhea, stomatitis, and occasionally mucositis—prevent with hydration and mild antiemetics. 
• **Hand–Foot Syndrome (HFS)** is less severe than capecitabine but cases have been reported (rare, 0.1–5%). Arises more commonly with UFT/LV. 
• **Neurotoxicity** may occur—manifesting as dizziness or ataxia; more common than with IV 5‑FU. 
• Caution in **DPD deficiency**—even heterozygosity may lead to life-threatening toxicity; test especially in high-risk patients. 

⚠️ Warnings & Drug Interactions

• Contraindicated in known DPD deficiency, during pregnancy, breastfeeding, and in patients with severe bone marrow suppression or allergy to fluoropyrimidines. 
• Avoid concurrent use of **warfarin or sorivudine (brivudine)**—risk of bleeding or fatal toxicity increases; monitor INR rigorously.
• Temporarily **hold before major surgery** to reduce risk of delayed wound healing. 
• Administer folinic acid (leucovorin) per clinical protocols to enhance efficacy in advanced/metastatic colorectal cancer. 

✅ Why Choose Luporal 100 mg?

• Oral UFT regimen supports outpatient treatment—no need for infusions or central catheters.
• Lower gastrointestinal toxicity and reduced risk of HFS compared to capecitabine or continuous IV 5‑FU.
• Widely prescribed adjuvant option post‑surgery in East Asia and India—affordable generic compared to IV therapy. 

❓ Frequently Asked Questions (FAQs)

1. What if I miss a dose?

If missed by less than 4–6 hours, take it immediately; otherwise skip, **do not double** at next scheduled time. Maintain TID spacing. 

2. Should folinic acid be co‑administered?

Yes—adding folinic acid (leucovorin) enhances response in metastatic or adjuvant colorectal cancer according to protocol (e.g. UFT/LV regimens). Not always required for monotherapy post‑treatment. 

3. How long is treatment continued?

Adjuvant treatment typically lasts 6–12 months; in metastatic patients, therapy continues until disease progression or toxicity. Treatment length is individualized. 

4. Is liver or renal impairment a concern?

Yes—use with caution in hepatic or renal dysfunction due to altered uracil metabolism. Dose adjustment may be necessary. 

5. How is diarrhea managed?

Withhold UFT until diarrhea resolves to ≤ Grade 1; resume at reduced dose. Support with loperamide and hydration.