Buy Tegafur / Gimeracil / Oteracil (Teysuno) online
Price: from 8,270 to 8,985 UAH
Known as original brand(s)
Teysuno
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Tegafur / Gimeracil / Oteracil (commonly known as S-1) is an advanced oral fluoropyrimidine antineoplastic combination drug, originally marketed under the brand name Teysuno. It is widely utilized in medical oncology for the treatment of gastric cancer, colorectal cancer, and various other solid tumors.
The innovative formulation combines three active pharmaceutical ingredients in a strictly balanced molar ratio:
- Tegafur: A prodrug of 5-fluorouracil (5-FU) that is slowly converted in the body, maintaining sustained therapeutic plasma concentrations of the active cytotoxic agent.
- Gimeracil: A potent inhibitor of dihydropyrimidine dehydrogenase (DPD), the enzyme responsible for 5-FU degradation. Gimeracil significantly enhances the systemic bioavailability and anti-tumor efficacy of tegafur while allowing lower doses.
- Oteracil: A compound that selectively inhibits the phosphorylation of 5-FU in gastrointestinal mucosal cells, markedly reducing severe diarrhea, nausea, and stomatitis.
Clinical administration of S-1 provides efficacy comparable to continuous infusion 5-FU with the convenience of oral dosing and an improved gastrointestinal safety profile.
Indications
Tegafur + Gimeracil + Oteracil (S-1) is indicated in clinical oncology for the following conditions:
- Gastric Cancer: Treatment of advanced or metastatic gastric cancer (as monotherapy or combined with cisplatin), as well as adjuvant therapy following radical resection.
- Colorectal Cancer: Treatment of metastatic colorectal cancer.
- Pancreatic and Biliary Tract Cancers: Management of locally advanced or metastatic pancreatic or biliary tract malignancies.
- Head & Neck / NSCLC: Squamous cell carcinoma of the head and neck and non-small cell lung cancer (per regional clinical guidelines).
Dosage and administration
S-1 is administered orally twice daily (morning and evening) for 28 consecutive days followed by a 14-day rest period (42-day cycle), or 14 days on / 7 days off (21-day cycle):
- Dose Calculation: Based on the patient's body surface area (BSA): BSA < 1.25 m² — 40 mg twice daily; BSA 1.25 to 1.5 m² — 50 mg twice daily; BSA > 1.5 m² — 60 to 65 mg twice daily (expressed as tegafur content).
- Administration Method: Capsules should be swallowed whole with water after meals (morning and evening). Do not crush or chew capsules.
- Monitoring: Regular complete blood counts (leukocytes, neutrophils, platelets, hemoglobin) and assessment of hepatic and renal function are mandatory prior to each treatment cycle.
Frequently Asked Questions
The combined antitumor drug S-1 integrates three pharmacologically active components in a strictly calibrated molar ratio to achieve maximum efficacy and safety. Tegafur serves as a prodrug of 5-fluorouracil, which is gradually released in the body and disrupts DNA synthesis in rapidly dividing cancer cells. Gimeracil is a potent reversible inhibitor of the enzyme dihydropyrimidine dehydrogenase, which allows maintaining high concentrations of 5-fluorouracil in blood plasma and tissues at lower dosages. Oteracil selectively blocks the enzyme orotate phosphoribosyltransferase in gastrointestinal mucosal cells, significantly reducing the severity of severe gastrointestinal side effects. This synergistic approach ensures selective cytotoxic action against the tumor while simultaneously protecting the body's healthy tissues.
The main indication for the use of S-1 is the treatment of unresectable or recurrent gastric cancer, where it demonstrates high clinical efficacy as monotherapy or in combination regimens. The medication is also widely used in adjuvant therapy protocols following surgical resection of gastric cancer to prevent metastasis. In addition, this combination is successfully used in clinical practice for the treatment of colorectal cancer, head and neck cancer, non-small cell lung cancer, as well as pancreatic and biliary tract cancers. The drug effectively inhibits tumor growth and improves overall survival rates in cancer patients. Prescription and selection of the treatment regimen are carried out exclusively by an oncologist based on the stage of the disease.
The drug is available in capsules and is taken orally twice daily, in the morning and evening, strictly after meals for twenty-one consecutive days followed by a seven-day rest period. Calculation of the daily dosage is performed individually by the attending physician based on the patient's body surface area. Capsules should be swallowed whole with a sufficient amount of water, without breaking or damaging their shell. In case of a missed dose, it is strictly forbidden to take a double number of capsules at the next administration; treatment should continue according to the normal schedule. The total duration and number of treatment cycles are determined by the treatment protocol and the patient's tolerability of the drug.
During treatment with S-1, patients may experience nausea, vomiting, diarrhea, stomatitis, loss of appetite, and fatigue. Bone marrow suppression frequently occurs within the hematopoietic system, manifesting as leukopenia, thrombocytopenia, and anemia, which requires regular complete blood count monitoring. Skin reactions such as hand-foot syndrome involving redness, peeling, and tenderness of the palms and soles may also develop. To monitor and minimize adverse reactions, timely dose adjustments, temporary drug withdrawal, or supportive symptomatic therapy are implemented. If signs of severe infection, bleeding, or profuse diarrhea occur, the patient must seek immediate medical attention.
Concomitant administration of S-1 with other fluoropyrimidines or bone marrow suppressants is strictly contraindicated due to the risk of severe toxicity. The drug should not be combined with sorivudine or similar antiviral agents capable of completely blocking metabolism and causing a fatal overdose of 5-fluorouracil. The drug is contraindicated in patients with severe renal or hepatic impairment, marked bone marrow suppression, as well as in pregnant and breastfeeding women. Women of reproductive potential must use reliable contraceptive methods during therapy and for a period following its completion. Prior to each new treatment cycle, mandatory monitoring of blood laboratory parameters and the patient's general health status is required.
Medicines containing Tegafur / Gimeracil / Oteracil
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