Trifluridine

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For the use of trifluridine as an anti-cancer drug, see Trifluridine/tipiracil.
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Trifluridine
Clinical data
Trade namesViroptic; Lonsurf (+tipiracil)
Other namesα,α,α-trifluorothymidine; 5-trifluromethyl-2′-deoxyuridine; FTD5-trifluoro-2′-deoxythymidine; TFT; CF3dUrd; FTD; F3TDR; F3Thd
AHFS/Drugs.comMonograph
License data
Routes of
administration		Eye drops; tablets (+tipiracil)
ATC code
Legal status
Legal status
Pharmacokinetic data
BioavailabilityNegligible (eye drops);
≥57% (oral)
Protein binding>96%
MetabolismThymidine phosphorylase
Elimination half-life12 minutes (eye drops);
1.4–2.1 hrs (combination with tipiracil)
ExcretionMostly via urine
Identifiers
  • 1-[4-Hydroxy-5-(hydroxymethyl)oxolan-2-yl]-5-(trifluoromethyl)-(1H,3H)-pyrimidine-2,4-dione
JSmol)
  • FC(F)(F)C=1C(=O)NC(=O)N(C=1)[C@@H]2O[C@@H]([C@@H](O)C2)CO
  • InChI=1S/C10H11F3N2O5/c11-10(12,13)4-2-15(9(19)14-8(4)18)7-1-5(17)6(3-16)20-7/h2,5-7,16-17H,1,3H2,(H,14,18,19)/t5-,6+,7+/m0/s1 checkY
  • Key:VSQQQLOSPVPRAZ-RRKCRQDMSA-N checkY
 ☒NcheckY (what is this?)  (verify)

Trifluridine (also called trifluorothymidine; abbreviation TFT or FTD

GlaxoSmithKline. The brand is now owned by Monarch Pharmaceuticals, which is wholly owned by King Pharmaceuticals
.

Trifluridine was approved for medical use in 1980.[2] It is also a component of the anti-cancer drug trifluridine/tipiracil, which is taken by mouth.

Medical uses

Trifluridine eye drops are used for the treatment of

vaccinia virus infections of the eye.[3]

A

Cochrane Systematic Review showed that trifluridine and aciclovir were a more effective treatment than idoxuridine or vidarabine,[4] significantly increasing the relative number of successfully healed eyes in one to two weeks.[4]

For cancer treatment, the combination trifluridine/tipiracil is used.[citation needed]

Adverse effects

Common side effects of trifluridine eye drops include transient burning, stinging, local irritation, and edema of the eyelids.[3]

Adverse effects of the anti-cancer formulation have only been evaluated for the combination trifluridine/tipiracil, not for the individual components.[citation needed]

Interactions

Only in vitro interaction studies are available. In these, trifluridine used the concentrative nucleoside transporter 1 (CNT1) and equilibrative nucleoside transporters 1 (ENT1) and 2 (ENT2). Drugs that interact with these transporters could influence blood plasma concentrations of trifluridine. Being a thymidine phosphorylase inhibitor, trifluridine could also interact with substrates of this enzyme such as zidovudine.[5]

For the eye drops, trifluridine absorption is negligible,[3] rendering interactions basically irrelevant.

Pharmacology

For the anti-cancer mechanism, see Trifluridine/tipiracil § Mechanism of action.

Mechanism of action (eye drops)

It is a nucleoside analogue, a modified form of deoxyuridine, similar enough to be incorporated into viral DNA replication, but the –CF3 group added to the uracil component blocks base pairing, thus interfering with viral DNA replication.[citation needed]

Pharmacokinetics (eye drops)

Trifluridine passes the cornea and is found in the aqueous humour. Systemic absorption is negligible.[3]

Pharmacokinetics (oral)

5-Trifluoromethyl-2,4(1H,3H)-pyrimidinedione (FTY), the main metabolite

Pharmacokinetic data of oral trifluridine have only been evaluated in combination with tipiracil, which significantly affects biotransformation of the former. At least 57% of trifluridine are absorbed from the gut, and highest blood plasma concentrations are reached after two hours in cancer patients. The substance has no tendency to accumulate in the body. Plasma protein binding is over 96%. Trifluridine is metabolised by the enzyme thymidine phosphorylase to 5-trifluoromethyl-2,4(1H,3H)-pyrimidinedione (FTY), and also by glucuronidation. Elimination half-life is 1.4 hours on the first day and increases to 2.1 hours on the twelfth day. It is mainly excreted via the kidneys.[5]

Tipiracil causes Cmax (highest blood plasma concentrations) of trifluridine to increase 22-fold, and its area under the curve 37-fold, by inhibiting thymidine phosphorylase.[5]

Chemistry

The substance is a white crystalline powder. It is freely soluble in

isopropyl ether.[6]

References

  1. PMID 34406678
    .
  2. ISBN 978-1437727029
    .
  3. ^ a b c d "Trifluridine". Drugs.com.
  4. ^
    PMID 25879115
    .
  5. ^ a b c Haberfeld H, ed. (2015). Austria-Codex (in German). Vienna: Österreichischer Apothekerverlag.
  6. ^ "Lonsurf Prescribing Information". Drugs.com.

External links

Retrieved from "https://en.wikipedia.org/w/index.php?title=Trifluridine&oldid=1216818772"