Mylod%2525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252520at

Mylot%2525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252520at is a brand name for trifluridine and tipiracil. ## Overview Trifluridine/tipiracil is an oral nucleoside analog antiviral that inhibits viral DNA synthesis. Tipiracil inhibits thymidine phosphorylase, increasing trifluridine bioavailability. ## Primary Indications * Treatment of adult patients with metastatic gastric or gastroesophageal junction adenocarcinoma whose disease is refractory to standard therapies. ## Adult Dosing * **Dosage:** 35.4 mg of trifluridine and 10 mg of tipiracil per square meter of body-surface area orally every 12 hours. * **Maximum Dose:** Daily dose should not exceed 200 mg/m² trifluridine and 56 mg/m² tipiracil. * **Administration:** Administer on an empty stomach. ## Pediatric Dosing * Safety and efficacy have not been established in pediatric patients. ## Dose Adjustments * **Adverse Events:** Dose modifications may be required based on the severity and persistence of adverse events, particularly neutropenia, thrombocytopenia, and diarrhea. Specific dose reduction schedules are provided in the prescribing information. * **Renal Impairment:** No dose adjustment necessary for mild to moderate renal impairment. Use with caution in severe renal impairment. * **Hepatic Impairment:** No dose adjustment necessary for mild to moderate hepatic impairment. Use with caution in severe hepatic impairment. ## Contraindications * None specifically listed for trifluridine/tipiracil. ## Adverse Effects * **Common:** Neutropenia, fatigue, nausea, decreased appetite, diarrhea, vomiting, stomatitis, thrombocytopenia, anemia. * **Serious:** Myelosuppression (neutropenia, thrombocytopenia, anemia), gastrointestinal toxicity (diarrhea, vomiting, nausea), fatigue, fever, infections. ## Key Drug Interactions * **Strong CYP3A4 inhibitors:** May increase trifluridine exposure; monitor for toxicity. * **Thymidine phosphorylase inhibitors:** May increase trifluridine exposure; concurrent use is not recommended. ## Monitoring * **Complete Blood Counts (CBCs):** Monitor frequently, especially before and during treatment, for neutropenia, thrombocytopenia, and anemia. * **Gastrointestinal Symptoms:** Monitor for diarrhea, nausea, and vomiting. * **Signs of Infection:** Monitor for fever and other signs of infection. ## Clinical Pearls * Administer trifluridine/tipiracil on an empty stomach to maximize absorption. * Educate patients on the importance of reporting any new or worsening symptoms, especially fever, diarrhea, or signs of infection. * Prophylactic antiemetics may be considered for patients at high risk of nausea and vomiting. *** **Disclaimer:** This information is intended for healthcare professionals and does not replace comprehensive drug information resources. Always consult the most current prescribing information and relevant literature before making clinical decisions.