Tegafur-uracil (Uftoral ®)
Tegafur-uracil is a chemotherapy drug used to treat colon and rectal cancer. It is a combination of two drugs: tegafur and uracil (uracil is also known as fluorouracil or 5FU). It is sometimes given with other chemotherapy drugs.
This information should ideally be read with our general information about chemotherapy and your type of cancer.
How tegafur-uracil is given
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Tegafur-uracil is given as capsules. To have this treatment, you will usually go to a chemotherapy day unit and see a cancer doctor, a chemotherapy nurse or a specialist nurse. This is who we mean when we mention doctor or nurse in this information.
Before or on the day of treatment, a nurse or person trained to take blood (phlebotomist) will take a blood sample from you. This is to check that it is okay for you to have chemotherapy.
You will also see a doctor or nurse before you have chemotherapy. They will ask you about how you have been. If your blood results are alright on the day of the treatment, the pharmacist will prepare your chemotherapy. Your nurse will tell you when your capsules are likely to be ready.
Taking your tegafur-uracil capsules
Before you leave hospital, the nurse or pharmacist will give you the capsules to take at home. Always take your capsules exactly as explained. This is important to make sure they work as well as possible for you.
The capsules should be taken three times a day at regular intervals. They should be swallowed whole and taken either an hour before or an hour after food.
A tablet called calcium folinate (folinic acid) is given with tegafur-uracil. This helps to make tegafur-uracil work better. Both tablets should be taken at the same time.
You will also be given anti-sickness drugs to take when you are at home. Take all your tablets exactly as your nurse or pharmacist has explained.
If you are sick just after taking the capsules, contact the hospital. You may need to take another dose. If you forget to take a capsule, do not take a double dose. Keep to your regular schedule and let your doctor or nurse know.
Other things to remember about your capsules:
Keep them in the original packaging and at room temperature, away from heat and direct sunlight.
Keep them safe and out of the reach of children.
Return any remaining capsules to the pharmacist if your treatment is stopped.
Your course of tegafur-uracil
You will have chemotherapy as a course of several sessions (or cycles) of treatment over a few months. Tegafur-uracil is usually taken for 28 days (four weeks), followed by a seven-day break. The cycle is then repeated.
Your doctor or nurse will tell you more about this and the number of cycles you are likely to have.
Possible side effects of tegafur-uracil
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We explain the most common side effects of tegafur-uracil here. But we don’t include all the rare ones that are unlikely to affect you.
You may get some of the side effects we mention but you are very unlikely to get all of them. If you are having other chemotherapy drugs as well, you may have some side effects that we don’t list here. Always tell your doctor or nurse about the side effects you have.
Your doctor can prescribe drugs to help control some side effects. It is very important to take them exactly as your nurse or pharmacist explains. This means they will be more likely to work better for you. Your nurse will give you advice about managing your side effects. After your treatment is over, the side effects will start to improve.
Contact the hospital
Your nurse will give you telephone numbers for the hospital. You can call them if you feel unwell or need advice any time of day or night. Save these numbers in your phone or keep them somewhere safe.
Risk of infection
Chemotherapy can reduce the number of white blood cells in your blood. This will make you more likely to get an infection. When the number of white blood cells is low, it’s called neutropenia.
Contact the hospital straight away on the contact number you’ve been given if:
your temperature goes over 37.5°C (99.5°F) or over 38°C (100.4°F), depending on the advice given by your chemotherapy team
you suddenly feel unwell, even with a normal temperature
you have symptoms of an infection – this can include feeling shaky, a sore throat, a cough, diarrhoea or needing to pass urine a lot.
The number of white blood cells usually increases steadily and returns to normal before your next treatment. You will have a blood test before having more chemotherapy. If your white blood cells are still low, your doctor may delay your treatment for a short time.
Bruising and bleeding
Tegafur-uracil can reduce the number of platelets in your blood. Platelets are cells that help the blood to clot. Tell your doctor if you have any bruising or bleeding you can’t explain. This includes nosebleeds, bleeding gums, blood spots or rashes on the skin. Some people may need a drip to give them extra platelets.
Anaemia (low number of red blood cells)
Tegafur-uracil can reduce the number of red blood cells in your blood. These cells carry oxygen around the body. If the number of red blood cells is low, you may be tired and breathless. Tell your doctor or nurse if you feel like this. If you are very anaemic, you may need a drip to give you extra red blood cells (blood transfusion).
Your doctor will prescribe anti-sickness (anti-emetic) drugs to help prevent or control sickness. They may also give you a steroid drug to help. Take the drugs exactly as your nurse or pharmacist explains. It’s easier to prevent sickness than to treat it after it has started.
If you still feel sick, or vomit twice or more in 24 hours, contact the hospital on the numbers they gave you as soon as possible. They will give you advice and may change the anti-sickness drug to one that works better for you. Some people may need to go to hospital for a short time so the doctors and nurses can control their sickness.
This can sometimes be severe. Your doctor can prescribe anti-diarrhoea drugs to control it. You may be given these before you leave hospital. It’s important to take them exactly as your nurse or pharmacist explained. Make sure you drink at least two litres (three and a half pints) of fluids every day if you have diarrhoea.
If you have diarrhoea more than 4–6 times a day, or at night, contact the hospital straight away on the numbers your nurse gave you.
If you get pain in your tummy (abdomen), let your doctor know. They can give you mild painkillers to control it.
Loss of appetite
You may lose your appetite during your treatment. Try to eat small meals regularly. Don’t worry if you don’t eat much for a day or two. If your appetite doesn’t improve after a few days, let your nurse or dietitian know. They can give you advice on getting more calories and protein in your diet. They may give you food supplements or meal replacement drinks to try. Your doctor can prescribe some of these and you can buy them from chemists.
Your mouth may become sore and you may get ulcers. This can make you more likely to get an infection in your mouth. Gently clean your teeth and/or dentures morning and night and after meals. Use a soft-bristled or children’s toothbrush. Your nurse might ask you to rinse your mouth regularly or use mouthwashes. It’s important to follow any advice you are given and to drink plenty of fluids.
Tell your nurse or doctor if you have any problems with your mouth. They can prescribe medicines to prevent or treat mouth infections and reduce any soreness.
Feeling very tired is a common side effect. It’s often worse towards the end of treatment and for some weeks after it’s finished. Try to pace yourself and get as much rest as you need. It helps to balance this with some gentle exercise, such as short walks. If you feel sleepy, don’t drive or operate machinery.
Tegafur-uracil may cause changes in the way your liver works, although it will return to normal when the treatment finishes. You're very unlikely to notice any problems, but your doctor will take regular blood samples to check your liver is working properly.
Less common side effects of tegafur-uracil
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Your hair may thin but you’re unlikely to lose all the hair from your head. This usually starts after your first or second cycle of chemotherapy. It is almost always temporary and your hair will grow back after chemotherapy ends. Your nurse can give you advice about coping with hair loss.
Tegafur-uracil can cause a rash, which may be itchy. Your doctor or nurse can tell you what to expect. If your skin feels dry, try using an unperfumed moisturising cream every day. Always tell your doctor or nurse about any skin changes. They can give you advice and may prescribe creams or medicines to help. Any changes to your skin are usually temporary and improve when treatment finishes.
You may get a bitter or metallic taste in your mouth or find that food tastes different. This should go away when your treatment finishes. Try using herbs and spices (unless you have a sore mouth or ulcers) or strong-flavoured sauces to give your food more flavour. Sucking boiled sweets can sometimes help get rid of a bitter or metallic taste. Your nurse can give you more advice.
Your eyes may become watery. They may also become sore and inflamed (conjunctivitis). Your doctor can prescribe eye drops if you need these.
Changes in the way your heart works
Very rarely, tegafur-uracil may affect the way your heart works. This is more likely if you have had a lot of heart problems in the past. Some people can experience chest pain and tightening across the centre of the chest while taking tegafur-uracil. Chest pain can be caused by many different things other than chemotherapy. If you develop any of these symptoms, contact your doctor immediately.
It is important to tell your doctor or nurse straight away if you feel ill or have severe side effects. This includes any we don’t mention here.
Other information about tegafur-uracil
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Blood clot risk
Cancer increases the chances of a blood clot (thrombosis) and chemotherapy can add to this. A clot can cause symptoms such as pain, redness and swelling in a leg, breathlessness and chest pain. Contact your doctor straight away if you have any of these symptoms. A blood clot is serious but your doctor can treat it with drugs that thin the blood. Your doctor or nurse can give you more information.
Some medicines can interact with chemotherapy or be harmful when you are having chemotherapy. This includes medicines you can buy in a shop or chemist. Tegafur-uracil may affect how some drugs, such as those used to prevent blood clots (for example warfarin) work . It may also affect the way phenytoin (anti-seizure medicine) works. Tell your doctor about any medicines you are taking, including over-the-counter drugs, complementary therapies and herbal drugs.
Tegafur-uracil can affect your fertility (being able to get pregnant or father a child). If you are worried about this, you can talk to your doctor before treatment starts.
Your doctor will advise you not to become pregnant or father a child during treatment. This is because the drugs may harm a developing baby. It’s important to use contraception during and for a few months after chemotherapy. You can talk to your doctor or nurse about this.
If you have sex while having chemotherapy treatment you need to use a condom. This is to protect your partner in case there is any chemotherapy in semen or vaginal fluid.
Women are advised not to breastfeed during treatment and for a few months after. This is in case there is chemotherapy in their breast milk.
Medical and dental treatment
If you need to go into hospital for any reason other than cancer, always tell the doctors and nurses that you are having chemotherapy. Give them contact details for your cancer doctor.
Talk to your cancer doctor or nurse if you think you need dental treatment. Always tell your dentist you are having chemotherapy.
This section has been compiled using a number of reliable sources, including:
electronic Medicines Compendium (eMC). medicines.org.uk (accessed September 2013).
British National Formulary. 65th edition. British Medical Association and Royal Pharmaceutical Society of Great Britain. 2013.
Truven Health Analytics Inc. Micromedex® 2.0. 2013. micromedexsolutions.com (accessed September 2013)
With thanks to: Rena Chauhan, Senior Cancer Services Pharmacist, and the people affected by cancer who reviewed this edition.
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