Pregnancycategory AU: D ATC code L01BC03 (WHO) Molar mass 200.16 g/mol | Routes ofadministration Oral Biological half-life 3.9-11 hours | |
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AHFS/Drugs.com International Drug Names Legal status AU: S4 (Prescription only)UK: POM (Prescription only) | ||
Tegafur (INN, BAN, USAN) is a chemotherapeutic fluorouracil prodrug used in the treatment of cancers. It is a component of the combination drug tegafur/uracil. When metabolised, it becomes 5-fluorouracil.
Contents
Medical uses
As a prodrug to 5-FU it is used in the treatment of the following cancers:
It is often given in combination with drugs that alter its bioavailability and toxicity such as gimeracil, oteracil or uracil. These agents achieve this by inhibiting the enzyme dihydropyrimidine dehydrogenase (uracil/gimeracil) or orotate phosphoribosyltransferase (oteracil).
Adverse effects
The major side effects of tegafur are similar to fluorouracil and include myelosuppression, central neurotoxicity and gastrointestinal toxicity (especially diarrhoea). Gastrointestinal toxicity is the dose-limiting side effect of tegafur. Central neurotoxicity is more common with tegafur than with fluorouracil.
Pharmacogenetics
The dihydropyrimidine dehydrogenase (DPD) enzyme is responsible for the detoxifying metabolism of fluoropyrimidines, a class of drugs that includes 5-fluorouracil, capecitabine, and tegafur. Genetic variations within the DPD gene (DPYD) can lead to reduced or absent DPD activity, and individuals who are heterozygous or homozygous for these variations may have partial or complete DPD deficiency; an estimated 0.2% of individuals have complete DPD deficiency. Those with partial or complete DPD deficiency have a significantly increased risk of severe or even fatal drug toxicities when treated with fluoropyrimidines; examples of toxicities include myelosuppression, neurotoxicity and hand-foot syndrome.
Mechanism of action
It is a prodrug to fluorouracil which is a thymidylate synthase inhibitor.
Pharmacokinetics
It is metabolised into fluorouracil by CYP2A6.
Interactive pathway map
Click on genes, proteins and metabolites below to link to respective articles.