Tipanat 20 is a combination oral anticancer medication containing trifluridine and tipiracil, formulated as tablets.
It is specifically developed to treat advanced cancers, most notably metastatic colorectal cancer, offering hope to patients who have exhausted standard treatments.

Trifluridine and tipiracil work together to slow the growth of cancer cells by attacking their DNA, while also ensuring the active drug remains effective in the body longer. Unlike traditional chemotherapy, which is often given intravenously, Tipanat offers the convenience of oral administration, although it still requires careful monitoring due to potential side effects.

Mechanism of Action

Tipanat combines two active ingredients that complement each other:

Trifluridine

• Trifluridine is an antimetabolite that gets incorporated directly into the DNA of cancer cells during replication.

• This incorporation leads to faulty DNA, preventing the cancer cell from copying its genetic material properly, ultimately triggering cell death.

Tipiracil

• Tipiracil does not directly attack cancer cells. Instead, it acts as a thymidine phosphorylase inhibitor.

• This enzyme would normally break down trifluridine in the body. By blocking it, tipiracil prolongs the presence and activity of trifluridine, allowing it to work more effectively against cancer cells.

Together, this combination ensures that higher levels of trifluridine stay in the bloodstream long enough to be taken up by cancer cells and disrupt their growth.

Uses

Tipanat 20 (trifluridine and tipiracil) is primarily indicated for:Metastatic colorectal cancer (mCRC) —

• Used in patients who have previously received, or are not candidates for, available standard therapies.

• This often includes those who have already been treated with fluoropyrimidine, oxaliplatin, irinotecan, anti-VEGF therapy (like bevacizumab), and anti-EGFR therapy if RAS wild-type.

Gastric or gastroesophageal junction adenocarcinoma (selected cases) —

• Used in some settings after prior chemotherapy regimens have failed.

By offering another line of defense, Tipanat helps to slow disease progression and maintain quality of life in advanced stages.

Side Effects

Because Tipanat affects dividing cells, it can impact not only cancer cells but also some normal cells, especially those in the bone marrow, gut, and hair follicles. Monitoring and supportive care are essential parts of therapy.

Common side effects

• Low blood counts (bone marrow suppression):

  • Neutropenia (low white cells) → increases infection risk

  • Anemia (low red cells) → may cause fatigue and weakness

  • Thrombocytopenia (low platelets) → risk of bleeding or bruising

• Nausea, vomiting, diarrhea — often managed with supportive medications.

• Loss of appetite (anorexia), weight loss

• Fatigue, which can sometimes be profound.

Less common but important

• Febrile neutropenia: combination of low white counts and fever, which can be serious and requires immediate medical attention.

• Mouth sores or taste changes

• Abdominal pain