Tegafur with uracil (Uftoral)

Uftoral is a combination of two chemotherapy drugs called tegafur and uracil. It is one of a group of chemotherapy drugs known as anti metabolites. These drugs stop cells making and repairing DNA. Cancer cells need to make and repair DNA so that they can grow and multiply.

When you swallow this drug, the tegafur part of the drug is turned into a chemotherapy drug called 5-fluorouracil (5FU). The other part of the drug, uracil, interacts with the tegafur and stops 5FU breaking down. This means that there is more of the active drug in your body for longer than if you'd had tegafur or 5FU alone. Doctors mainly use it to treat bowel cancer.

Uftoral comes as white capsules, which you take 3 times a day for 28 days. You then have a 7 day break. This cycle of treatment is repeated about 6 to 8 times. There is detailed information about how doctors plan chemotherapy on CancerHelp UK. 

You have tablets called calcium folinate (leucovorin or folinic acid) to take with Uftoral. These may help Uftoral to work better. Take the Uftoral and calcium folinate tablets at the same time, either at least 1 hour before or 1 hour after a meal.

It is very important that you take tablets according to the instructions your doctor or pharmacist gave you. Whether you have a full or empty stomach, for example, can affect how much of a drug gets into your bloodstream. You should take the right dose, not more or less. And never stop taking a cancer drug without talking to your specialist first.

Uftoral side effects are listed below. You can use the links to find out more about each side effect. Or go to the cancer drug side effects section for general information.

More than 10 in every 100 people have one or more of the side effects listed below.

Temporary drop in the number of blood cells made by the bone marrow, causing

• Increased risk of getting an infection from a drop in white blood cells – it is harder to fight infections and you can become very ill. You may have headaches, aching muscles, a cough, sore throat, pain passing urine or feel cold and shivery
• Tiredness and breathlessness due to a drop in red blood cells (anaemia) – you may need a blood transfusion
• Bruising more easily due to a drop in platelets – you may have nosebleeds, bleeding gums after brushing your teeth, or lots of tiny red spots or bruises on your arms or legs (known as petechia)

Some of these side effects can be life threatening, particularly infections. You should contact your treatment centre if you have any of these effects. Your doctor will check your blood counts regularly to see how well your bone marrow is working.

Other common side effects include

• Fatigue (tiredness) and lack of energy during and after treatment – most people find their energy levels are back to normal from 6 months to a year after their treatment finishes
• Diarrhoea in about 2 out of 10 people (20%) – drink plenty of fluids and tell your doctor if it becomes severe or lasts more than a couple of days, as you could get dehydrated
• Feeling sick affects about 1 in 10 people (10%) and is usually easily controlled with anti sickness injections and tablets – tell your doctor if you still have sickness, as you can try other anti sickness medicines
• A sore mouth
• Uftoral may harm a developing baby so it is not advisable to become pregnant or father a child if you are having this drug – talk about contraception to your doctor before having the treatment if there is any chance you or your partner could become pregnant
• Abdominal pain

Between 1 and 10 in every 100 people have one or more of these.

• Hair thinning is usually mild, but can start 3 to 4 weeks after treatment – total hair loss is rare with this drug and your hair will grow back when your treatment ends
• Brittle, chipped and ridged nails
• Sensitivity of the skin to sunlight – stay in the shade and if you have to go in the sun, cover up or use a sun block
• A rash, which may be itchy
• Eye problems including increased production of tears, gritty eyes, blurred vision and eye infections
• Loss of appetite
• Liver changes can happen, but will go back to normal when treatment ends – your doctor will take regular blood tests to check how your liver is working
• Changes in taste
• Headaches
• Difficulty sleeping (insomnia)
• Depression
• Constipation – your5 doctor or nurse can prescribe laxatives if necessary

Fewer than 1 in 100 people have these.

• Darkened skin or changes in skin colour
• Heart problems including chest pain (angina) or heart attack
• Confusion and dizziness
• Kidney problems that are mild and unlikely to cause symptoms may occur – they will almost certainly go back to normal when treatment finishes, but you will have regular blood tests to check how well your kidneys are working
• Loss of fertility may happen with this drug, so it is important to talk to your doctor before starting treatment if having a baby is important to you
• Women may stop having periods (amenorrhoea) but this may only be temporary
• Men may have difficulty in getting an erection (impotence)

The side effects above may be mild or more severe. A side effect may get better or worse through your course of treatment, or more side effects may develop as the course goes on. This depends on

• How many times you've had the drug before
• Your general health
• The amount of the drug you have (the dose)
• Other drugs you are having

Talk to your doctor, pharmacist or nurse about all your side effects so that they can help you manage them. Your chemotherapy nurse, clinic or ward nurse will give you a contact number. You can ring if you have any questions or problems. They can give you advice or reassure you. If in doubt, call them.

Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and other over the counter remedies – some drugs can react together.

You should not have immunisations with live vaccines while you are having this treatment or for at least 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG and yellow fever. You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered.

It is safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with oral vaccines, but not many people in the UK have oral vaccines now. So there is usually no problem in being with any baby or child who has recently had any vaccination in the UK. You might need to make sure that you aren't in contact with anyone who has had oral polio, cholera or typhoid vaccination recently, particularly if you live abroad.