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Cisplatin and Teysuno

Cisplatin and Teysuno (pronounced tay-soon-oh) is a combination of chemotherapy drugs. You might have it as a treatment for advanced stomach cancer.

Advanced stomach cancer means that a cancer that began in the stomach has spread to at least one other part of the body, such as the liver or lungs.

How cisplatin and Teysuno work

Teysuno is made up of 3 different drugs called tegafur, gimeracil and oteracil. Tegafur is changed into a drug called fluorouracil in the body. These drugs stop cells making and repairing DNA. Cancer cells need to make and repair DNA in order to grow and multiply. 

Cisplatin is a chemotherapy drug that works by damaging the DNA in cancer cells and stopping them from multiplying. 

How you have cisplatin and Teysuno

You have cisplatin as a drip into your bloodstream (intravenously). 

Teysuno is a capsule that you take twice a day, morning and evening. You swallow them whole with plenty of water. You should take the capsules either an hour before eating or an hour after eating. 

Into your bloodstream

You have the treatment through a drip into your arm or hand. A nurse puts a small tube (a cannula) into one of your veins and connects the drip to it.

You might need a central line. This is a long plastic tube that gives the drugs into a large vein, either in your chest or through a vein in your arm. It stays in while you’re having treatment, which may be for a few months.

Taking your capsules

You must take capsules according to the instructions your doctor or pharmacist gives you.

You should take the right dose, not more or less.

Talk to your specialist or advice line before you stop taking a cancer drug.

When you have cisplatin and Teysuno

You have this chemotherapy combination as a course of several cycles of treatment. Each cycle of treatment lasts 28 days (4 weeks). Depending on your needs, you may have up to 6 cycles of treatment. 

You usually have each cycle of treatment in the following way:

Day 1
  • You have cisplatin as a drip into your bloodstream over about 2 hours
  • You take Teysuno capsules twice a day

You also have other fluids as a drip into your bloodstream before and after you have cisplatin. This helps to keep you hydrated. In total it can take about 6 hours. 

Day 2 to 21
  • You take Teysuno capsules twice a day
Day 22 to 28
  • You have no treatment

You then start a new cycle of treatment. After 6 cycles of cisplatin and Teysuno, you may be able to continue to take Teysuno for as long as it works. 

Tests

You have blood tests before and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.

Side effects

We haven't listed all the side effects. It's very unlikely that you will have all of these side effects, but you might have some of them at the same time.

How often and how severe the side effects are can vary from person to person. They also depend on what other treatments you're having. For example, your side effects could be worse if you're also having other drugs or radiotherapy.

When to contact your team

Your doctor, nurse or pharmacist will go through the possible side effects. They will monitor you closely during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:

  • you have severe side effects 
  • your side effects aren’t getting any better
  • your side effects are getting worse

Early treatment can help manage side effects better. 

Contact your doctor or nurse immediately if you have signs of infection, including a temperature above 37.5C or below 36C.

Common side effects

Each of these effects happens in more than 1 in 10 people (10%). You might have one or more of them. They include: 

Risk of infection 

Increased risk of getting an infection is due to a drop in white blood cells. Symptoms include a change in temperature, aching muscles, headaches, feeling cold and shivery and generally unwell. You might have other symptoms depending on where the infection is.

Infections can sometimes be life threatening. You should contact your advice line urgently if you think you have an infection. 

Breathlessness and looking pale

You might be breathless and look pale due to a drop in red blood cells. This is called anaemia.

Bruising and bleeding

This is due to a drop in the number of platelets in your blood. These blood cells help the blood to clot when we cut ourselves. You may have nosebleeds or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs (known as petechia).

Loss of appetite

You might lose your appetite for various reasons when you are having cancer treatment. Sickness, taste changes or tiredness can put you off food and drinks.

Numbness or tingling in fingers and toes

Numbness or tingling in fingers or toes is often temporary and can improve after you finish treatment. Talk to the team looking after you when you first notice this. 

Diarrhoea or constipation 

Tell your doctor or nurse if you have diarrhoea or constipation. They can give you medicine to help. 

Feeling or being sick

Feeling or being sick is usually well controlled with anti sickness medicines. Avoiding fatty or fried foods, eating small meals and snacks, drinking plenty of water, and relaxation techniques, can all help.

It is important to take anti sickness medicines as prescribed even if you don’t feel sick. It is easier to prevent sickness rather than treating it once it has started.

Tiredness (fatigue)

Tiredness and weakness (fatigue) can happen during and after treatment - doing gentle exercises each day can keep your energy up. Don't push yourself, rest when you start to feel tired and ask others for help.

Occasional side effects

Each of these effects happens in more than 1 in 100 people (1%). You might have one or more of them. They include:

  • not enough fluid in your body (dehydration) that can make you very thirsty and have dark coloured urine
  • low levels of sodium, calcium, magnesium and albumin in your body
  • changes in the levels of potassium in your body that can cause muscle cramps, palpitations and dizziness
  • difficulty sleeping
  • dizziness
  • headaches
  • taste changes that usually goes back to normal when your treatment is over
  • eye problems such as inflammation of the eyes and a blockage in the tear glands
  • hearing loss especially with high pitched sounds
  • heart problems such as high or low blood pressure
  • blood clots in the large veins of your body
  • lung problems such as a cough and difficulty breathing
  • hiccups
  • indigestion and tummy (abdominal) pain
  • dry mouth and mouth ulcers
  • a bleeding in your stomach or bowel
  • liver changes that usually go back to normal when treatment finishes
  • soreness, redness and peeling on palms and soles of feet
  • skin changes such as dry skin, redness and itching
  • hair loss
  • muscle pain
  • changes to the way your kidneys work that can cause swelling of your legs and a reduction in the amount of urine you make
  • weight loss
  • high temperature and chills
  • inflammation of your bowel
  • swelling in your legs and feet caused by a build up of fluid

Rare side effects

Each of these effects happens in fewer than 1 in 100 people (1%). You might have one or more of them. They include:

  • mood changes that can include feeling very sad and depressed
  • breast tenderness and pain in your nipples
  • difficulty getting an erection
  • pain in your chest, back, joints, neck and bones
  • inflammation around the drip site
  • hot flushes
  • memory loss and confusion
  • fits (convulsions)
  • a stroke
  • high blood sugar levels
  • inner ear problems which can affect your balance (vertigo)
  • a blockage in your bowel (obstruction)
  • piles (haemorrhoids)
  • a severe skin reaction that may start as tender red patches which leads to peeling or blistering of the skin. You might also feel feverish and your eyes may be more sensitive to light. This is serious and could be life threatening

Coping with side effects

We have more information about side effects and tips on how to cope with them.

What else do I need to know

Other medicines, foods and drinks 

Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.

Pregnancy and contraception 

This treatment may harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment and for at least 6 months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.

Loss of fertility 

You may not be able to become pregnant or father a child after treatment with these drugs. Talk to your doctor before starting treatment if you think you may want to have a baby in the future. Men may be able to store sperm before starting treatment. Women may be able to store eggs or ovarian tissue but this is rare.

Breastfeeding 

Don’t breastfeed during this treatment because the drug may come through into your breast milk.

Treatment for other conditions 

Always tell other doctors, nurses, pharmacists or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.

Immunisations 

Having immunisations 

Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having. Ask your doctor or pharmacist how long you should avoid live vaccinations.

In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and the shingles vaccine (Zostavax).

You can:

  • have other vaccines, but they might not give you as much protection as usual
  • have the flu vaccine (as an injection)

Contact with others who have had immunisations 

You can be in contact with other people who have had live vaccines as injections. Avoid close contact with people who have recently had live vaccines taken by mouth (oral vaccines) such as the oral typhoid vaccine.

If your immune system is severely weakened, you should avoid contact with children who have had the flu vaccine as a nasal spray. This is for 2 weeks following their vaccination.

Babies have the live rotavirus vaccine. The virus is in the baby’s poo for about 2 weeks and could make you ill if your immunity is low. Get someone else to change their nappies during this time if you can. If this isn't possible, wash your hands well after changing their nappy.

More information about this treatment

For further information about this treatment go to the electronic Medicines Compendium (eMC) website.

You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.

Last reviewed: 
04 Dec 2018
  • Electronic Medicines Compendium
    Accessed December 2018

  • Fluorouracil versus combination of irinotecan plus cisplatin versus S-1 in metastatic gastric cancer: a randomised phase 3 study

    N. Boku and other.

    The Lancet Oncology, 2009. Vol 10, Pages 1063–1069

  • Multicenter phase III comparison of cisplatin/S-1 with cisplatin/infusional fluorouracil in advanced gastric or gastroesophageal adenocarcinoma study: the FLAGS trial

    J. A. Ajani and others.

    Journal of Clinical Oncology, 2010. Vol 28, Number 9, Pages 1547-1553.

  • Immunisation against infectious disease: Chapter 6: General contraindications to vaccination
    Public Health England
    First published: March 2013 and regularly updated on the Gov.UK website

  • Tegafur/gimeracil/oteracil 15mg/4.35mg/11.8mg and 20mg/5.8mg/15.8mg hard capsules (Teysuno®)
    Scottish Medicines Consortium (SMC)​, 2012

  • Tegafur/gimeracil/oteracil (Teysuno®) 15 mg/4.35 mg/11.8 mg and 20 mg/5.8 mg/15.8 mg capsules

    All Wales Medicines Strategy Group (AWMSG), 2016 

Information and help