Trifluridine: Uses, Dosage, Side Effects and More

This information is not country-specific. Please refer to the Hong Kong prescribing information.

Generic Medicine Info

Indications and Dosage

Ophthalmic
Primary herpes simplex keratoconjunctivitis, Recurrent herpes simplex virus epithelial keratitis

Adult: As 1% ophthalmic solution: Instil 1 drop into the affected eye(s) 2 hourly while awake until complete re-epithelialisation of corneal ulcer occurs. Max dose: 9 drops daily. After re-epithelialisation, instil 1 drop into the affected eye(s) 4 hourly while awake for a further 7 days (recommended minimum dose: 5 drops daily). If no signs of improvement after 7-14 days, consider other forms of therapy. Treatment duration should not exceed a total of 21 days.
Child: ≥6 years Same as adult dose.

Contraindications

Hypersensitivity.

Special Precautions

Children. Pregnancy and lactation.

Adverse Reactions

Significant: Mild, transient local irritation of the conjunctiva and cornea.
Eye disorders: Palpebral oedema, superficial punctate keratopathy, epithelial keratopathy, stromal oedema, keratitis sicca, hyperaemia.
Immune system disorders: Hypersensitivity reactions.
Investigations: Increased IOP.

Action

Description:
Mechanism of Action: Trifluridine is a fluorinated pyrimidine nucleoside which is active against herpes simplex virus types 1 and 2 (HSV-1 and HSV-2), vaccinia virus, cytomegalovirus, and some adenoviruses. It irreversibly inhibits thymidylate synthetase (an enzyme necessary for DNA synthesis) and incorporates into viral DNA in place of thymidine, thereby interfering with viral replication.
Pharmacokinetics:
Absorption: Absorbed through the cornea; increased intraocular penetration in the presence of inflammation or damage.
Excretion: Elimination half-life: Approx 12 minutes.

Chemical Structure

Storage

Store between 2-8°C. Do not freeze.

MIMS Class

Eye Anti-Infectives & Antiseptics

ATC Classification

S01AD02 - trifluridine ; Belongs to the class of antiinfectives, antivirals. Used in the treatment of eye infections.

References

Brayfield A, Cadart C (eds). Trifluridine. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 07/07/2025.

Trifluridine Ophthalmic Solution, 1 % (Sandoz Inc). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 07/07/2025.

Trifluridine. Gold Standard Drug Database in ClinicalKey [online]. Elsevier Inc. https://www.clinicalkey.com. Accessed 14/07/2025.

Trifluridine. UpToDate Lexidrug, AHFS DI (Adult and Pediatric) Online. American Society of Health-System Pharmacists, Inc. Waltham, MA. UpToDate, Inc. https://online.lexi.com. Accessed 07/07/2025.

Trifluridine. UpToDate Lexidrug, Lexi-Drugs Multinational Online. Waltham, MA. UpToDate, Inc. https://online.lexi.com. Accessed 07/07/2025.

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