Description: Antineoplastic; Antimetabolite; Immunosuppressant
CSA NA – FDA Approved – REMS (N) – Can Ship
How Does It Work
Mercaptopurine is a purine antagonist and blocks the incorporation of purine nucleotides into DNA and RNA essentially inhibiting their synthesis.
Indications For Use
Officially indicated for use in acute lymphoblastic leukemia. It is also prescribed off-label for use in acute promyelocytic leukemia, Crohn disease, lymphoblastic lymphoma, and ulcerative colitis.
Bone marrow suppression
Risk of hematologic toxicity in patients with hepatic impairment
Can cause infections, macrophage activation syndrome, malignancy
Can cause photosensitivity
Use with caution in patients with hepatic and renal impairment
Acute, lymphoblastic leukemia
Oral: Take 1.5mg/kg to 2.5mg/kg once daily
Pharmacist Tips On Using
How to Take 6-Mercaptopurine, Purinethol/Purixan: Take on an empty stomach at the same time each day.
The frequency of side effects is not defined:
Central Nervous System: Malaise (5% to 20%), drug fever
Dermatologic: Skin rash (5% to 20%), hyperpigmentation (<5%), urticaria (<5%), alopecia
Endocrine & Metabolic: Hyperuricemia (<5%)
Gastrointestinal: Anorexia (5% to 20%), diarrhea (5% to 20%), nausea (5% to 20%; minimal), vomiting (5% to 20%; minimal), oral lesion (<5%), pancreatitis (<5%), cholestasis, mucositis, sprue-like symptoms, stomach pain, ulcerative bowel lesion Genitourinary: Oligospermia, renal toxicity, uricosuria Hematologic & Oncologic: Bone marrow depression (>20%; onset 7 to 10 days; nadir 14 days; recovery: 21 days), anemia, granulocytopenia, hemorrhage, hepatosplenic T-cell lymphomas, leukopenia, lymphocytopenia, metastases, neutropenia, thrombocytopenia
Hepatic: Hyperbilirubinemia (<5%), increased serum transaminases (<5%), ascites, hepatic encephalopathy, hepatic fibrosis, hepatic injury, hepatic necrosis, hepatomegaly, hepatotoxicity, intrahepatic cholestasis, jaundice, toxic hepatitis
Respiratory: Pulmonary fibrosis