Purinethol

Common Name

mercaptopurine

How does this medication work? What will it do for me?

Mercaptopurine belongs to the group of cancer-fighting medications known as antineoplastics, and specifically to the group of antineoplastics known as antimetabolites. Mercaptopurine fights cancer by preventing the growth of cancer cells, which eventually results in their destruction. Mercaptopurine is usually used to treat leukemia. Sometimes mercaptopurine is used along with other cancer medications.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

Each pale yellow to buff, scored tablet, imprinted with "PURINETHOL" and "O4A", contains mercaptopurine 50 mg. Nonmedicinal ingredients: corn starch, lactose, magnesium stearate, potato starch, and stearic acid.

How should I use this medication?

The recommended dose of mercaptopurine varies according to the specific disease being treated, the response to therapy, the other medications used, the stage of the disease, and the person's body size or weight. A typical starting dose for adults is between 100 mg and 200 mg daily, while an average 5 year old child could typically start on a dose of 50 mg daily. The appropriate dose of mercaptopurine is usually taken by mouth as a single dose on a daily basis.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor. If you vomit shortly after taking the medicine, contact your doctor for instruction on whether to take more medication or not. If you miss a dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.

Your doctor may want you to drink extra fluids while taking this medication in order to help you pass more fluid and protect your kidneys.

As well as interfering with the genetic material DNA of cancer cells, mercaptopurine can interfere with some of your normal cells. This can cause a number of side effects such as mouth sores. Keep track of any side effects and report them to your doctor as suggested in the section, "What side effects are possible with this medication?"

Store this medication at room temperature, and protect it from excessive heat, direct light, and moisture.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not take this medication if you:

• are allergic to mercaptopurine or any ingredients of this medication
• have been resistant to the effects of mercaptopurine or thioguanine in the past

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• darkening of skin
• diarrhea
• headache
• nausea and vomiting
• skin rash and itching
• weakness

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• appetite loss
• joint pain
• sores in mouth or on lips
• swelling of feet or lower legs
• unusual tiredness or weakness
• yellow eyes or skin

Stop taking the medication and seek immediate medical attention if any of the following occur:

• black, tarry stools or blood in stools or urine
• cough or hoarseness
• fever or chills
• lower back or side pain
• painful or difficult urination
• pinpoint red spots on skin
• unusual bleeding or bruising

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Blood clotting: This medication can reduce the number of platelet cells in the blood. Platelets help the blood to clot, and a shortage could make you bleed more easily. Tell your doctor of any signs that your blood is not clotting as quickly. Such symptoms may include black and tarry stools, blood in the urine, easy bruising, or cuts that won't stop bleeding.

Gout: This medication increases the blood levels of uric acid, which may increase the risk of gout.

Infection and vaccines: As well as killing cancer cells, this medication can reduce the number of cells that fight infection in the body (white blood cells). Avoid contact with people with contagious infections and tell your doctor if you begin to notice signs of an infection, such as fever or chills. Also tell your doctor if you have been vaccinated, or are planning to be vaccinated with a live vaccine.

Pregnancy: There is a possibility of birth defect if either the man or woman is using mercaptopurine at the time of conception, or if it is taken during pregnancy. Effective birth control should be practiced while using this medication. This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while you or your partner are taking this medication, contact your doctor immediately.

Breast-feeding: This medication passes into breast milk. Because of the risks associated with mercaptopurine, a decision should be made to cease breast-feeding or discontinue the medication, taking into account the importance of the medication to the mother.

What other drugs could interact with this medication?

There may be an interaction between mercaptopurine and any of the following:

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

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