Mercaptopurine 50mg

Antineoplastic; Antimetabolite; Immunosuppressant

CSA NA – FDA Approved – REMS (N) – Can Ship

Mercaptopurine is a purine antagonist and blocks the incorporation of purine nucleotides into DNA and RNA essentially inhibiting their synthesis.

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

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

Immunologic: Immunosuppression

Infection: Infection

Respiratory: Pulmonary fibrosis