What is Mercaptopurine?

  • Mercaptopurine is an anti-cancer drug used either alone or in combination with other approved anti- cancer drugs for treatment of acute lymphoblastic leukaemia (ALL).
  • Mercaptopurine is a chemotherapy drug which is available in tablet form for oral administration.
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Uses of Mercaptopurine:

  • Indicated for maintenance therapy of acute lymphoblastic leukemia
  • Mercaptopurine is not effective for treatment of acute myelogenous leukemia, chronic lymphatic leukemia and lymphomas (hodgkin’s lymphoma).
Know more: Zanaflex Uses

How does Mercaptopurine work?

  • The exact mechanism of action of Mercaptopurine is unknown but it works by slowing or stopping the growth of cancer cells.

How to Take Mercaptopurine?

  • Mercaptopurine is available as 50mg scored tablet which has to be administered once daily with plenty of fluids.

Common Dosage for Mercaptopurine:

  • The recommended maintenance dose of Mercaptopurine is 1.5-2.5mg/kg/day as a single dose.
  • Mercaptopurine is rarely administered as a single agent for maintenance of acute leukaemia. For superior result, it can be combined with other anti-cancer drugs like methotrexate.
  • Dose reduction is advised for patients with liver and kidney disease and in patients with little or no thiopurine S-methyltransferase (TPMT) activity.
Know more: Kenalog Dosage

When to avoid Mercaptopurine and precautions to take?

Mercaptopurine should not be used or should be used with caution when:

  • Allergic to any of its components
  • Patients with liver and kidney disease
  • Pregnant and lactating females
  • Patients with immunosuppression

Side effects of Mercaptopurine?

  • Mercaptopurine may produce multiple side effects, although they may not be common in all the patients. Commonly observed side effects include:
  • Nausea
  • Vomiting
  • Anorexia
  • Immunosuppression (decreased WBC, RBC and platelet count)
  • Alopecia
  • Skin rash
  • Hyperpigmentation
  • Kidney related side effects (hyperuricemia)
Read more: Mefloquine Side Effects | Namenda Side Effects

Effects on organs?

  • Mercaptopurine can lead to immunosuppression and thus increased chances of infection. Continuous monitoring of blood cells should be done prior to and at intervals after treatment.
  • Mercaptopurine can lead to kidney and liver damage so it should be used with caution in patients already having kidney and liver disease.

Reported Allergic Reactions?

  • Tell your doctor if you are allergic to any of its ingredients.
  • Allergy with Mercaptopurine may exhibit following symptoms:
  • Rash
  • Chest tightness
  • Itching
  • Shortness of breath
  • Swelling of face, lips, tongue, or throat.

Drug Interactions to Be Careful About

Consult your doctor before administering any other drugs concomitantly with Mercaptopurine. All the possible drug interactions might not be listed here. Few important ones include:

  • Allopurinol
  • Warfarin
  • Mesalazine
  • Sulphasalazine
  • Rituximab

Shows Effects / Results In:

  • The time required by Mercaptopurine to show its desired effect varies from person to person and depends on the clinical situation.

Storage of Mercaptopurine

  • Storage at room temperature away from direct heat and light.
  • Keep medicines away from children and pets.

Pro Tips When Taking Mercaptopurine:

  • Patients with long term use of Mercaptopurine are associated with increased rate of opportunistic infections which may sometimes be serious and fatal.
  • Kidney related side effects observed with Mercaptopurine can be minimized by increased hydration and urine alkalinisation.

Frequently Asked Questions

Is Mercaptopurine addictive?

  • No such tendency has been reported.

Can I have Mercaptopurine with alcohol?

  • Interaction of Mercaptopurine with alcohol is unknown. But it may increase the incidence of hepatic (liver) damage when administered concomitantly.

Any particular food item to be avoided?

  • No such interaction with food products observed.

Can I have Mercaptopurine when Pregnant?

  • Mercaptopurine is contraindicated in pregnant women.

Can I have Mercaptopurine when feeding a baby?

  • Women should be advised not to administer Mercaptopurine while lactating.

Can I drive after taking Mercaptopurine?

  • Mercaptopurine does not usually affect your ability to drive.

What happens if I overdose on Mercaptopurine?

  • It should not be administered in more than prescribed dose or frequency.
  • In cases of over dosage, observe the patient and supportive therapy is administered.

What happens if I eat expired Mercaptopurine?

  • The medicine may not work as well as the potency of the medicines decreases and also it may lead to some adverse effects.

What happens if I miss a dose of Mercaptopurine?

  • Always consume the missed dose as soon as you remember. But, if it is already time for the next dose – do not double the dose.

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