Drug Interaction:
Interacting drugs- summary -
+Mercaptopurine
Allopurinol when administered concomittantly with mercaptopurine , reduce the mercaptopurine to 1/3 to 1/4 the usual dose . Failure to observe dosage reduction will delay catabolosim of mercaptopurine and increase likelihood of severe toxiicity
Trimethoprin-sulfomethoxazole when coadmin with mercaptopurine enhanced marrow suppression has occurred
Indication:
Proprietary Name- PURIXAN*
Established Name- Mercaptopurine
Applicant- NOVA LABORATORIES LTD.
Indication- Indicated for the treatment of patients with Acute
Lymphoblastic Leukemia (ALL) as part of combination
regimen
Approval Date- 28/4/2014
Approved by U.S.FDA (Ref- FDA approved List- 2014)
Acute lympatic leukemia.
Adverse Reaction:
Myleosupression. Hyperuricaemia, bone marrow toxicity, Anorexia,diarrhoea, leucopenia, Thrombocytoenia, Hepatic injury, jaundice, Intestinal ulceration, Immunosupression, Intestinal pneumonitis.
Contra-Indications:
Breast feeding.
Special precautions:
Hepatic or renal dysfunction. Use only specialists direction. Support facilities must be available in case of bone marrow aplasia.
The drug is potentially mutagenic, teratogenic and carcinogenic.
Dosages/ Overdosage Etc:
Indications:
Acute lympatic leukemia.
Dosage:
Individualise dose. Usual dose - 2.5mg/kg/day( 100 to 2OOmg for average
Adult and 50mg for average 5 years old).
Continue daily for several weeks or more.
Patient Information:
Re - USP PDI Vol II 17th Edition (1997)
1.Allergies-
Tell your doctor if you have ever had any unusual or allergic reaction to
mercaptopurine.
2.Pregnancy-
Tell your doctor if you are pregnant or intend to have children. There is a chance
that this medicine may cause birth defects if either the male or female is taking it
at the time of conception or it is taken during pregnancy.
3. Breast-feeding-
Tell your doctor if you are breast feeding or if you intend to breast feed during
treatment with this medicine. Breast feeding is not generally recommended
while you are taking it.
4.Children-
Although there is no specific information comparing use of mercaptopurine in children
with use in other age groups, this medicine is not expected to cause different side
effects or problems than it does in adults.
5.Older adults-
There is no specific information comparing use of mercaptopurine in the elderly with use
in other age groups
6. Other medicines-
Tell your doctor if you are using any of the following-
Acetoamoniphen or
Anabolic steroids or
Androgens or
Anti-infectives by mouth or
Antithyroid agents or
Carbamazeoine or
Chloroquine or
Dantrolene or
Disulfram or
Estrogens or
Gold salts or
Methyldopa or
Naltrexone or
Oral contraceptives or
Phenytoin or
Valproic acid - risks of unwanted side effects increased
7. Other medical problems-
Make sure you tell your doctor if you have any other medical problems
especially-
Chicken pox or
Herpes zoster - risk of severe disease sepreading to other parts of the body
Gout or
Kidney stones - mercaptopurine may increase the levels of uric acid in the body,
which can cause gout or kidney stones.
Liver disease- effects of mercaptopurine may be increased because of slower
removal the body.
Pharmacology/ Pharmacokinetics:
Pharmacology:
Mercaptopurine (6-MP) competes with hypoxanthine and guanine for the enzyme hypoxanthine-guanine phosphoribosyltransferase and is converted to thionosinic acid(TIMP). This intracellular nucleotide inhibits several reactions involving inosinic acid(IMP).
Pharmacokinetics:
The absorption of oral mercaptopurine is complete.
Interaction with Food:
None reported.
Pregnancy and lactation:
Refer methotrexate- antimetabolites
Manufacturer Details