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Purinethol

Last reviewed on RxList: 2/2/2017
Purinethol Side Effects Center

Last reviewed on RxList 02/15/2017

Purinethol (mercaptopurine) is a cancer medication that interferes with the growth of cancer cells and slows their growth and spread in the body used to treat acute lymphatic leukemia or acute myelogenous leukemia. Purinethol is usually given together with other cancer medications. Purinethol is available in generic form. Common side effects of Purinethol include:

  • nausea,
  • vomiting,
  • diarrhea,
  • loss of appetite,
  • itching or skin rash, or
  • darkened skin color.

Temporary hair loss may also occur. Normal hair growth should return after treatment with Purinethol has ended. Tell your doctor if you have unlikely but serious side effects of Purinethol including:

  • easy bruising or bleeding,
  • dizziness,
  • fainting,
  • joint pain or swelling,
  • tongue or mouth sores or pain,
  • unusual tiredness, or
  • symptoms of liver disease (such as persistent nausea or vomiting, stomach or abdominal pain, dark urine, yellowing eyes or skin).

The usual daily maintenance dose of Purinethol is 1.5 to 2.5 mg/kg/day as a single dose. Purinethol may interact with allopurinol, azathioprine, blood thinners, cyclosporine, olsalazine or sulfasalazine, sulfamethoxasole and trimethoprim, or thioguanine. Tell your doctor all medications you are taking. Purinethol is not recommended for use during pregnancy. It may harm the fetus, particularly during the first 3 months of pregnancy. It is not known whether this drug passes into breast milk. Because of the possible risk to the infant, breastfeeding while using this drug is not recommended.

Our Purinethol (mercaptopurine) Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Purinethol Consumer Information

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using mercaptopurine and call your doctor right away if you have any of these symptoms of lymphoma:

  • fever, night sweats, weight loss, tiredness;
  • feeling full after eating only a small amount;
  • pain in your upper stomach that may spread to your shoulder;
  • easy bruising or bleeding, pale skin, feeling light-headed or short of breath, rapid heart rate; or
  • nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Stop using mercaptopurine and call your doctor at once if you have any of these other serious side effects:

  • signs of infection (fever, chills, sore throat, body aches, weakness, muscle pain, flu symptoms);
  • severe nausea, vomiting, or diarrhea;
  • bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;
  • pain or burning with urination; or
  • white patches or sores inside your mouth or on your lips.

Less serious side effects may include:

  • vomiting, mild diarrhea;
  • hair loss;
  • mild itching or skin rash; or
  • darkened skin color.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Read the entire detailed patient monograph for Purinethol (Mercaptopurine)

Purinethol Professional Information

SIDE EFFECTS

The principal and potentially serious toxic effects of PURINETHOL are bone marrow toxicity and hepatotoxicity (see WARNINGS and PRECAUTIONS).

Hematologic

The most frequent adverse reaction to PURINETHOL is myelosuppression. The induction of complete remission of acute lymphatic leukemia frequently is associated with marrow hypoplasia. Patients without TPMT enzyme activity (homozygous-deficient) are particularly susceptible to hematologic toxicity, and some patients with low or intermediate TPMT enzyme activity are more susceptible to hematologic toxicity than patients with normal TPMT activity (see WARNINGS, Bone Marrow Toxicity), although the latter can also experience severe toxicity. Maintenance of remission generally involves multiple-drug regimens whose component agents cause myelosuppression. Anemia, leukopenia, and thrombocytopenia are frequently observed. Dosages and also schedules are adjusted to prevent life-threatening cytopenias.

Renal

Hyperuricemia and/or hyperuricosuria may occur in patients receiving PURINETHOL as a consequence of rapid cell lysis accompanying the antineoplastic effect. Renal adverse effects can be minimized by increased hydration, urine alkalinization, and the prophylactic administration of a xanthine oxidase inhibitor such as allopurinol. The dosage of PURINETHOL should be reduced to one third to one quarter of the usual dose if allopurinol is given concurrently.

Gastrointestinal

Intestinal ulceration has been reported. Nausea, vomiting, and anorexia are uncommon during initial administration, but may increase with continued administration. Mild diarrhea and sprue-like symptoms have been noted occasionally, but it is difficult at present to attribute these to the medication. Oral lesions are rarely seen, and when they occur they resemble thrush rather than antifolic ulcerations.

Miscellaneous

The administration of PURINETHOL has been associated with skin rashes and hyperpigmentation. Alopecia has been reported.

Drug fever has been very rarely reported with PURINETHOL. Before attributing fever to PURINETHOL, every attempt should be made to exclude more common causes of pyrexia, such as sepsis, in patients with acute leukemia.

Oligospermia has been reported.

Read the entire FDA prescribing information for Purinethol (Mercaptopurine)

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© Purinethol Patient Information is supplied by Cerner Multum, Inc. and Purinethol Consumer information is supplied by First Databank, Inc., used under license and subject to their respective copyrights.

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