February 7, 2016
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"The U.S. Food and Drug Administration today approved Imbruvica (ibrutinib) to treat patients with mantle cell lymphoma (MCL), a rare and aggressive type of blood cancer.

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Major Toxicities

Inform patients and caregivers that the major toxicities of PURIXAN are related to myelosuppression, hepatotoxicity, and gastrointestinal toxicity. Advise patients to contact their physician if they experience fever, sore throat, jaundice, nausea, vomiting, signs of local infection, bleeding from any site, or symptoms suggestive of anemia.


Advise women of childbearing potential to avoid becoming pregnant.


Inform patients and caregivers to shake the bottle vigorously for at least 30 seconds to ensure the oral suspension is well mixed. PURIXAN (mercaptopurine) oral suspension is pink in color but because it contains a natural fruit extract, the color of the suspension may vary from pink to brown. Instruct patients and caregivers that once opened, PURIXAN should be used within 6 weeks.

Tell patients and caregivers to ensure that the pharmacist includes a commercially available oral syringe and suitable adaptor, based on the dosing requirement for an individual patient.

If the syringe is intended for multiple use, instruct patients and caregivers to: wash the syringe with warm 'soapy' water and rinse well; hold the syringe under water and move the plunger up and down several times to make sure the inside of the syringe is clean; ensure the syringe is completely dry before use of the syringe again for dosing; and store the syringe in a hygienic place with the medicine.

Last reviewed on RxList: 5/9/2014
This monograph has been modified to include the generic and brand name in many instances.

Report Problems to the Food and Drug Administration


You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.

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