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Purixan Side Effects Center

Medical Editor: John P. Cunha, DO, FACOEP

Last reviewed on RxList 4/7/2016

Purixan (mercaptopurine) Oral Suspension is a nucleoside metabolic inhibitor used to treat patients with acute lymphoblastic leukemia as part of a combination regimen. Common side effects of Purixan include:

  • nausea
  • vomiting
  • diarrhea
  •  skin rash
  • loss of appetite (anorexia)
  • anemia
  • low neutrophils (white blood cells)
  • low levels of platelets in the blood (thrombocytopenia)
  • elevated liver enzymes (transaminases)
  •  elevated bilirubin, and
  • intestinal ulcers

The starting dose of Purixan in multi-agent combination chemotherapy maintenance regimens is 1.5 to 2.5mg/kg (50 to 75 mg/mē) as a single daily dose. Purixan may interact with allopurinol, warfarin, other drugs whose primary or secondary toxicity is myelosuppression, trimethoprim/sulfamethoxazole, and aminosalicylate derivatives (e.g., olsalazine, mesalamine, or sulfasalazine). Tell your doctor all medications and supplements you use. Purixan is not recommended for use during pregnancy. It may cause spontaneous abortion and stillbirth. It is unknown if this drug passes into breast milk. Consult your doctor before breastfeeding.

Our Purixan (mercaptopurine) Oral Suspension 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.

What is Prescribing information?

The FDA package insert formatted in easy-to-find categories for health professionals and clinicians.

Purixan FDA Prescribing Information: Side Effects
(Adverse Reactions)


The following serious adverse reactions are described elsewhere in the prescribing information:

Clinical Studies Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.

Based on multicenter cooperative group ALL trials, the most common adverse reaction occurring in > 20% of patients is myelosuppression including anemia, neutropenia, lymphopenia and thrombocytopenia. Adverse reactions occurring 5 to 20 % include anorexia, nausea, vomiting, diarrhea, malaise, and rash. Rare adverse reactions occuring < 5 % include urticaria, hyperuricemia, oral lesions, elevated transaminases, hyperbilirubinemia, hyperpigmentation, pancreatitis. Oral lesions resemble thrush rather than antifolic ulcerations. Delayed or late toxicities include hepatic fibrosis, hyperbilirubinemia, alopecia, pulmonary fibrosis, oligospermia and secondary malignancies [see WARNINGS AND PRECAUTIONS].

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

Read the entire FDA prescribing information for Purixan (Mercaptopurine Oral Suspension)

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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