Mercaptopurine

Details About Generic Salt ::  Mercaptopurine 

Main Medicine Class:: Gastrointestinal System   Sub Medicine Class ::  Drugs for Inflammatory Bowel Disease

18A. ANTI-NEOPLASTIC AGENTS in 18. ANTI-NEOPLASTIC AGENTS
MERCAPTOPURINE
ANTIMETABOLITE | ANTI-NEOPLASTIC
also comes under 7H. Drugs for Inflammatory Bowel Disease in 7. Gastrointestinal System
PK: A: Variable & incomplete M: Hepatic & GI mucosa E: Urine (46% as mercaptopurine & metabolites)

Indications & Dose: ACUTE LYMPHOBLASTIC LEUKEMIA PO Adult Induction: 2.5-5mg/kg/day (100-200 mg), MD 1.5-2.5mg/kg/day or 80-100mg/m2/day Child Induction: 2.5-5mg/kg/day or 70-100mg/m2/day, MD 1.5-2.5mg/kg/day or 50-75mg/m2/day | CROHN’S DISEASE PO Adult 1-1.5mg/day, increase to 125mg/day if needed Child 1-1.5mg/day, max 75mg/day

Contra: Hypersensitivity, patients resistance to mercaptopurine/thioguanine, severe liver disease, severe bone marrow suppression

Precautions: Decreased platelet/neutrophil counts, inherited thiopurine methyltransferase deficiency, renal impairment, preexisting bone-marrow depression, contact with skin & eyes avoided

ADR: Serious: Pancreatitis, blood disorders, hepatotoxicity, GI ulcers, painful oral ulcers, hyperuricemia, Others: rash, hyperpigmentation, nausea, vomiting, anorexia, diarrhea

DDI: Serious Warfarin/Acenocoumarol effects decreases markedly by drug, Vaccines (Live) generalized infection may occur, Mesalazine/Allopurinol/Olsalazine/Sulfasalazine hematological effects (toxicity) markedly increases, Natalizumab serious infection may occur, Infliximab trough levels increases by drug

Diet: Empty stomach (1h before/2h after food)

Monitor: CBC with DC & platelet count, LFTs, uric acid, urinalysis, TPMT genotyping

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