Article Contents ::
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) |
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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 |