mercaptopurine

What is the most important information I should know about mercaptopurine?

What is mercaptopurine?

Mercaptopurine is used to treat acute lymphoblastic or lymphocytic leukemia. Mercaptopurine is sometimes given with other cancer medications.

Mercaptopurine may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking mercaptopurine?

Using mercaptopurine may also increase your risk of developing other types of cancer. Ask your doctor about your specific risk.

Tell your doctor if you have ever had:

• liver disease;
• kidney disease;
• an inherited condition in which your body cannot produce enough of the enzyme thiopurine methyltransferase (TPMT);
• any type of viral, bacterial, or fungal infection; or
• ulcerative colitis (treated with mesalamine, sulfasalazine, or similar medicines).

How should I take mercaptopurine?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Mercaptopurine can increase your risk of bleeding, infection, or liver problems. You will need frequent medical tests. Your next dose may be delayed based on the results.

You may be given other medication to help prevent serious side effects on your kidneys. Keep using this medicine for as long as your doctor has prescribed.

What happens if I miss a dose?

What happens if I overdose?

Early symptoms of an overdose may include loss of appetite, nausea, vomiting, or diarrhea. Later symptoms may include fever or flu-like symptoms.

What should I avoid while taking mercaptopurine?

Do not receive a "live" vaccine while using mercaptopurine. The vaccine may not work as well and may not fully protect you from disease. Live vaccines include measles, mumps, rubella (MMR), polio, rotavirus, typhoid, yellow fever, varicella (chickenpox), zoster (shingles), and nasal flu (influenza) vaccine.

Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.

What are the possible side effects of mercaptopurine?

• low blood cell counts --fever, chills, tiredness, mouth sores, skin sores, easy bruising, unusual bleeding, pale skin, cold hands and feet, feeling light-headed or short of breath;
• liver problems --loss of appetite, nausea, vomiting, diarrhea, upper stomach pain, swelling in your midsection, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or
• symptoms of lymphoma --fever, night sweats, tiredness, stomach bloating, feeling full, weight loss.

Common side effects may include:

• low blood cell counts;
• bruising or bleeding;
• nausea, vomiting, loss of appetite;
• diarrhea;
• rash, changes in skin color;
• hair loss; or
• general ill feeling.

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 other drugs will affect mercaptopurine?

Mercaptopurine can harm your liver, especially if you also use certain medicines for infections, tuberculosis, depression, birth control, hormone replacement, high cholesterol, heart problems, high blood pressure, seizures, pain, or arthritis (including Tylenol, Advil, Motrin, or Aleve).

Tell your doctor about all your other medicines, especially:

• allopurinol;
• olsalazine, mesalazine, sulfasalazine or similar medicines;
• sulfamethoxazole and trimethoprim; or
• warfarin (Coumadin, Jantoven).

This list is not complete. Other drugs may affect mercaptopurine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Where can I get more information?

Your doctor or pharmacist can provide more information about mercaptopurine.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2023 Cerner Multum, Inc. Version: 11.02. Revision date: 3/25/2020.