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Home > Drug Category > Cancer Medications > Purinethol and Equivalent

Purinethol (Mercaptopurine) Information

Purinethol, which contains the active ingredient mercaptopurine, is a chemotherapy medication known as an antimetabolite. It is primarily used to treat acute lymphoblastic leukemia (ALL) in both children and adults, often as part of a maintenance therapy program to keep the cancer in remission. Mercaptopurine is also sometimes used off-label to manage certain inflammatory bowel diseases (IBD), such as Crohn’s disease or ulcerative colitis, when other treatments have not been effective. In IBD, it is considered a second-line immunosuppressant and requires careful monitoring. The medication is taken by mouth as a tablet, usually once daily. Take this drug at the same time each day to ensure consistent absorption. Your doctor may advise you to take it either consistently with food or consistently on an empty stomach to avoid fluctuations in how much medicine enters your system.

Mercaptopurine is a purine analogue. It interferes with the production of DNA and RNA in rapidly dividing cells, such as cancer cells, by inhibiting purine nucleotide synthesis. This prevents cancer cells from growing and dividing, ultimately leading to their death.

Purinethol Side Effects

Purinethol is generally well-tolerated, but common side effects may occur as your body adjusts to the medication. Commonly reported effects include nausea, vomiting, loss of appetite, and a general feeling of tiredness or weakness. You may also experience mild skin rashes, thinning hair, or mouth sores.

More serious side effects can occur and require immediate medical attention. Stop taking the medication and seek help if you experience:
• Blood cell changes: Fever, chills, sore throat, or unusual bruising and bleeding, which may indicate a drop in white blood cells or platelets.
• Liver problems: Yellowing of the skin or eyes (jaundice), dark urine, or pain in the upper right side of the stomach.
• Severe allergic reactions: Swelling of the face, lips, or tongue; hives; or significant difficulty breathing.
• Severe digestive issues: Persistent or bloody diarrhea and severe abdominal pain.
• Signs of infection: Any new fever or signs of illness, as the medication can suppress the immune system.

Purinethol Precautions

Do not use Purinethol if you have a known allergy to mercaptopurine or any of the inactive ingredients in the medication. Before starting treatment, inform your doctor of your complete medical history, especially if you have pre-existing liver disease or a genetic condition called TPMT deficiency, which makes the body process this drug much more slowly than normal.

Tell your doctor about all medications you take, as Purinethol has significant drug interactions. Purinethol has a very dangerous interaction with allopurinol (used for gout); taking these together can cause the levels of Purinethol to rise to toxic levels. Your doctor must significantly lower your dose if you are taking both. Also, inform your doctor if you are taking blood thinners like warfarin.

Inform your doctor if you are pregnant, planning to become pregnant, or breastfeeding. Purinethol can cause serious harm to a developing fetus and should not be used during pregnancy unless the benefits clearly outweigh the risks. Women of childbearing age should use effective contraception during treatment. Breastfeeding is not recommended while taking this medication, as it can pass into breast milk and potentially harm the infant.

Take Purinethol exactly as prescribed. Do not change your dose without consulting your doctor, as they will use frequent blood tests to find the "just right" amount for your body. If you miss a dose, contact your doctor for instructions rather than taking a double dose. Because this is a chemotherapy drug, caregivers should wear gloves when handling the tablets to avoid skin contact. Store the tablets at room temperature in a dry place, away from children and pets.

Do I need a prescription to order Purinethol?

Yes, a prescription is required from your physician to order Purinethol.