- March 15, 2022
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Brand Name :
Hanixol
(United States) [Available]Synonyms :
6 mercaptopurine monohydrate, 6 mercaptopurine
Class :
Antineoplastics, Antimetabolite; Immunomodulators
Dosage Forms & Strengths:
Tablet
50 mg
Oral Suspension
20 mg per ml
acute lymphoblastic leukemia(All)
Induce the dose of 2.5 mg/kg orally daily
Usually, it is 100-200 mg orally each day in an average adult
May increase the dose by 5 mg/kg after every 4 weeks
The maintenance dose is 1.5-2.5 mg/kg orally each day
Off-Label 1 to 1.5 mg per kg orally every night before bedtime
Dosage Forms & Strengths:
Tablet
50 mg
Oral suspension (Purixan)
20 mg per ml
acute lymphoblastic leukemia(All)
The induction dose is 1.25-2.5 mg/kg (50-75 mg/m²) orally each day
The maintenance dose is 1.5-2.5 mg/kg orally each day in combination with methotrexate
Reduce the dose by 75% if there is concomitant administration of allopurinol
Reduce dose in case of renal impairment
Refer to the adult dosing
when given simultaneously with mercaptopurine, it decreases the catabolic activity of the same
the antagonistic effect of adenovirus decreases with mercaptopurine
shows immunosuppression by synergistic activity between both risk of infection increases on administering both the drugs simultaneously
the BCG vaccine shows a diminished activity due to the antagonistic activity of mercaptopurine on BCG risk of infection increases on administering both the drugs simultaneously
either of the drugs increases the effect of one another causing immunosuppression risk of infection increases on administering both the drugs simultaneously
the synergistic effect is shown between acalabrutinib and mercaptopurine, leading to an increased risk of myelosuppression risk of infection increases on administering both the drugs simultaneously adalimumab: synergistic effect; causing immunosuppression risk of infection increases on administering both the drugs simultaneously
increase in immunosuppression due to synergism risk of infection increases on administering both the drugs simultaneously
the metabolism is decreased by allopurinol, and the activity of mercaptopurine is increased risk of infection increases on administering both the drugs simultaneously
both, if used simultaneously, show immunosuppression risk of infection increases on administering both the drugs simultaneously
the antagonistic effect of mercaptopurine over anthrax decreases its effect risk of infection increases on administering both the drugs simultaneously
anti thymocyte globulin equine
risk of getting infection increases, when administered together, increases the immunosuppression effect risk of infection increases on administering both the drugs simultaneously
anti thymocyte globulin rabbit
risk of getting infection increases, when administered together, increases the immunosuppression effect
the drug interaction between the two is not clear yet; the mercaptopurine increases while the astragalus decreases the effect of immunosuppression risk of infection increases on administering both the drugs simultaneously
both the drugs increase the effect of immunosuppression risk of infection increases on administering both the drugs simultaneously
both the drugs increase the effect of immunosuppression risk of infection increases on administering both the drugs simultaneously
both the drugs increase the effect of immunosuppression risk of infection increases on administering both the drugs simultaneously
both the drugs increase the effect of immunosuppression risk of infection increases on administering both the drugs simultaneously
the immunosuppressive effects of the cholera vaccine are decreased by mercaptopurine risk of infection increases on administering both the drugs simultaneously
both the drugs increase the effect of immunosuppression risk of infection increases on administering both the drugs simultaneously
the immunosuppression effect of the dengue vaccine is decreased by mercaptopurine risk of infection increases on administering both the drugs simultaneously
risk of infection is increased due to immunosuppression caused by the administration of both the drugs
both the drugs increase the effect of immunosuppression risk of infection increases on administering both the drugs simultaneously
both the drugs increase the effect of immunosuppression risk of infection increases on administering both the drugs simultaneously
both the drugs increase the effect of immunosuppression risk of infection increases on administering both the drugs simultaneously
both the drugs increase the effect of immunosuppression risk of infection increases on administering both the drugs simultaneously
type b Haemophilus influenzae vaccine
the antagonistic effect caused by mercaptopurine decreases the effect of the Haemophilus vaccine risk of infection increases on administering both the drugs simultaneously
both the drugs increase the effect of immunosuppression risk of infection increases on administering both the drugs simultaneously
both the drugs decrease the effect of immunosuppression when used simultaneously risk of infection increases on administering both the drugs simultaneously
both the drugs increase the effect of immunosuppression risk of infection increases on administering both the drugs simultaneously
mercaptopurine on interacting with this vaccine decreases the vaccine's effect by antagonistic activity risk of infection increases on administering both the drugs simultaneously
both the drugs increase the effect of immunosuppression risk of infection increases on administering both the drugs simultaneously
both the drugs increase the effect of immunosuppression risk of infection increases on administering both the drugs simultaneously
mercaptopurine on interacting with this vaccine decreases the vaccine's effect by antagonistic activity risk of infection increases on administering both the drugs simultaneously
mercaptopurine on interacting with this vaccine decreases the vaccine's effect by antagonistic activity risk of infection increases on administering both the drugs simultaneously
both the drugs increase the effect of immunosuppression risk of infection increases on administering both the drugs simultaneously
both the drugs increase the effect of immunosuppression risk of infection increases on administering both the drugs simultaneously
both the drugs increase the effect of immunosuppression risk of infection increases on administering both the drugs simultaneously
both the drugs increase the effect of immunosuppression risk of infection increases on administering both the drugs simultaneously
typhoid polysaccharide vaccine
mercaptopurine on interacting with this vaccine decreases the vaccine's effect by antagonistic activity risk of infection increases on administering both the drugs simultaneously
both the drugs increase the effect of immunosuppression risk of infection increases on administering both the drugs simultaneously
mercaptopurine on interacting with this vaccine decreases the vaccine's effect by antagonistic activity risk of infection increases on administering both the drugs simultaneously
It may enhance and diminish the immunosuppressive effects when combined with maitake
when both the drugs are combined, the risk or severity of adverse effects increases
methotrexate may increase the serum concentration of mercaptopurine
trimetrexate may increase the serum concentration of mercaptopurine
risk of severe infection due to immunosuppressive effects
sulfamethoxazole increases the effect of myelosuppression of mercaptopurine
trimethoprim: they may increase the myelosuppressive effect of mercaptopurine
insignificant or little drug interaction is seen due to synergistic pharmacodynamic activity
the effect of mercaptopurine is increased by synergism
the levels of taurine are decreased by mercaptopurine’s unspecific mechanism of interaction
the synergistic effect of vitamin A shows the enhanced efficacy of mercaptopurine and reduces the toxicity of anticancer drugs
The synergistic effect of vitamin A shows the improved effectiveness of mercaptopurine and reduces the toxicity of anticancer drugs
Actions and Spectrum:
Adverse drug reactions:
Frequency defined:
>10%
Increased value of liver functioning; more than 15%
1% to 10%
Leukopenia
Alopecia
Dizziness
Diarrhea
Rash
Thrombocytopenia
Stomatitis
Vomiting
Nausea
Frequency not defined:
Tinnitus
Eye discomfort
Arthralgias
Hyperpigmentation
Nephrotoxicity
Hyperuricemia
Infection intolerance
Decrease in hematocrit count
Hepatotoxicity
Myelosuppression
Intestinal ulcers
Ulcerative stomatitis
Cough
Chest pain
Chills
Fever
Headache
Anorexia
Fatigue
Black Box Warning:
mercaptopurine is a potent medication that is primarily used to treat acute lymphoblastic leukemia (ALL). However, it is essential to ensure that the patient’s diagnosis is accurate before administering this drug, as it can have serious side effects.
Contraindication/Caution:
Pregnancy warnings:
Not indicated to be administered during pregnancy, as the gestating females who intake mercaptopurine are prone to the risk of stillbirth & miscarriage.
The females of fertile potential should use effective measures of contraception before and after 6 months of initiation and termination of mercaptopurine therapy, respectively
The drug shows a high teratogenic effect as studied in various animal species
Breastfeeding warnings:
The data for medicine and its metabolites secretion in breastmilk is unknown, but for the sake of precaution, females shouldn’t perform lactation during and one week later the treatment after the mercaptopurine dose
Pregnancy Categories:
Pharmacology:
mercaptopurine is inactive until it is metabolized in the liver into its active form, 6-thioguanine. 6-thioguanine is a purine analog that mimics the structure of purines, a type of nitrogen-containing base found in DNA and RNA. By doing so, it interferes with the synthesis of new DNA and RNA molecules, which is necessary for cell growth and division. This mechanism of action is the basis for mercaptopurine’s use as an anti-cancer and immunosuppressive medication.
Pharmacodynamics:
mercaptopurine acts by interfering with DNA and RNA synthesis in cells. The drug is converted into 6-thioguanine, which is incorporated into the DNA and RNA molecules during replication, leading to the inhibition of the synthesis of new DNA and RNA molecules. This inhibition of DNA and RNA synthesis leads to the inhibition of cell division and can result in the death of cancerous cells.
Pharmacokinetics:
The pharmacokinetics of bepotastine are as follows
Absorption
mercaptopurine is well absorbed from the gastrointestinal tract and reaches peak concentrations in the blood within 1-2 hours after oral administration
Distribution
The medication is distributed widely throughout the body and can cross the blood-brain barrier and the placenta.
Metabolism
mercaptopurine is metabolized in the liver into its active metabolite, 6-thioguanine, by the enzyme thiopurine methyltransferase (TPMT).
Elimination
The active metabolite is then further metabolized and excreted in the urine.
Administration:
mercaptopurine is an oral medication that is usually taken once a day, typically in the morning or evening. Take the medication on an empty stomach to reduce the risk of nausea or vomiting.
Patient information leaflet
Generic Name: mercaptopurine
Pronounced: mer-KAP-toe-PURE-een
Why do we use mercaptopurine?
mercaptopurine is a medication that is commonly used to treat certain types of leukemia, including acute lymphoblastic leukemia (ALL) and some types of chronic myeloid leukemia (CML). It is a type of chemotherapy drug that belongs to the class of medications known as purine analogs.
They help to reduce swelling and redness associated with allergies. In addition to its use in leukemia, mercaptopurine may also be used to treat other conditions, such as inflammatory bowel disease (IBD) and rheumatoid arthritis (RA).
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