Generic Name and Formulations:
Mercaptopurine (6-MP) 50mg; scored tabs.
Indications for PURINETHOL:
Maintenance therapy of acute lymphatic leukemia as part of a combination regimen.
Adults and Children:
1.5–2.5mg/kg per day as a single dose. Concomitant allopurinol: reduce dose of mercaptopurine to 1/3–1/4 of the usual dose. TPMT-deficient, renal or hepatic impairment: reduce dose, see literature.
Prior resistance to mercaptopurine.
Not effective in CNS leukemia, acute myelogenous leukemia, chronic lymphocytic leukemia, the lymphomas (including Hodgkin's disease), or solid tumors. Renal impairment. Monitor liver function tests weekly at start of therapy, then monthly thereafter; discontinue if hepatotoxicity occurs. Pre-existing liver disease (monitor more frequently). Obtain CBCs with differential, hemoglobin, hematocrit, platelets; discontinue if severe bone marrow suppression occurs. Thiopurine-S-methyltransferase (TPMT) deficient: increased risk of myelosuppression, consider genotypic/phenotypic testing. Pregnancy (Cat. D); esp. 1st trimester, nursing mothers: not recommended.
Increased risk of bone marrow suppression with allopurinol, aminosalicylate derivatives (eg, olsalazine, mesalazine, sulphasalazine), trimethoprim-sulfamethoxazole. Antagonizes warfarin. Caution with concomitant hepatotoxic agents.
Myelosuppression, hyperuricemia/hyperuricosuria, GI upset, intestinal ulceration, rash, hyperpigmentation, alopecia, oligospermia; hepatotoxicity, infection, immunosuppression.
Psychiatry Advisor Articles
- Continuing Research, Emerging Treatments Hold Promise for Treating Anorexia Nervosa
- ACOG Update: Marijuana Use Discouraged During Pregnancy, Breastfeeding
- Asenapine Prevents Recurrence of Mood Events in Bipolar Disorder
- Depression Profiles in Patients With Type 1 Diabetes vs Type 2 Diabetes
- Purpose, Questions of Social Interaction Lead Physicians to Delay Retirement
- CBT, Acceptance Commitment Therapy Helpful for Those With Chronic Pain
- Suicidal Behavior, Thoughts Associated With Perfectionist Tendencies
- Depression Reduced by Social Belonging, Feelings of Inclusion
- Sleep Disturbance May Be Causal Factor in Psychotic Experiences
- Is Antidepressant Use in Pregnancy Tied to Psychiatric Disorders in Offspring?
- Cardiovascular Risk Management May Slow Neurocognitive Decline in HIV
- Maintenance rTMS for Treatment-Resistant Depression
- New Study Compares Opioid Dependence Relapse Treatments
- Increase Use of Nursing Home for Patients With Cognitive Impairment Category
- Venlafaxine XR Safe, Effective in Treating Generalized Anxiety Disorder