Patient Education Quick Reference Guide Diablo Valley Oncology/Hematology Medical Group Phone Number: 925-677-5041WARNING Mercaptopurine should not be used unless you have been diagnosed with acute lymphoblastic leukemia. Uses For This Medication
- Mercaptopurine is used in combination with other chemotherapy medications to treat adults with acute lymphoblastic leukemia.
- Mercaptopurine may also be used to treat adults with inflammatory diseases of the bowel, including Crohn’s disease and ulcerative colitis.
- This medication may also be given for other conditions as determined by your doctor.
- Are allergic to mercaptopurine or any of its components.
- Have taken thioguanine (Tabloid®) previously and your disease did not respond to it.
Blood related precautions
- This medication may temporarily reduce the number of platelets in your blood. This can increase your risk of bleeding. Contact your doctor or healthcare provider if you notice unusual bleeding or bruising, have black or tar-like stools, see blood in your urine, or develop pinpoint red spots on your skin. If your platelet levels become too low, your doctor or healthcare provider may recommend that your treatment be delayed, that you receive a platelet transfusion, and/or that you take medication to help increase the number of platelets in your blood. To lower your chance of bleeding, do not use aspirin, aspirin-containing medications, or aspirin-like medications (for example ibuprofen, naproxen). Use caution with sharp objects like razors and nail cutters, and avoid activities that can cause cuts, bumps and bruises. You should avoid flossing if you have been told you have low platelets.
- This medication may temporarily reduce the number of germ fighting white blood cells in your blood. This can increase your risk of infection. Contact your doctor or healthcare provider promptly if you develop any signs of an infection such as fever, painful urination, chills or a sore throat that doesn’t go away. If your white blood cell levels become too low, your doctor or healthcare provider may recommend that your treatment be delayed and/or you receive medication to increase the number of white cells in your blood. To lower your risk of infection, stay away from crowds and people with colds or other illnesses, wash your hands well and often with soap and water, brush and floss your teeth daily.
- This medication may temporarily lower the number of red cells in your blood. This can increase your risk of anemia. If your red blood cell level becomes low, you may feel tired and weak. If your red blood cell level becomes too low, your doctor or healthcare provider may recommend that your treatment be delayed, that you receive a red blood cell transfusion, and/or you receive a medication to help increase the red cells in your blood.
- Some patients may have an inherited deficiency of the enzyme called thiopurine methyltransferase (TPMT). Patients who have this enzyme deficiency may be more sensitive to the blood related side effects of mercaptopurine. Your doctor or healthcare provider may perform blood tests prior to starting mercaptopurine to determine if you have this enzyme deficiency. The development of additional, or secondary, cancers has been reported in patients receiving mercaptopurine.
- Do not receive any immunizations (vaccinations) while on this medication without your doctor or healthcare provider’s approval. This medication can increase your risk of infection. For certain immunizations, you may develop the infection that the immunization is intended to prevent.
Patient specific precautions
- This medication is safe and effective in the treatment of children. Like adults, children can have liver related problems from this medication.
- Olsalazine (Dipentum®)
- Sulfasalazine (Azulfidine®)
- Warfarin (Coumadin)
- All medications can cause side effects. However, not all patients will experience these side effects. In addition, other side effects not listed can also occur in some patients. You should call your doctor or healthcare provider if you have any questions or concerns while you are on this medication.
- You should contact your doctor or healthcare provider if you experience any side effect(s) which don’t go away, worsen, are serious in nature, or are worrisome to you.
- Side effects can occur when mercaptopurine is given alone or together with other chemotherapy medications. The side effects listed below are those reported in patients who were treated with mercaptopurine alone.
More common side effects
- Decreased platelet, red blood cell, and/or white blood cell levels (see Precautions To Be Aware Of Before Taking This Medication)
- High uric acid levels
- Less common side effects
- Nausea, vomiting, loss of appetite
Rare side effectsThis is not a complete list of the rare side effects reported with mercaptopurine. For a complete list, please talk with your doctor or healthcare provider about reviewing a copy of the package insert.
- Liver problems (see Precautions To Be Aware Of Before Taking This Medication)
- Skin rashes, hyperpigmentation (darkening) of the skin
- Hair loss
- Drug fever
- Mouth sores
- This medication is taken by mouth (orally). Take this medication exactly as directed by your doctor or healthcare provider. If you do not understand these instructions, ask your doctor or healthcare provider to explain them to you. This medication can be given in different doses depending on your weight and the type of condition being treated.
- It is important that you only use this medication when it’s been prescribed for you. Sharing this medication with someone for whom it is not prescribed could cause harm.
- If you accidentally take too many pills or someone else accidentally takes your medication, contact your doctor, your local poison control center at 1-800-222-1222, or emergency services immediately.
- Store this medication at controlled room temperature.
- Keep this medication out of the reach of children or pets.
- Ask your doctor or healthcare provider how to dispose of any medication that you no longer use.