Mercaptopurine
Description
Mercaptopurine is an anti-cancer medicine. It is used to treat acute lymphocytic leukemia, a type of blood cancer that affects your white blood cells. It works by stopping the growth of cancer cells (cells that divide continually and form tumors) and prevents the spread of cancer to other parts of your body.
Mercaptopurine may cause common side effects such as nausea/vomiting, anaemia (low red blood cell count), etc. Consult your doctor if these symptoms persist or if you experience any other severe side effects. Frequent monitoring of your red blood cell count is recommended.
Mercaptopurine should be taken exactly as advised by your doctor. Take it at the same time every day to maintain a constant level of this medicine in your body.
Mercaptopurine should be avoided if you are allergic to it. Inform your doctor if you have liver or kidney problems before taking this medicine. Close evaluation with respect to your current medicines is necessary to avoid any undesired side effects. If you are pregnant, breastfeeding, or are planning a pregnancy, consult your doctor before taking this medication.
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Side effects
Major & minor side effects for Mercaptopurine
- Nausea or Vomiting
- Anaemia (Low red blood cell count)
- Loss of appetite
- Mouth ulcers
- Hair loss
Uses of Mercaptopurine
What is it prescribed for?
- Blood cancer
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Concerns
Commonly asked questions
- Onset of actionThe time required for Mercaptopurine to show its action is one hour.
- Duration of effectThe duration for which Mercaptopurine remains active in your body is not clinically known.
- Safe with alcohol?Interaction with alcohol is unknown. It is advisable to consult your doctor before consumption.
- Is it habit forming?No habit-forming tendencies have been reported with Mercaptopurine.
- Usage in pregnancy?Mercaptopurine is not recommended during pregnancy unless absolutely necessary. This medicine may cause severe side effects in your foetus. If you are pregnant, discuss all the risks and benefits of taking this medicine with your doctor before starting treatment.
- Usage while breast-feeding?Mercaptopurine passes into breast milk and may affect your infant. If you are breastfeeding, this medicine is not recommended.
Allergy
Avoid taking Mercaptopurine if you are allergic to it. Seek immediate medical attention if you notice any symptoms such as skin rash, itching/swelling (especially of your/tongue/throat), severe dizziness, breathing difficulty, etc.
Warnings for special population
Pregnancy
Mercaptopurine is not recommended during pregnancy unless absolutely necessary. This medicine may cause severe side effects in your foetus. If you are pregnant, discuss all the risks and benefits of taking this medicine with your doctor before starting treatment.
Breast-feeding
Mercaptopurine passes into breast milk and may affect your infant. If you are breastfeeding, this medicine is not recommended.
General warnings
Infections
Mercaptopurine may increase your risk of infections. Hence, close monitoring of your body temperature and blood cell count is recommended.
Driving or operating machinery
Mercaptopurine is not known to affect your ability to drive and operate machines. However, do not perform any activities that require mental alertness until you completely know how this medicine affects you.
Photosensitivity
When taken along with other anti-cancer medicines, Mercaptopurine may increase your risk of skin cancer. Avoid excessive exposure to sunlight. Use sunscreen (with a high sun protection factor) and wear protective clothing.
Use contraception
Use a reliable form of contraception to avoid pregnancy for the entire course of treatment with Mercaptopurine and for at least 3 months after receiving the last dose. This is recommended for both men and women.
Other Medicines
Mercaptopurine may interact with other medicines and may cause undesired side effects. Inform your doctor about all your current medicines including any herbs or supplements before taking this medicine.
Missed Dose
Try not to skip a dose of Mercaptopurine. Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed one. Do not double the dose to compensate for a missed one.
Overdose
Do not take more than what is prescribed by your doctor. Contact your doctor in case of an overdose with Mercaptopurine.
All drugs interact differently for person to person. You should check all the possible interactions with your doctor before starting any medicine.
Interaction with Alcohol
Description
Interaction with alcohol is unknown. It is advisable to consult your doctor before consumption.
Instructions
Interaction with alcohol is unknown. It is advisable to consult your doctor before consumption.
Interaction with Medicine
Febuxostat
Live vaccines
Etanercept
Zidovudine
Adalimumab
Azathioprine
Allopurinol
Disease interactions
Myelosuppression
Myelosuppression is a condition in which there is reduced production of blood cells in your body. In such conditions, Mercaptopurine is not recommended as it may further lower your red blood cell, white blood cell, and platelet counts.
Kidney Disease
Mercaptopurine is eliminated by kidneys and should be used with caution if you have pre-existing kidney problems due to the increased risk of side effects, resulting from the accumulation of this medicine in your body. Your kidney function will be closely monitored and the dose may be adjusted based on your clinical condition.
TMPT enzyme deficiency
TPMT deficiency is a condition with reduced levels of the enzyme Thiopurine S-methyltransferase (TPMT). This enzyme is required to break down Mercaptopurine and helps in its elimination from your body. Lack of this enzyme results in the accumulation of this medicine and causes severe myelosuppression (low blood cell count). Hence dose adjustments may be required if you have this condition.
Liver Disease
Mercaptopurine may increase your risk of liver damage. This risk is especially higher if you have pre-existing liver problems. Inform your doctor if you experience any signs and symptoms of liver damage such as jaundice (the whites of your eyes or skin turn yellow), dark urine, etc. Your liver function will be closely monitored through periodic liver function tests while you are taking this medicine.
Mutated NUDT15 gene
Caution should be maintained as there is an increased risk of toxicity with Mercaptopurine if there is a mutation in NUDT15 (Nudix Hydrolase 15, a Protein Coding gene). Medical tests would be conducted before initiating Mercaptopurine therapy.
Food interactions
Food may reduce the absorption of Mercaptopurine. Hence take this medicine on an empty stomach, at least 1 hour before or 2 hours after your meal.
Lab interactions
Information not available.
Take Mercaptopurine on an empty stomach, at least 1 hour before or 2 hours after your meal. Do not stop the use of this medicine without consulting your doctor as it may worsen your condition.
Anti-cancer medicines are usually very strong and can have many side effects. Discuss with your doctor to understand all the benefits and risks before starting the treatment. Consult your doctor if you experience any side effects or if they become severe.
Mercaptopurine may lower your blood cell count, therefore periodic monitoring of your blood cell count is recommended.
Do not drive or operate machines if you experience any symptoms that may affect your alertness after taking Mercaptopurine.
Miscelleneous
How it works
Mercaptopurine is an anti-cancer medicine that works by stopping the growth and spread of cancer cells.
Legal Status
Classification
Category
Antimetabolites, Purine antagonists, Antineoplastics
Schedule
Schedule G
Medicines.org.uk. 2021. Mercaptopurine 50 mg tablets - Summary of Product Characteristics (SmPC) - (emc). [online] Available at: < [Accessed 23 September 2021].
Medicines.org.uk. 2021. [online] Available at: < [Accessed 23 September 2021].
Accessdata.fda.gov. 2021. [online] Available at: < [Accessed 23 September 2021].
Drugs, H., 2021. Mercaptopurine: MedlinePlus Drug Information. [online] Medlineplus.gov. Available at: < [Accessed 23 September 2021].
Information on this page was last updated on 25 Oct 2021
Disclaimer
We’ve made all possible efforts to ensure that the information provided here is accurate, up-to-date and complete, however, it should not be treated as a substitute for professional medical advice, diagnosis or treatment. Practo only provides reference source for common information on medicines and does not guarantee its accuracy or exhaustiveness. The absence of a warning for any drug or combination thereof, should not be assumed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Practo does not assume any responsibility for any aspect of healthcare administered with the aid of information provided above. If you have any doubts about your medication then we strongly recommend that you consult with your doctor, nurse or healthcare provider. See detailed T&C here.