Why is this medication prescribed?

Purinethol is the brand name for a medication called mercaptopurine, which belongs to a class of drugs known as antimetabolites. It is commonly prescribed for the treatment of certain types of cancer, particularly acute lymphoblastic leukemia (ALL), a type of blood cancer that affects the white blood cells.

The mechanism of action of Purinethol involves interfering with the growth and multiplication of cancer cells. Mercaptopurine is a purine analog, which means it disrupts the synthesis of DNA and RNA, inhibiting the replication of rapidly dividing cells such as cancer cells.

How should this medicine be used?

The dosage and usage of Purinethol will depend on the specific medical condition being treated, the patient’s overall health, and other factors. It’s crucial to follow the prescribing doctor’s instructions carefully. The medication is typically taken orally, usually with food to help reduce stomach upset. Here are some general guidelines for using Purinethol:

• Dosage: The dosage will be determined by the prescribing healthcare provider based on factors such as the patient’s weight, overall health, and the specific type of cancer being treated.
• Administration: Purinethol is usually taken as a tablet with a full glass of water. It’s important not to crush or break the tablets unless specifically instructed by the healthcare provider.
• Timing: The medication is often taken once daily. The timing of administration and whether it’s taken with or without food can vary, so it’s essential to follow the doctor’s instructions.
• Monitoring: Regular blood tests may be required to monitor the effects of Purinethol on blood cell counts and liver function. This helps healthcare providers adjust the dosage if needed and monitor for potential side effects.
• Adherence: It’s crucial to take Purinethol exactly as prescribed by the healthcare provider. Missing doses or adjusting the dosage without consulting the doctor can impact the effectiveness of the treatment.
• Side Effects: Like all medications, Purinethol can cause side effects. Common side effects may include nausea, vomiting, loss of appetite, and lowered blood cell counts. Serious side effects are possible, and patients should promptly report any unusual or severe symptoms to their healthcare provider.

Patients should communicate openly with their healthcare team about any concerns, side effects, or questions related to Purinethol. It’s important to attend all scheduled medical appointments and laboratory tests to ensure proper monitoring during treatment.

Other uses for this medicine

• Inflammatory Bowel Disease (IBD): In some cases, Purinethol may be used to treat inflammatory bowel diseases such as Crohn’s disease and ulcerative colitis. It can help suppress the immune system, which is often overactive in these conditions.
• Rheumatoid Arthritis: Purinethol may be used in the treatment of rheumatoid arthritis, particularly in cases where other medications have not been effective.
• Autoimmune Hepatitis: It may be prescribed in the treatment of autoimmune hepatitis, a condition where the immune system mistakenly attacks the liver.

What special precautions should I follow?

Special Precautions for Purinethol:

• Pregnancy and Contraception: Purinethol may cause harm to a developing fetus. It’s crucial to inform the healthcare provider if the patient is pregnant, planning to become pregnant, or breastfeeding. Adequate contraception should be discussed and used during treatment.
• Hematologic Monitoring: Regular blood tests are essential during treatment with Purinethol to monitor blood cell counts, including white blood cells, red blood cells, and platelets. This helps detect any abnormalities and allows for adjustments to the dosage if necessary.
• Liver Function Monitoring: Purinethol can affect liver function, so regular liver function tests are often conducted. If there are signs of liver dysfunction, the healthcare provider may adjust the dosage or discontinue the medication.
• Infection Risk: Since Purinethol suppresses the immune system, there is an increased risk of infections. Patients should report any signs of infection, such as fever or persistent sore throat, to their healthcare provider promptly.
• Drug Interactions: Certain medications may interact with Purinethol, potentially affecting its effectiveness or increasing the risk of side effects. It’s important to inform the healthcare provider about all medications, including prescription, over-the-counter, and herbal supplements.
• Hypersensitivity Reactions: Some individuals may experience hypersensitivity reactions to Purinethol. If there are signs of an allergic reaction, such as rash, itching, swelling, severe dizziness, or difficulty breathing, medical attention should be sought immediately.
• Live Vaccines: The use of live vaccines is generally contraindicated during treatment with Purinethol, as the immune system suppression may affect the body’s ability to mount an appropriate response.

Patients should follow their healthcare provider’s instructions carefully, report any concerns or side effects promptly, and attend all scheduled medical appointments for monitoring and adjustments to the treatment plan. The information provided here is general, and individualized guidance from a healthcare professional is essential for the safe and effective use of Purinethol.

What special dietary instructions should I follow?

Special Dietary Instructions for Purinethol:

• Food Intake: Purinethol is usually taken with food to help reduce stomach upset. Patients should follow the specific instructions given by their healthcare provider regarding whether to take the medication with or without food.
• Avoid Grapefruit: Grapefruit and grapefruit juice may interact with Purinethol and increase the risk of side effects. It’s advisable to avoid consuming grapefruit products while on this medication.

What should I do if I forget a dose?

• If a Dose is Missed: If a dose of Purinethol is missed, it should be taken as soon as remembered. However, if it is almost time for the next scheduled dose, the missed dose should be skipped, and the regular dosing schedule should be resumed. Taking a double dose to make up for a missed one is not recommended.
• Consult with Healthcare Provider: If there are concerns about missed doses or confusion about the dosing schedule, it’s crucial to contact the healthcare provider for guidance. They can provide specific instructions based on the individual’s treatment plan.

What side effects can this medication cause?

Purinethol (mercaptopurine) can cause various side effects, and their severity can vary from person to person. It’s important for individuals taking Purinethol to be aware of potential side effects and promptly report any unusual or severe symptoms to their healthcare provider. Some common and serious side effects associated with Purinethol include:

Common Side Effects:

• Nausea and Vomiting: Gastrointestinal symptoms such as nausea and vomiting are relatively common. Taking Purinethol with food may help alleviate these symptoms.
• Loss of Appetite: Some individuals may experience a decreased appetite while taking Purinethol.
• Bone Marrow Suppression: Purinethol can suppress bone marrow function, leading to reduced production of blood cells. This can result in an increased risk of infection (due to lowered white blood cell counts), anemia (due to lowered red blood cell counts), and bleeding or bruising (due to lowered platelet counts).
• Liver Function Abnormalities: Elevated liver enzymes may occur, and regular monitoring of liver function is typically recommended during treatment.
• Hair Loss: Some individuals may experience hair loss as a side effect of Purinethol.

Serious Side Effects:

• Infections: The immune system-suppressing effects of Purinethol can increase the risk of infections. Fever or signs of infection should be reported to the healthcare provider promptly.
• Pancreatitis: Inflammation of the pancreas (pancreatitis) is a potential serious side effect. Symptoms may include severe abdominal pain, nausea, and vomiting.
• Hypersensitivity Reactions: Allergic reactions to Purinethol can occur, leading to symptoms such as rash, itching, swelling, severe dizziness, or difficulty breathing. Immediate medical attention is necessary if such symptoms occur.
• Tumor Lysis Syndrome: In some cases, Purinethol may cause tumor lysis syndrome, a potentially life-threatening condition characterized by the rapid breakdown of cancer cells, releasing substances into the bloodstream that can harm the kidneys and other organs.
• Secondary Cancers: Long-term use of Purinethol has been associated with an increased risk of secondary cancers.
• Gastrointestinal Toxicity: Severe gastrointestinal toxicity, including inflammation and ulceration of the digestive tract, may occur.

It’s important to note that not everyone will experience these side effects, and some individuals may tolerate the medication well. Additionally, the benefits of Purinethol in treating certain types of cancer often outweigh the risks associated with its side effects. Healthcare providers carefully monitor patients undergoing treatment with Purinethol and may adjust the dosage or recommend supportive measures to manage side effects.

Patients should discuss potential side effects with their healthcare provider before starting treatment, report any concerns promptly, and attend regular follow-up appointments for monitoring. The information provided here is not exhaustive, and individual responses to medication can vary.

What should I know about storage and disposal of this medication?

Storage and Disposal of Purinethol:

• Storage:
  • Store Purinethol (mercaptopurine) at room temperature, away from excessive heat and moisture.
  • Keep the medication in its original container, tightly closed, and out of reach of children.
• Disposal:
  • Follow local guidelines for the proper disposal of unused or expired medications. Do not flush them down the toilet or throw them in the trash without proper precautions.
  • Check with your healthcare provider or pharmacist for information on local medication disposal programs or take-back events.

In case of emergency/overdose

• Contact Emergency Services: In case of a suspected overdose or if someone has ingested Purinethol accidentally, contact emergency medical services immediately.
• Poison Control: If available, contact your local poison control center for guidance. In the United States, you can call the Poison Help hotline at 1-800-222-1222.
• Symptoms of Overdose: Symptoms of Purinethol overdose may include severe nausea, vomiting, diarrhea, bone marrow suppression (resulting in low blood cell counts), and other serious complications. Prompt medical attention is essential.

What other information should I know?

• Regular Monitoring: Regular blood tests are often necessary to monitor blood cell counts and liver function during Purinethol treatment. Attend all scheduled appointments as recommended by your healthcare provider.
• Avoid Grapefruit: Grapefruit and grapefruit juice may interact with Purinethol and should be avoided. Discuss dietary restrictions with your healthcare provider.
• Inform Healthcare Providers: Inform all healthcare providers, including dentists and emergency medical personnel, about your use of Purinethol. They should be aware of the medications you are taking to prevent potential interactions.
• Contraception: If you are of childbearing age and capable of becoming pregnant, discuss contraception options with your healthcare provider. Purinethol may cause harm to a developing fetus.
• Infections: Since Purinethol suppresses the immune system, be vigilant about avoiding infections. Report any signs of infection, such as fever or persistent sore throat, to your healthcare provider promptly.
• Communicate Side Effects: Report any side effects or concerns to your healthcare provider. Do not make changes to your treatment plan without consulting them.
• Drug Interactions: Inform your healthcare provider about all medications you are taking, including prescription, over-the-counter, and herbal supplements, as some may interact with Purinethol.
• Medical Alert Bracelet: Consider wearing a medical alert bracelet or carrying a medical information card indicating that you are taking Purinethol. This can be helpful in emergency situations.

Always follow your healthcare provider’s instructions and ask any questions you may have about Purinethol. It’s important to have open communication with your healthcare team to ensure safe and effective use of the medication.