Mercaptopurine
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| Mercaptopurine
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| Systematic (IUPAC) name | |
| 3,7-dihydropurine-6-thione | |
| Identifiers | |
| CAS number | |
| ATC code | L01 |
| PubChem | |
| DrugBank | |
| Chemical data | |
| Formula | C5H4N4S |
| Mol. mass | 152.181 g/mol |
| Pharmacokinetic data | |
| Bioavailability | 5 to 37% |
| Metabolism | ? |
| Half life | 60 to 120 min., longer for its active metabolites |
| Excretion | Renal |
| Therapeutic considerations | |
| Pregnancy cat. |
?,(Increased Risk of Abortion) |
| Legal status |
? |
| Routes | Oral |
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Ongoing Trials on Mercaptopurine at Clinical Trials.gov Trial results on Mercaptopurine Clinical Trials on Mercaptopurine at Google
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US National Guidelines Clearinghouse on Mercaptopurine NICE Guidance on Mercaptopurine
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Overview
Mercaptopurine (also called 6-Mercaptopurine, 6-MP or its brand name Purinethol) is an immunosuppressive drug used to treat leukemia. It is also used for pediatric non-Hodgkin's lymphoma, polycythemia vera, psoriatic arthritis, and inflammatory bowel disease (such as Crohn's Disease and ulcerative colitis).
Adverse reactions
Some of the adverse reactions of taking Mercaptopurine might include diarrhea, nausea, vomiting, loss of appetite, stomach/abdominal pain, weakness, skin rash, darkening of the skin, or hair loss. Serious adverse reactions include mouth sores, fever, sore throat, easy bruising or bleeding, pinpoint red spots on the skin, yellowing of eyes or skin, dark urine, painful or difficult urination. Unlikely but serious side effects include: black or tarry stools (melena), bloody stools, and bloody urine.
Symptoms of allergic reaction to Mercaptopurine include rash, itching, swelling, dizziness, trouble breathing.
Mercaptopurine causes myelosuppression, suppressing the production of white blood cells. It may be toxic to bone marrow. Weekly blood counts are recommended for patients on mercaptopurine. The patient should stop taking the medication at least temporarily if there is an unexplained, abnormally large drop in white blood cell count, or any other blood count.
Patients who exhibit myelosuppression or bone marrow toxicity should be tested for Thiopurine methyltransferase (TPMT) enzyme deficiency. Patients with TPMT deficiency are much more likely to develop dangerous myelosuppression. In such patients it may be possible to continue using mercaptopurine, but at a lower dose.
Precautions
Mercaptopurine can lower the body's ability to fight off infection. Those taking mercaptopurine should get permission from a doctor in order to receive immunizations and vaccinations. It is also recommended that while on the drug one should avoid those who have recently received oral polio vaccine.
This drug is traditionally not recommended during pregnancy but this issue has been debated and current evidence indicates that pregnant women on the drug show no increase in fetal abnormalities. However, women receiving mercaptopurine during the first trimester of pregnancy have an increased incidence of abortion. Davis et al 1999 found that mercaptopurine, compared to methotrexate, was ineffective as a single-agent abortifacient; every woman in the mercaptopurine arm of the study had fetal cardiac activity at follow-up (two weeks later) and was given a suction abortion.[1]
Mercaptopurine causes changes to chromosomes in animals and humans. In mice these changes have given rise to lethal mutations. Therefore the drug has the potential to be cancer causing in humans.
See also
References
de:Mercaptopurin fr:Mercaptopurine
Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
