Mercaptopurine

What is mercaptopurine?

Mercaptopurine (also called 6-MP) is an anticancer medicine. It is available as a 50-mg pale yellow tablet and an oral liquid taken by mouth. The liquid (also called Purixan™) is pink to brown in color with a raspberry taste.

Laboratory testing on mercaptopurine

Two enzymes in the body called thiopurine methyltransferase (TPMT) and nudix type motif 15 (NUDT15) have the ability to break down certain medicines, including mercaptopurine. A genetic test can be done to determine how well your TPMT and NUDT15 enzymes break down medicines. If your body breaks down the medicine slower than most people, you should receive lower doses of mercaptopurine. For information about both TPMT and NUDT15 and their effect on mercaptopurine, talk with your doctor or pharmacist, and see “Do you know… Thiopurine methyltransferase (TPMT) and medicines.” For more details, go to www.stjude.org/pg4kds.

Possible side effects of mercaptopurine

Early

• Mild nausea and vomiting (in the morning)
• Rash (may worsen when exposed to sun)

Later (usually more than a day after treatment starts)

• Low blood counts, with an increased risk of infection, bleeding, and anemia
• Mouth sores
• Decreased liver function

These are the most common side effects, but there may be others. Please report all side effects to the doctor or nurse.

In case of a severe side effect or reaction, call the doctor, nurse, or pharmacist at 901-595-3300. If you are outside the Memphis area, dial toll-free 1-866-2STJUDE (1-866-278-5833), and press 0 once the call is connected.

Pregnancy risk and mercaptopurine

This medicine may be harmful to the unborn child. Avoid becoming pregnant during treatment. Contact one of your caregivers at St. Jude if you are sexually active or think you may be pregnant.

Special instructions for mercaptopurine

• 6-MP should be taken every day. It is very important that you take your medicine as your doctor tells you. If you do not take your medicine regularly, your disease is more likely to come back.
• If you miss a dose, take the dose as soon as you remember, as long as it is at least 6 hours before the next scheduled dose.
• If you have nausea or vomiting, tell your doctor. The doctor can prescribe medicine to keep you from feeling sick and throwing up while you are taking mercaptopurine.
• The staff will take blood samples to test for changes in your liver function and blood counts. Blood samples also may be taken to measure 6-MP levels. Your doctor will tell you if these tests show that your 6-MP dose should be changed.
• Store 6-MP tablets at room temperature in a dry place.
• Store the liquid medicine at room temperature. Shake the bottle for at least 30 seconds before filling the oral syringe with the correct dose.
• Do not use after the expiration date written on the medicine label.
• Keep this and all medicine out of the reach of children and pets.

Safe handling of mercaptopurine

All chemotherapy drugs taken by mouth can pose a health hazard to caregivers and patients. You should be careful when handling this medicine and try to keep the drug from touching the skin. Taking precautions will ensure that both the patient and the caregiver are protected as well as possible.

• Prepare a clean area where the drug can be handled safely (away from areas where food is prepared, out of the reach of children, and out from under any air vents or fans).
• We suggest you or the caregiver wear gloves while handling this medicine. Wash your hands right away if your skin comes in contact with the medicine.
• Carefully wash tablet cutters with warm soapy water after each use and allow to dry. Completely clean up any spills in the area where the medicine is prepared.
• For the liquid, St. Jude will provide enough oral syringes for each dose. Use each oral syringe only one (1) time and then discard it in the trash. Do not try to wash and reuse the syringes.