Question 1

How can I lower the cost of my mercaptopurine

Accepted Answer

You can lower cost of your mercaptopurine using one of the 4 following drug savings programs: Rx Advantage Card for mercaptopurine, Canadian Prescription Savings for mercaptopurine, mercaptopurine Drug Coupons, mercaptopurine Patient Assistance Programs

Question 2

What dosages is mercaptopurine available in?

Accepted Answer

mercaptopurine is available as a 100 mg oral tablet.

Question 3

What is mercaptopurine used for?

Accepted Answer

mercaptopurine is an antimetabolite that is used to treat acute lymphoblastic leukemia (ALL).

Question 4

How does mercaptopurine work?

Accepted Answer

mercaptopurine is a type of antimetabolite medication called a nucleoside metabolic inhibitor. It stops cancer cells from being able to make their own genetic material. This kills cancer cells and stops cancer growth.

Question 5

How do I take mercaptopurine?

Accepted Answer

mercaptopurine is dosed based on your body weight, so your provider will help determine the right dose for you. The recommended starting dose is 1.5 mg/kg to 2.5 mg/kg of weight by mouth once a day. Your dose might differ if you have side effects (e.g., severely low blood cell counts) or if you take allopurinol (Zyloprim).

Question 6

Is it safe for me to take mercaptopurine?

Accepted Answer

mercaptopurine is a safe and effective treatment when used for FDA licensed indications. However, like all medications, they may give you unwanted side effects. You should always discuss potential side effects with your physician to ensure the medication is suitable and right for you.
mercaptopurine should not be used in patients whose disease has demonstrated prior resistance to this drug. In animals and humans, there is usually complete cross-resistance between mercaptopurine and thioguanine. mercaptopurine should not be used in patients who have a hypersensitivity to mercaptopurine or any component of the formulation.

Question 7

mercaptopurine Common Side Effects

Accepted Answer

Common side effects of mercaptopurine:  Anemia (low red blood cell count) Low white blood cell count Low platelet count Low appetite Nausea Vomiting Diarrhea General feeling of discomfort Rash

Question 8

mercaptopurine Serious Side Effects

Accepted Answer

Serious side effects are rare with mercaptopurine. Contact your healthcare provider immediately if you experience any of the following.  Low blood cell counts: fever, sore throat, frequent infections, unusual bleeding or bruising, pale skin, tiredness problems: yellowing of the skin or eyes, dark urine, pale stools, loss of appetite, stomach bloating

Question 9

Effects of other drugs, drug classes and over-the-counter products on mercaptopurine

Accepted Answer

The following medications may interact with mercaptopurine:  When allopurinol and mercaptopurine are administered concomitantly, the dose of mercaptopurine must be reduced to one third to one quarter of the usual dose to avoid severe toxicity There is usually complete cross-resistance between mercaptopurine and thioguanine The dosage of mercaptopurine may need to be reduced when this agent is combined with other drugs whose primary or secondary toxicity is myelosuppression. Enhanced marrow suppression has been noted in some patients also receiving trimethoprim-sulfamethoxazole Inhibition of the anticoagulant effect of warfarin, when given with mercaptopurine, has been reported

Question 10

Who makes mercaptopurine?

Accepted Answer

Various FDA-approved generic manufacturers

Question 11

Is mercaptopurine safe in pregnancy?

Accepted Answer

mercaptopurine can cause fetal harm when administered to a pregnant woman. Women receiving mercaptopurine in the first trimester of pregnancy have an increased incidence of abortion.

Question 12

What is the brand name for mercaptopurine?

Accepted Answer

PURINETHOL

Question 13

How can NowPatient help me to lower the cost of my mercaptopurine prescription?

Accepted Answer

After you create a FREE account with NowPatient, you will have access to 4 programs that can help lower the cost of your mercaptopurine prescription

Applicability to each program will be dependent on your insurance status.

Question 14

How do the NowPatient mercaptopurine savings programs work?

Accepted Answer

After you have created your FREE account with NowPatient, you can access the various programs from your account dashboard. Each program has clear instructions on how to check your eligibility. You can see how the process works by clicking on the feature link below and seeing the ‘How it works’ steps.

Drug Coupon and Patient Assistance Programs require an eligibility quiz to be completed.

Question 15

Are the NowPatient mercaptopurine savings programs suitable for everyone, regardless of insurance status?

Accepted Answer

No. Each program has its own eligibility and applicability requirements. The table below shows if a program is available to you, based on your insurance status.

	Rx Advantage Card* for mercaptopurine	Canadian Prescription Savings* for mercaptopurine	mercaptopurine Drug Coupon*	mercaptopurine Patient Assistance Program*
Insured (federal, state or government)	Available	Available	Not Available	Available If Offered by Pharmaceutical Company
Insured (Commercial or Private)	Available	Available	Available If Offered by Pharmaceutical Company	Available If Offered by Pharmaceutical Company
Uninsured	Available	Available	Not Available	Available If Offered by Pharmaceutical Company
Insured but without pharmacy benefit or drug coverage	Available	Available	Not Available	Available If Offered by Pharmaceutical Company

*This is not insurance.

Question 16

Are the NowPatient drug savings programs suitable for brand and generic versions of mercaptopurine?

Accepted Answer

No. Each program has applicability requirements. Please see below

	Rx Advantage Card* for mercaptopurine	Canadian Prescription Savings* for mercaptopurine	mercaptopurine Drug Coupon*	mercaptopurine Patient Assistance Program*
Brand	Yes	Yes	Yes, If Offered by Pharmaceutical Company	Yes, If Offered by Pharmaceutical Company
Generic	Yes	Yes	No	No

*This is not insurance.

Question 17

If you have Medicare Part D or Medicare Advantage and none of the mercaptopurine savings options are applicable or affordable for me, what can you do?

Accepted Answer

If you are insured with Medicare and the mercaptopurine drug savings options are not applicable to you and still remain unaffordable, then you can check Medicaid eligibility in your state by following the instructions at HealthCare.gov.

The government site is easy to use and after you have selected your state, it will navigate you to the appropriate contact point to make the application. State Medicaid programs may cover the full cost of your medication.

People who qualify for both Medicare and Medicaid are called ‘dual eligibles’.

If you are denied Medicaid for mercaptopurine, and you are still unable to afford your copay or co-insurance element (for example if you are in the coverage gap or Donut Hole) then you may be eligible for a federal support program like Low Income Subsidy. To be eligible for Low Income Subsidy, you need to be a resident in one of the 50 States or the District of Columbia. You can check eligibility online at SSA Medicare D Extra Help. You can also call Social Security at 1-800-772-1213 (TTY 1-800-325-0778).

Question 18

I am uninsured or underinsured and none of the mercaptopurine prescription saving options are applicable or affordable for me, what can I do?

Accepted Answer

If you are uninsured or underinsured (for example, mercaptopurine is not covered by your plan) and the drug savings options are not applicable or still unaffordable, then you can check Medicaid eligibility in your state by following the instructions at HealthCare.gov.

The government site is easy to use and you can select your state and it will navigate you to the appropriate contact point to make the application. State Medicaid programs may cover the full cost of your medication.

If you are denied and all else fails, and if you have been prescribed mercaptopurine for an FDA-approved indication, you can call the pharmaceutical company to see if they have any other assistance programs.

Question 19

I am commercially or privately insured and none of the mercaptopurine prescription saving options are applicable or affordable for me, what can I do?

Accepted Answer

If your medication is not covered by your plan, you can appeal your insurance company’s decision. Sometimes, a formal appeal can result in the drug being covered if it is deemed medically necessary.

If you cannot afford your copay contribution, then you can check Medicaid eligibility in your state by following the instructions at HealthCare.gov.

However, being privately insured might complicate your eligibility for Medicaid, as having private insurance may be considered in the financial eligibility assessment.

The government site is easy to use and you can select your state and it will navigate you to the appropriate contact point to make the application. If you qualify, state Medicaid may cover the full cost of your medication.

Question 20

If I have federal, state or commercial insurance and none of the mercaptopurine prescription saving options are applicable or affordable for me, are there any other support organisations that can help me with my co-insurance or copay contributions?

Accepted Answer

If you have already tried Medicaid and received a denial letter or if you are insured with Medicare and have been denied Low-Income Subsidy, then you can try one of the following organizational support programs:

1. Patient Access Network Foundation (PAN) assistance for mercaptopurine

If you are having trouble paying for your mercaptopurine medication due to unaffordable copays or deductibles, the Patient Access Network Foundation (PAN), may be able to assist you. To qualify for PAN assistance for mercaptopurine you will need to meet one or all of the following criteria:

Your income is below 400% of the federal poverty level
mercaptopurine is prescribed for an approved FDA indication
You live in and receive treatment in the United States or U.S. territories, even if you do not have U.S. citizenship
You have Medicare insurance coverage that covers mercaptopurine
If mercaptopurine is listed on PAN’s list of covered medications

You can check the Patient Access Network Foundation Website for more information.

2. HealthWell Foundation Copay Program for mercaptopurine

If you are having trouble paying for your mercaptopurine medication due to unaffordable copays or deductibles, the HealthWell Foundation Copay Program may be able to assist you. To qualify for assistance for mercaptopurine you will need to meet the following criteria:

You live in and are being treated in the United States
You are insured and your plan covers mercaptopurine
If mercaptopurine is listed on the HealthWell Foundation’s list of covered medications

You can check the HealthWell Foundation Website for more information.

3. Patient Advocate Foundation Co-Pay Relief Program for mercaptopurine

Patient Advocate Foundation’s Co-Pay Relief program exists to help reduce the financial distress you or your family may face when paying for your mercaptopurine treatment. If you qualify and can demonstrate the need, the foundation will provide you with direct payment covering co-pays, co-insurance, and deductibles. To qualify for assistance for mercaptopurine you will need to meet the following criteria:

You must be currently insured and have coverage for mercaptopurine
You must have a confirmed diagnosis and treatment plan
You must reside and receive treatment in the United States
Your Income must fall at or below 300% or 400% of the Federal Poverty Guideline (FPG) with consideration for the Cost of Living Index (COLI) and number in the household
Applications can also be completed by contacting the program sponsor, toll-free at 866-512-3861.

You can check the Patient Advocate Foundation Website for more information.