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Mercaptopurine is available as a 100 mg oral tablet.

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

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.

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).

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.

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

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

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

Various FDA-approved generic manufacturers

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.

• Purinethol