Advanced Breast Cancer: Learn about treatment options.

thioguanine

Generic Name: thioguanine (THYE oh GWA neen)
Brand Name: Tabloid

What is thioguanine?

Thioguanine is a cancer medication that interferes with the growth and spread of cancer cells in the body.

Thioguanine is used to treat certain types of leukemia. Thioguanine is sometimes given with other cancer medications.

Thioguanine may also be used for purposes not listed in this medication guide.

What is the most important information I should know about thioguanine?

Do not use thioguanine if you are pregnant. It could harm the unborn baby.

You should not use thioguanine if you are allergic to it, or if you have ever used thioguanine or mercaptopurine (Purinethol) and they were not effective in treating your condition.

Slideshow: View Frightful (But Dead Serious) Drug Side Effects

Before taking thioguanine, tell your doctor if you have liver or kidney disease, or any type of infection.

Stop taking this medication and call your doctor at once if you have easy bruising or bleeding, fever, flu symptoms, mouth sores, dark urine, upper stomach pain, jaundice (yellowing of the skin or eyes), or ongoing diarrhea.

Thioguanine can lower blood cells that help your body fight infections. Your blood cells, kidney function, and liver function may need to be tested often. Your cancer treatments may be delayed based on the results of these tests. Do not miss any follow up visits to your doctor for blood or urine tests.

What should I discuss with my healthcare provider before taking thioguanine?

You should not use thioguanine if you are allergic to it, or if you have ever used thioguanine or mercaptopurine (Purinethol) and they were not effective in treating your condition.

To make sure you can safely take thioguanine, tell your doctor if you have any of these other conditions:

  • liver disease;

  • kidney disease; or

  • any type of viral, bacterial, or fungal infection.

FDA pregnancy category D. Do not use thioguanine if you are pregnant. It could harm the unborn baby. Use effective birth control, and tell your doctor if you become pregnant during treatment.

It is not known whether thioguanine passes into breast milk or if it could harm a nursing baby. You should not breast-feed while taking thioguanine.

How should I take thioguanine?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Your doctor may occasionally change your dose to make sure you get the best results.

Thioguanine can lower blood cells that help your body fight infections. Your blood cells, kidney function, and liver function may need to be tested often. Your cancer treatments may be delayed based on the results of these tests. Do not miss any follow up visits to your doctor for blood or urine tests.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Contact your doctor if you miss a dose of thioguanine.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include some of the serious side effects listed in this medication guide.

What should I avoid while taking thioguanine?

Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.

This medicine can pass into body fluids (including urine, feces, vomit, semen, vaginal fluid). For at least 48 hours after you receive a dose, avoid allowing your body fluids to come into contact with your hands or other surfaces. Patients and caregivers should wear rubber gloves while cleaning up body fluids, handling contaminated trash or laundry or changing diapers. Wash hands before and after removing gloves. Wash soiled clothing and linens separately from other laundry.

Body fluids should not be handled by a woman who is pregnant or who may become pregnant. Use condoms during sexual activity to avoid exposure to body fluids.

Do not receive a live vaccine while using thioguanine. The vaccine may not work as well during this time, and may not fully protect you from disease. Live vaccines include measles, mumps, rubella (MMR), oral polio, rotavirus, typhoid, varicella (chickenpox), H1N1 influenza, and nasal flu vaccine.

Thioguanine side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using thioguanine and call your doctor at once if you have any of these serious side effects:

  • pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating;

  • fever, chills, body aches, flu symptoms, sores or white patches in your mouth and throat;

  • easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;

  • severe vomiting, ongoing diarrhea;

  • severe pain in your upper stomach spreading to your back, fast heart rate;

  • bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds; or

  • nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Less serious side effects may include:

  • vomiting, mild diarrhea;

  • hair loss;

  • mild itching or skin rash; or

  • darkened skin color.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Thioguanine dosing information

Usual Adult Dose for Acute Nonlymphocytic Leukemia:

Single Agent Chemotherapy: Usual Initial dose: 2 mg/kg/day orally.
If, after 4 weeks on this dosage, there is no clinical improvement and no leukocyte or platelet depression, the dosage may be cautiously increased to 3 mg/kg per day. The total daily dose may be given at one time.

As a part of combination therapy for induction of remission in patients with acute nonlymphocytic leukemia: 75 to 200 mg/m2/day in 1 to 2 divided doses for 5 to 7 days or until remission is attained.

Usual Geriatric Dose for Acute Nonlymphocytic Leukemia:

Single Agent Chemotherapy: Usual Initial dose: 2 mg/kg/day orally.
If, after 4 weeks on this dosage, there is no clinical improvement and no leukocyte or platelet depression, the dosage may be cautiously increased to 3 mg/kg per day. The total daily dose may be given at one time.

As a part of combination therapy for induction of remission in patients with acute nonlymphocytic leukemia: 75 to 200 mg/m2/day in 1 to 2 divided doses for 5 to 7 days or until remission is attained.

Because clinical studies of thioguanine did not include sufficient numbers of subjects 65 years of age or over to determine whether they respond differently from younger subjects, dose selection for elderly patients should be cautious, usually starting at the low end of the dosing range.

Usual Pediatric Dose for Acute Nonlymphocytic Leukemia:

<3 years: As a part of combination drug therapy for Acute Nonlymphocytic Leukemia: 3.3 mg/kg/day in divided doses twice a day for 4 days.

>1 year: As a part of combination therapy for induction of remission in patients with acute nonlymphocytic leukemia: 75 to 200 mg/m2/day in 1 to 2 divided doses for 5 to 7 days or until remission is attained.

Single Agent Chemotherapy: Usual Initial dose: 2 mg/kg/day orally.
If, after 4 weeks on this dosage, there is no clinical improvement and no leukocyte or platelet depression, the dosage may be cautiously increased to 3 mg/kg per day. The total daily dose may be given at one time.

What other drugs will affect thioguanine?

Tell your doctor about all other cancer treatments you are receiving. Also tell your doctor about all other medicines you use, especially:

  • acetaminophen;

  • auranofin;

  • azathioprine;

  • cyclosporine;

  • mercaptopurine;

  • methotrexate;

  • olsalazine, mesalamine or sulfasalazine;

  • sulfamethoxazole and trimethoprim;

  • birth control pills or hormone replacement therapy;

  • a blood thinner such as warfarin;

  • tuberculosis medications;

  • cholesterol medications such as niacin, atorvastatin, simvastatin, lovastatin, pravastatin and others;

  • an NSAID (non-steroidal anti-inflammatory drug) such as ibuprofen, naproxen, diclofenac, etodolac, indomethacin, ketoprofen and others; or

  • an ACE inhibitor such as benazepril, enalapril, lisinopril, quinapril, ramipril and others;

  • an antibiotic such as dapsone, erythromycin or rifampin;

  • antifungal medication such as fluconazole, itraconazole, or ketoconazole;

  • seizure medications such as carbamazepine, phenytoin, felbamate, valproic acid; or

  • HIV/AIDS medications such as abacavir/lamivudine/zidovudine, lamivudine, nevirapine, tenofovir or zidovudine;

This list is not complete and other drugs may interact with thioguanine. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about thioguanine.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 6.02. Revision Date: 2013-07-09, 11:56:21 AM.

Hide
(web4)