Tabloid Side Effects

Generic name: thioguanine

Note: This document contains side effect information about thioguanine. Some of the dosage forms listed on this page may not apply to the brand name Tabloid.

Some side effects of Tabloid may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

For the Consumer

Applies to thioguanine: oral tablet

Get emergency medical help if you have any of these signs of an allergic reaction while taking thioguanine (the active ingredient contained in Tabloid) 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 of thioguanine 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.

For Healthcare Professionals

Applies to thioguanine: oral tablet

Hematologic

Because thioguanine (the active ingredient contained in Tabloid) may have delayed effect, the drug should be withdrawn temporarily at the first sign of an abnormally large fall in any of the formed elements of the blood.

Hyperuricemia can be minimized by increased hydration, urine alkalinization, and the prophylactic administration of a xanthine oxidase inhibitor such as allopurinol.

Hematologic side effects including myelosuppression have been reported. Myelosuppression is the most frequent adverse reaction to thioguanine and may appear as anemia, leukopenia, and/or thrombocytopenia. The induction of complete remission of acute myelogenous leukemia usually requires combination chemotherapy in dosages which produce marrow hypoplasia. Since consolidation and maintenance of remission are also affected by multiple drug regimens whose component agents cause myelosuppression, pancytopenia is observed in nearly all patients.

Hyperuricemia frequently occurs in patients receiving thioguanine as a consequence of rapid cell lysis accompanying the antineoplastic effect.

Life-threatening infection and bleeding have been observed as consequences of thioguanine-induced granulocytopenia and thrombocytopenia.

Gastrointestinal

Gastrointestinal side effects including nausea, vomiting, diarrhea, anorexia, and stomatitis have been reported. Intestinal necrosis and perforation have been reported in patients who received multiple drug chemotherapy which included thioguanine (the active ingredient contained in Tabloid)

If severe diarrhea and/or stomatitis develop, a decrease in dosage may be appropriate.

Hepatic

Hepatic side effects including veno-occlusive liver disease have been reported. A case of peliosis hepatitis has been reported. Liver enzyme and other liver function studies are occasionally abnormal.

If jaundice, hepatomegaly, or anorexia with tenderness in the right hypochondrium occurs, thioguanine should be withheld until the exact etiology can be determined.

Respiratory

Respiratory side effects including esophageal varices have been reported in patients receiving continuous busulfan and thioguanine (the active ingredient contained in Tabloid) therapy. Nasal congestion and rhinorrhea have been reported with high dose IV therapy.

Renal

Renal side effects including nephrotoxicity have been reported in high-dose therapy.

Dermatologic

Dermatologic side effects including the development of painful erythematous swelling of the palms and soles occurring several days after courses of therapy, have been reported in 5 women on cytarabine, doxorubicin, and thioguanine (the active ingredient contained in Tabloid) Alopecia has also been reported.

Other

Other side effects including malaise, lethargy, weakness, ataxia, and loss of vibratory sensation have been reported.

Cardiovascular

Cardiovascular side effects have been reported. In one study, two of thirteen patients administered 700 mg/m2 intravenously developed bradycardia and nonspecific T-wave flattening, which resolved within 3 hours. In another study, five of nineteen patients administered 1000 mg/m2 intravenously demonstrated minor changes: bradycardia (two patients), nonspecific ST- and T-wave changes (five), and P-wave changes (one).

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