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Purinethol (mercaptopurine) Disease Interactions

There are 5 disease interactions with Purinethol (mercaptopurine):

Major

Antineoplastics (applies to Purinethol) infections

Major Potential Hazard, High plausibility. Applicable conditions: Infection - Bacterial/Fungal/Protozoal/Viral

Because of their cytotoxic effects on rapidly proliferating tissues, antineoplastic agents frequently can, to varying extent, induce myelosuppression. The use of these drugs may be contraindicated in patients with known infectious diseases. All patients should be instructed to immediately report any signs or symptoms suggesting infection such as fever, sore throat, or local infection during antineoplastic therapy. Close clinical monitoring of hematopoietic function is recommended.

References

  1. "Product Information. Novantrone (mitoxantrone)." Immunex Corporation, Seattle, WA.
  2. "Product Information. Doxil (doxorubicin liposomal)." Sequis Pharmaceuticals Inc, Menlo Park, CA.
  3. "Product Information. Fludara (fludarabine)." Berlex, Richmond, CA.
  4. Frame JN, Dahut WL, Crowley S "Fludarabine and acute tumor lysis in chronic lymphocytic leukemia." N Engl J Med 327 (1992): 1396-7
  5. "Product Information. Matulane (procarbazine)." Roche Laboratories, Nutley, NJ.
  6. "Product Information. Mutamycin (mitomycin)." Bristol-Myers Squibb, Princeton, NJ.
  7. "Product Information. Adriamycin PFS (doxorubicin)." Pharmacia and Upjohn, Kalamazoo, MI.
  8. Schilling PJ, Vadhan-Raj S "Concurrent cytomegalovirus and pneumocystis pneumonia after fludarabine therapy for chronic lymphocytic leukemia." N Engl J Med 323 (1990): 833-4
  9. "Product Information. Alkeran Tablets (melphalan)." Glaxo Wellcome, Research Triangle Pk, NC.
  10. "Product Information. Purinethol (mercaptopurine)." Glaxo Wellcome, Research Triangle Pk, NC.
  11. "Product Information. Taxotere (docetaxel)." Rhone-Poulenc Rorer, Collegeville, PA.
  12. "Product Information. Platinol (cisplatin)." Bristol-Myers Squibb, Princeton, NJ.
  13. "Product Information. Hycamtin (topotecan)." SmithKline Beecham, Philadelphia, PA.
  14. "Product Information. Cytosar-U (cytarabine)." Pharmacia and Upjohn, Kalamazoo, MI.
  15. "Product Information. Methotrexate (methotrexate)." Lederle Laboratories, Wayne, NJ.
  16. "Product Information. Xeloda (capecitabine)." Roche Laboratories, Nutley, NJ.
  17. Girmenia C, Mauro FR, Rahimi S "Late listeriosis after fludarabine plus prednisone treatment." Br J Haematol 87 (1994): 407-8
  18. "Product Information. Ifex (ifosfamide)." Bristol-Myers Squibb, Princeton, NJ.
  19. "Product Information. Vepesid (etoposide)." Bristol-Myers Squibb, Princeton, NJ.
  20. "Product Information. Nipent (pentostatin)." Hospira Inc, Lake Forest, IL.
  21. "Product Information. Uracil Mustard (uracil mustard)." Roberts Pharmaceutical Corporation, Eatontown, NJ.
  22. "Product Information. Gemzar (gemcitabine)." Lilly, Eli and Company, Indianapolis, IN.
  23. "Product Information. DTIC-Dome (dacarbazine)." Bayer, West Haven, CT.
  24. "Product Information. Taxol (paclitaxel)." Bristol-Myers Squibb, Princeton, NJ.
  25. "Product Information. Thiotepa (thiotepa)." Hikma USA (formerly West-Ward Pharmaceutical Corporation), Eatontown, NJ.
  26. "Product Information. Leukeran Tablets (chlorambucil)." Glaxo Welcome, Research Triangle Pk, NC.
  27. "Product Information. Leustatin (cladribine)." Ortho Biotech Inc, Raritan, NJ.
  28. Sanders C, Perez EA, Lawrence HJ "Opportunistic infections in patients with chronic lymphocytic leukemia following treatment with fludarabine." Am J Hematol 39 (1992): 314-5
  29. "Product Information. Tabloid (thioguanine)." Prasco Laboratories, Cincinnati, OH.
  30. "Product Information. Idamycin (idarubicin)." Pharmacia and Upjohn, Kalamazoo, MI.
  31. Bastion Y, Coiffier B, Tigaud JD, Espinouse D, Bryon PA "Pneumocystis pneumonia in a patient treated with fludarabine for chronic lymphocytic leukemia." Eur J Cancer 27 (1991): 671
View all 31 references
Major

Mercaptopurine (applies to Purinethol) hepatic dysfunction

Major Potential Hazard, Moderate plausibility. Applicable conditions: Liver Disease

Mercaptopurine is hepatotoxic. Hepatic injury can occur at any dosage, however, increased frequency of injury occurs when doses exceed 2.5 mg/kg/day. Deaths due to hepatic necrosis have been reported. Patients should be instructed to immediately report any signs of hepatotoxicity such as jaundice, hepatic dysfunction such as, jaundice, dark urine, right upper quadrant pain, or anorexia. Therapy with mercaptopurine should be administered cautiously in patients with or predisposed to compromised hepatic function. Clinical monitoring of hepatic function and determination of the etiology of hepatic dysfunction is recommended.

References

  1. "Product Information. Purinethol (mercaptopurine)." Glaxo Wellcome, Research Triangle Pk, NC.
Major

Mercaptopurine (applies to Purinethol) myelosuppression

Major Potential Hazard, High plausibility. Applicable conditions: Bleeding, Bone Marrow Depression/Low Blood Counts, Fever

Mercaptopurine induces dose-related myelosuppression which can be delayed. Leukopenia, thrombocytopenia, and anemia have been reported during mercaptopurine therapy. Therapy should be administered cautiously in patients with myelosuppression and therapy should be withheld at the first indication of an abnormally large reduction of any bone marrow element. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Close monitoring of hematopoietic function is recommended.

References

  1. "Product Information. Purinethol (mercaptopurine)." Glaxo Wellcome, Research Triangle Pk, NC.
Major

Thioguanine (applies to Purinethol) TMPT enzyme deficiency

Major Potential Hazard, Moderate plausibility. Applicable conditions: Enzymopathy (Unspecified)

Thioguanine is closely related structurally and functionally to mercaptopurine. A rare deficiency in the enzyme thiopurine methyltransferase (TMPT) results in an increased sensitivity to the myelosuppressive effects of both drugs causing rapid bone marrow suppression following initial mercaptopurine or thioguanine administration. Therapy with thioguanine or mercaptopurine should be administered cautiously and at a reduced dose in patients with TMPT deficiency.

References

  1. "Product Information. Tabloid (thioguanine)." Prasco Laboratories, Cincinnati, OH.
Moderate

Mercaptopurine (applies to Purinethol) renal dysfunction

Moderate Potential Hazard, Moderate plausibility.

Mercaptopurine is excreted in the urine as unchanged drug and metabolites. Renal elimination may be reduced in patients with impaired renal function. Therapy with mercaptopurine should be initiated at a reduced dosage in patients with compromised renal function. Clinical monitoring of renal function is recommended.

References

  1. "Product Information. Purinethol (mercaptopurine)." Glaxo Wellcome, Research Triangle Pk, NC.

Purinethol (mercaptopurine) drug interactions

There are 223 drug interactions with Purinethol (mercaptopurine)

Purinethol (mercaptopurine) alcohol/food interactions

There is 1 alcohol/food interaction with Purinethol (mercaptopurine)

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.