Indications
Puri-Nethol Tablet is used for:
Acute lymphatic leukaemia, Crohn's disease
Adult Dose
Acute Lymphatic Leukemia
Induction: 2.5 mg/kg PO qDay; usually 100-200 mg PO qDay in average adult (other agents preferred)
May increase by 5 mg/kg/day after 4 weeks
Maintenance: 1.5-2.5 mg/kg PO qDay
Reduce dose by 75% if concomitant allopurinol administration
Crohn's disease
Adult: Initially 1-1.5 mg/kg daily, may increase to 125 mg daily.
Hepatic impairment: Dosage may need to be reduced.
Child Dose
Acute Lymphatic Leukemia
Starting dose: 1.25-2.5 mg/kg (50-75 mg/m²) PO qDay
Maintenance: 1.5-2.5 mg/kg PO qDay in combination with methotrexate
Renal Dose
Renal Impairment: Dosage may need to be reduced.
Administration
Should be taken on an empty stomach. Best taken on an empty stomach 1 hr before or 2 hr after meals. Ensure adequate fluid intake.
Contra Indications
Pregnancy and lactation. Prior resistance to mercaptopurine or thioguanine; severe liver disease; severe bone marrow suppression.
Precautions
Hepatic or renal dysfunction; monitor hepatic function periodically. Mercaptopurine is potentially carcinogenic. Thiopurine S-methyl transferase (TPMT) deficiency; porphyria.
Lactation: not known if excreted in breast milk, do not nurse
Pregnancy-Lactation
Pregnancy Category: D
Lactation: not known if excreted in breast milk, do not nurse
Interactions
Anticoagulant action of warfarin may be inhibited by mercaptopurine. Enhanced toxicity with myelosuppressive drugs.
Potentially Fatal: Effects enhanced by allopurinol (reduce dose of mercaptopurine). Other hepatotoxic drugs (e.g. doxorubicin) potentiate toxicity.
Side Effects
Side effects of Mercaptopurine :
>10%
Elevated LFT's (15%)
1-10%
Nausea (10%), Vomiting (10%), Stomatitis (3-10%), Thrombocytopenia (3-10%), Rash (1-3%), Diarrhea (1-3%), Dizziness (1-3%), Alopecia (1-3%), Leukopenia (1-3%)
Frequency Not Defined
Fatigue, Anorexia, Headache, Chills and fever, Chest pain, Mucositis, Upper respiratory infection, Cough, Ulceration of intestine, Ulcerative stomatitis, Myelosuppressionm, Decreased hematocrit, Hepatotoxicity, Decreased resistance to infections, Hyperuricemia, Nephrotoxicity, Increased risk of pancreatitis in pts with IBD, Hyperpigmentation of skin, Arthralgias, Eye discomfort, Tinnitus
Potentially Fatal: Myelosuppression; hepatotoxicity, cholestatic jaundice.
Mode of Action
Mercaptopurine is a purine antagonist which is converted intracellularly into its active nucleotides, including thioinosinic acid. The nucleotides inhibit several reactions which ultimately interferes with nucleic acid synthesis and prevents the formation of RNA and DNA.
Note
Puri-Nethol 50mg Tablet generic name is Mercaptopurine. Puri-Nethol 50mg Tablet is manufactured by Excella, GermanyPuri-Nethol is availble in all over Bangladesh.
Mes BD drug index information on Puri-Nethol Tablet is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.