{"id":21472,"date":"2022-05-24T12:46:00","date_gmt":"2022-05-24T12:46:00","guid":{"rendered":"https:\/\/zeepedia.com\/?p=21472"},"modified":"2022-05-24T14:32:00","modified_gmt":"2022-05-24T14:32:00","slug":"puri-nethol","status":"publish","type":"post","link":"https:\/\/zeepedia.com\/medical\/medicines\/puri-nethol\/","title":{"rendered":"Puri-nethol | 6-mercaptopurine uses, dose and side effects"},"content":{"rendered":"\n<p>50 mg&nbsp;tablets<br>6-mercaptopurine&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">What Puri-nethol is and what it is used for<\/h2>\n\n\n\n<p>Purinethol contains the active substance 6-mercaptopurine.\u00a06-mercaptopurine belongs to a group of medicines called cytotoxic drugs (also called\u00a0cytostatics\u00a0) and works by reducing the number of new\u00a0blood cells\u00a0that your body produces.<\/p>\n\n\n\n<p>Purinethol is used to treat cancer of the blood (\u00a0leukemia\u00a0) in adults, adolescents, and children.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">What you need to know before you take Puri-nethol<\/h2>\n\n\n\n<h2 class=\"wp-block-heading\">Do not take Purinethol:<\/h2>\n\n\n\n<ul class=\"wp-block-list\"><li>if you are allergic to 6-mercaptopurine or any of the other ingredients of this medicine (listed in section 6).<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Warnings and cautions<\/h2>\n\n\n\n<p>Talk to your doctor or pharmacist before taking Puri-nethol:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>if you have recently been or will be vaccinated.\u00a0If you are being treated with Puri-nethol, you should not be vaccinated with a live vaccine (such as the flu vaccine, measles vaccine, and BCG vaccine) until your doctor tells you it is safe.\u00a0This is because some vaccines can lead to an\u00a0infection\u00a0if you are vaccinated while you are being treated with Purinethol.<\/li><li>if you have impaired liver function or liver damage.<\/li><li>if you have a genetic disorder called TPMT deficiency (thiopurine methyltransferase).<\/li><li>if you are allergic to a medicine called azathioprine (also used to treat cancer).<\/li><li>if you have impaired kidney function.<\/li><li>Tell your doctor if you have, or have not, had chickenpox,\u00a0shingles,\u00a0or\u00a0hepatitis\u00a0B (a liver disease caused by a\u00a0virus\u00a0).<\/li><li>if you have a genetic disorder called Lesch-Nyhan syndrome.<\/li><\/ul>\n\n\n\n<p>Taking immunosuppressive therapy and taking Puri-nethol may increase your risk of:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>tumor\u00a0er, including skin cancer.\u00a0When taking Puri-nethol, you should therefore avoid excessive sunbathing and wear protective clothing, and use sunscreen with a high protection factor.<\/li><li>lymphoproliferative disorders<ul><li>treatment with Puri-nethol increases your risk of developing a type of cancer called a lymphoproliferative disorder.\u00a0Treatment regimens that contain several immunosuppressive drugs (including thiopurines), can lead to death.<\/li><li>A combination of several concomitant immunosuppressive drugs increases the risk of\u00a0lymphatic system\u00a0disorders due to a viral infection (lymphoproliferative disorders associated with\u00a0Epstein-Barr\u00a0virus\u00a0(\u00a0EBV\u00a0)).<\/li><\/ul><\/li><\/ul>\n\n\n\n<p>Taking Puri-nethol may increase your risk of:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>development of a serious condition called macrophage activation syndrome (excessive activation of\u00a0white blood cells\u00a0associated with\u00a0inflammation\u00a0), which usually occurs in people with certain types of\u00a0arthritis.<\/li><\/ul>\n\n\n\n<p>Blood tests<\/p>\n\n\n\n<p>Purinethol treatment can affect your\u00a0bone marrow.\u00a0This means that you may have a reduced number of\u00a0white blood cells,\u00a0platelets,\u00a0and (less commonly)\u00a0red blood cells\u00a0in your blood.\u00a0Your doctor will take blood samples every day at the beginning of your treatment (\u00a0induction\u00a0) and at least once a week later in your treatment (maintenance).\u00a0This is to monitor the levels of these\u00a0blood cells\u00a0in your blood.\u00a0If the treatment is stopped in time, the number of\u00a0blood cells\u00a0in your blood will return to normal.<\/p>\n\n\n\n<p>Other laboratory samples<\/p>\n\n\n\n<p>Additional laboratory tests (such as urine and blood) may also be taken as directed by your\u00a0doctor.<\/p>\n\n\n\n<p>Liver function<\/p>\n\n\n\n<p>Purinethol is toxic to the liver.\u00a0Therefore, your doctor will take liver function tests every week while you are being treated with Purinethol.\u00a0If you already have liver disease, or if you are taking other medicines that may affect your liver, your doctor will take samples more often.\u00a0Talk to your doctor immediately if you notice that the whites of the eyes or your skin turn yellow.\u00a0This is a sign of jaundice and you may need to stop your treatment immediately.<\/p>\n\n\n\n<p>Infection&nbsp;is<\/p>\n\n\n\n<p>When you are treated with Puri-nethol, the risk of\u00a0viral, fungal, and bacterial infections increases, and the\u00a0infections\u00a0can be more serious.\u00a0See also section 4.<\/p>\n\n\n\n<p>Tell your doctor before starting treatment if you have had chickenpox,\u00a0shingles,\u00a0or\u00a0hepatitis\u00a0B (a liver disease caused by a\u00a0virus\u00a0).<\/p>\n\n\n\n<p>NUDT15 gene mutation<\/p>\n\n\n\n<p>If you have a hereditary\u00a0mutation\u00a0in the NUDT15 gene (a gene that is involved in the breakdown of Puri-nethol in the body), then the risk is higher for you to get\u00a0infection\u00a0and hair loss and in this case, the doctor can give you a lower\u00a0dose.<\/p>\n\n\n\n<p>Sun and UV light<\/p>\n\n\n\n<p>During your treatment with Puri-nethol, you are more sensitive to the sun and UV light.\u00a0You need to make sure you limit your exposure to sunlight and UV light, wear protective clothing, and use sunscreen with a high sun protection factor.<\/p>\n\n\n\n<p><strong>Children and young people<\/strong><\/p>\n\n\n\n<p>In some children treated with Puri-nethol, low blood sugar levels, with symptoms such as more sweating than usual, nausea, dizziness, and confusion, have been reported.\u00a0Most of these children were younger than 6 years old and had a low body weight.<\/p>\n\n\n\n<p>If you are not sure if any of the above applies to you, talk to your doctor or pharmacist before taking Purinethol.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Other medicines and Puri-nethol<\/h2>\n\n\n\n<p>Tell your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines.<\/p>\n\n\n\n<p>In particular, tell your doctor or pharmacist if you are taking any of the following medicines:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>ribavirin (used to treat\u00a0viruses\u00a0)<\/li><li>other\u00a0chemotherapy drugs\u00a0(used to treat cancer)<\/li><li>allopurinol, thiopurine, oxypurinol, or febuxostat (used to treat\u00a0gout\u00a0)<\/li><li>olsalazine (used to treat intestinal\u00a0ulcerative colitis\u00a0)<\/li><li>mesalazine (used to treat intestinal diseases Crohn&#8217;s disease and\u00a0ulcerative colitis\u00a0)<\/li><li>sulfasalazine (used to treat\u00a0rheumatoid arthritis\u00a0or intestinal\u00a0ulcerative colitis\u00a0)<\/li><li>methotrexate (is used to treat\u00a0rheumatoid arthritis\u00a0or severe\u00a0psoriasis\u00a0(skin disease)<\/li><li>infliximab (used to treat intestinal diseases Crohn&#8217;s disease and\u00a0ulcerative colitis,\u00a0rheumatoid arthritis,\u00a0inflammation\u00a0of the spine (\u00a0ankylosing spondylitis\u00a0), or severe\u00a0psoriasis\u00a0(skin disease)<\/li><li>warfarin\u00a0or acenocoumarol (blood thinner).<\/li><\/ul>\n\n\n\n<p>Vaccination during treatment with Puri-nethol<\/p>\n\n\n\n<p>Talk to a doctor or nurse before vaccination.\u00a0If you are being treated with Puri-nethol, you should not be vaccinated with a live vaccine (such as the flu vaccine, measles vaccine, and BCG vaccine) until your doctor tells you it is safe.\u00a0This is because some vaccines can lead to an\u00a0infection\u00a0if you are vaccinated while you are being treated with Purinethol.<\/p>\n\n\n\n<p><strong>Purinethol with food and drink<\/strong><\/p>\n\n\n\n<p>You can take Puri-nethol with food or on an empty stomach, but the method you choose should be the same from day today.\u00a0You should take Puri-nethol at least 1 hour before or 2 hours after consuming milk or milk products.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Pregnancy, breastfeeding, and fertility<\/h2>\n\n\n\n<p>If you are pregnant or breastfeeding, think you may be pregnant, or are planning to have a baby, ask your doctor for advice before using this medicine.<\/p>\n\n\n\n<p><strong>Pregnancy<\/strong><\/p>\n\n\n\n<p>Purinethol treatment is not recommended during pregnancy, especially during the first three months of pregnancy, as it may cause birth defects.\u00a0If you are pregnant, your doctor will consider the risks and benefits to you and your baby before prescribing Puri-nethol to you.<\/p>\n\n\n\n<p>If you or your partner are being treated with Puri-nethol, you must use an effective method of contraception to avoid pregnancy during and at least 3 months after stopping treatment with Purinethol.<\/p>\n\n\n\n<p><strong>This applies to both men and women<\/strong>.<\/p>\n\n\n\n<p><strong>Breast-feeding<\/strong><\/p>\n\n\n\n<p>Purinethol should not be used during breastfeeding.\u00a0<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Driving and using machines<\/h2>\n\n\n\n<p>Purinethol is not expected to affect the ability to drive or use machines, but no studies have been performed to confirm this.<\/p>\n\n\n\n<p>You are responsible for assessing whether you are fit to drive a motor vehicle or perform work that requires sharpened attention.\u00a0One of the factors that can affect your ability in these respects is the use of drugs due to their effects and\/or\u00a0side effects.\u00a0Descriptions of these effects and\u00a0side effects\u00a0can be found in other sections.\u00a0Read all the information in this leaflet for guidance.\u00a0If you are not sure, talk to your doctor or pharmacist.<\/p>\n\n\n\n<p><strong>Purinethol contains\u00a0lactose<\/strong><\/p>\n\n\n\n<p>If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicine.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">3. How to take Puri-nethol<\/h2>\n\n\n\n<p>Purinethol should only be prescribed to you by a specialist doctor who has experience in the treatment of blood cancer.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>During treatment with Puri-nethol, your doctor will take regular blood tests.\u00a0This is to check the number and type of cells in the blood and to check that your liver is functioning properly.<\/li><li>Your doctor may also\u00a0prescribe\u00a0other blood and urine tests to check how your kidneys are working and to measure\u00a0uric acid levels.\u00a0Uric acid\u00a0is a natural substance that is formed in the body and the levels of\u00a0uric acid\u00a0can rise during treatment with Purinethol.\u00a0High levels of\u00a0uric acid\u00a0can damage the kidneys.<\/li><li>Your doctor may change your\u00a0dose\u00a0of Puri-nethol depending on the results of these tests.<\/li><\/ul>\n\n\n\n<p>Always take this medicine exactly as your doctor or pharmacist has told you.\u00a0Ask your doctor or pharmacist if you are unsure.\u00a0You must take your medicine at the right time.\u00a0The label on the package contains information on how many tablets to take and how often to take them.\u00a0Consult a doctor, nurse, or pharmacist if the label lacks this information or if you are unsure.<\/p>\n\n\n\n<p>The recommended\u00a0dose\u00a0for adults and children is 2.5 mg per kilogram body weight per day (or 50 to 75 mg per square meter (m\u00a02\u00a0) body surface area per day).\u00a0Your doctor will calculate and adjust your\u00a0dose\u00a0based on your body weight, the results of your blood tests, if you are taking other\u00a0chemotherapy drugs,\u00a0and your kidney and liver function.<\/p>\n\n\n\n<p>Swallow the tablets whole with a little water.\u00a0The tablets should not be split or crushed.\u00a0Do not chew the tablets either.\u00a0If you or your caregiver handle broken tablets, wash your hands immediately afterward.\u00a0You must know how to handle this medicine safely.<\/p>\n\n\n\n<p>You can take your medicine with food or on an empty stomach, but the way you choose should be the same from day today.\u00a0You should take Puri-nethol at least 1 hour before or 2 hours after consuming milk or milk products.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">If you take more Puri-nethol than you should:<\/h2>\n\n\n\n<p>If you have ingested too much medicine or if e.g.\u00a0If a child has ingested the medicine by mistake, contact a doctor or hospital for risk assessment and advice.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">If you forget to take Puri-nethol:<\/h2>\n\n\n\n<p>Talk to a doctor.\u00a0Do not take a double\u00a0dose\u00a0to make up for a forgotten\u00a0dose.<\/p>\n\n\n\n<p><strong>If you stop taking Purinethol<\/strong><\/p>\n\n\n\n<p>Talk to your doctor immediately if you stop taking Purinethol.<\/p>\n\n\n\n<p>If you have any further questions on the use of this product, ask your doctor, pharmacist, or nurse.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Possible side effects<\/h2>\n\n\n\n<p>Like all medicines, this medicine can cause\u00a0side effects, although not everybody gets them.<\/p>\n\n\n\n<p><strong>If you get any of the following\u00a0side effects, talk to your specialist doctor or hospitalize\u00a0immediately:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>An\u00a0allergic reaction\u00a0with swelling of the face and in some cases mouth and throat (this is a very rare\u00a0side effect\u00a0)<\/li><li>An\u00a0allergic reaction\u00a0with joint pain, rash, fever (this is a rare\u00a0side effect\u00a0)<\/li><li>Yellow-colored skin or yellow-colored whites of the eyes.\u00a0If you experience any of these symptoms, stop taking Purinethol.<\/li><li>Signs of fever or\u00a0infection\u00a0(sore throat, sore mouth, or difficulty urinating) or unexplained bruising or bleeding.\u00a0Treatment with Puri-nethol affects the\u00a0bone marrow\u00a0and causes a decrease in\u00a0white blood cells\u00a0and\u00a0platelets\u00a0(this is a very common\u00a0side effect\u00a0).<\/li><\/ul>\n\n\n\n<p>Talk to your doctor if you experience any of the following\u00a0side effects, which may also occur with this medicine:<\/p>\n\n\n\n<p><strong>Common&nbsp;<\/strong><strong>(may affect up to 1 in 10 people)<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Nausea or vomiting<\/li><li>Low&nbsp;red blood cell count&nbsp;(&nbsp;anemia&nbsp;)<\/li><\/ul>\n\n\n\n<p><strong>Uncommon (may affect up to 1 in 100 people)<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Loss of appetite<\/li><\/ul>\n\n\n\n<p><strong>Rare&nbsp;<\/strong><strong>(may affect up to 1 in 1,000 people)<\/strong>&nbsp;<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Cold sores<\/li><li>Inflammation\u00a0of the pancreas (\u00a0pancreatitis\u00a0), with symptoms such as abdominal pain, nausea, or vomiting<\/li><li>Liver damage (liver necrosis)<\/li><li>Hair loss<\/li><li>Different types of cancer, including blood, lymph, and skin cancers<\/li><\/ul>\n\n\n\n<p><strong>Very&nbsp;<\/strong><strong>rare (may affect up to 1 in 10,000 people)<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Blood cancer<\/li><li>Cancer of the spleen and liver (in patients with a disease called&nbsp;inflammatory&nbsp;bowel disease)<\/li><li>Sores in the intestines, with symptoms such as abdominal pain and bleeding<\/li><li>Low sperm count in men<\/li><\/ul>\n\n\n\n<p><strong>Has been reported (occurs in an unknown number of users)<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Increased sensitivity to sunlight and UV light<\/li><\/ul>\n\n\n\n<p><strong>Additional&nbsp;side effects&nbsp;are in children<\/strong><\/p>\n\n\n\n<p>In some children treated with Puri-nethol, low blood sugar levels, with symptoms such as more sweating than usual, nausea, dizziness, and confusion, have been reported.\u00a0Most of these children were younger than 6 years old and had a low body weight.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">How to store Puri-nethol<\/h2>\n\n\n\n<p>Sensitive to light.&nbsp;Moisture sensitive.&nbsp;Store in the original package.<\/p>\n\n\n\n<p>Keep this medicine out of the sight and reach of children.<\/p>\n\n\n\n<p>Do not use this medicine after the expiry date which is stated on the carton.<\/p>\n\n\n\n<p>Medicines should not be disposed of via wastewater or household waste.&nbsp;Ask your pharmacist how to dispose of medicines no longer required.&nbsp;These measures will help to protect the environment.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Contents of the pack and other information<\/h2>\n\n\n\n<h2 class=\"wp-block-heading\">Content declaration<\/h2>\n\n\n\n<p>The active substance is 6-mercaptopurine 50 mg per tablet<\/p>\n\n\n\n<p>The other ingredients are stearic acid,\u00a0lactose monohydrate\u00a0magnesium stearate, corn starch, and modified corn starch.<\/p>\n\n\n\n<p><strong>What the medicine looks like and the contents of the pack<\/strong><\/p>\n\n\n\n<p>Purinethol tablets are yellow with a notched, imprinted PT \/ 50 on one side.<\/p>\n\n\n\n<p>The tablets are supplied in a glass jar containing 25 tablets.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Marketing Authorization Holder and Manufacturer<\/h2>\n\n\n\n<p>Aspen Pharma Trading Limited<\/p>\n\n\n\n<p>3016 Lake Drive,<\/p>\n\n\n\n<p>Citywest Business Campus<\/p>\n\n\n\n<p>Dublin 24, Ireland<\/p>\n\n\n\n<p>+46 856 642 572<\/p>\n\n\n\n<p><strong>Manufacturer:<\/strong><\/p>\n\n\n\n<p>Excella GmbH &amp; Co.&nbsp;KG<\/p>\n\n\n\n<p>N\u00fcrnberger Strasse 12,<\/p>\n\n\n\n<p>90537 Moisture,<\/p>\n\n\n\n<p>Germany<\/p>\n\n\n\n<p>Aspen Bad Oldesloe GmbH<\/p>\n\n\n\n<p>Industriestrasse 32-36<\/p>\n\n\n\n<p>23843 Bad Oldesloe<\/p>\n\n\n\n<p>Germany<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Puri-nethol contains the active substance 6-mercaptopurine. 6-mercaptopurine belongs to a group of medicines called cytotoxic drugs (also called cytostatics ) and works by reducing the number of new blood cells that your body produces.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"cybocfi_hide_featured_image":"","footnotes":""},"categories":[2200,18527],"tags":[22191,22195,22194,22196,22202,22197,22201,22200,22193,22192,22198,22199],"class_list":["post-21472","post","type-post","status-publish","format-standard","hentry","category-medicines","category-p","tag-6-mercaptopurine","tag-6-mercaptopurine-side-effects","tag-6-mercaptopurine-tablet","tag-benefits-of-6-mercaptopurine","tag-benefits-of-puri-nethol","tag-puri-nethol","tag-puri-nethol-side-effects","tag-puri-nethol-tablet","tag-what-6-mercaptopurine-is-used-for","tag-what-is-6-mercaptopurine","tag-what-is-puri-nethol","tag-what-puri-nethol-is-used-for"],"_links":{"self":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/21472","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/comments?post=21472"}],"version-history":[{"count":4,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/21472\/revisions"}],"predecessor-version":[{"id":21510,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/21472\/revisions\/21510"}],"wp:attachment":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/media?parent=21472"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/categories?post=21472"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/tags?post=21472"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}