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Purinethol (mercaptopurine) is an anti-cancer medication commonly used to treat acute lymphocytic leukemia. Less commonly it may be used to treat Crohn's disease and ulcerative colitis. With respect to leukemia, it is used, usually along with Trexall (methotrexate), as a maintenance therapy following remission.

Purinethol should not be used to treat or prevent central nervous system leukemia, acute myelogenous leukemia, or solid tumors.

This medication can be used in patients of all ages, though dosage adjustments will be required. This is a very potent medication and no one should use it without first getting a diagnoses of acute lymphatic leukemia, or similar condition in which Purinethol may provide benefit. Use of this product without doctor involvement is strongly advised against.

How It Works

Purinethol is an antimetabolite, which is very similar to natural substances found in cells---so similar that cells will incorporate Purinethol into their metabolism. Once in the cell, Purinethol halts cellular division and induces cell suicide.

This mechanism is effective against cancer, as cancer cells tend to replicate themselves rapidly. The medication does not, unfortunately distinguish between healthy cells and cancer cells; as with most chemotherapies, Purinethol will most likely produce a number of side effects, including nausea, diarrhea, low blood counts, liver problems, and so forth.

Side effects from Purinethol are, to some extent, dose-dependent; relatively low doses are unlikely to produce as many or as severe as experienced by those taking higher doses.

Administration

Purinethol comes in tablets, available in 50 mg doses. There are no other strengths currently available.

Tablets should be taken once per day. For leukemia, tablets should be taken on an empty stomach; either 1 hour before or 2 hours after a meal. The medication is absorbed better on an empty stomach. For Crohn's disease or ulcerative colitis, dosage is considerably lower and a doctor may or may not recommend taking each tablet with milk or a snack.

Dosage ranges from 1.5 to 2.5 mg per kg of body weight per day for leukemia, usually 1/2 to 1/4 of that for other conditions. Factors influencing dosage are weight, age, other medications being taken, other medical conditions present, and so forth. For example, if taking Purinethol with the gout medication allopurinal, the Purinethol dosage should be 1/3 to 1/4 of the standard dose.

Patient response to treatment is also important; regular tests will be utilized, particularly at the start of treatment, to ensure the medication is acting as expected. A low percentage of patients may have an allergic reaction, or simply don't respond to treatment as some individuals are resistant to it.

Duration of treatment can also be variable; it is typically given long-term for everything it treats, be that leukemia or Crohn's disease. Treatment will likely span several months to years.

The medication can irritate the skin and eyes; wash hands thoroughly after handling tablets. Patients may be advised to drink extra fluids during treatment to help the kidneys process it. If another person or pets accidentally consume tablets seek emergency medical attention.

Other Considerations

Purinethol, and methotrexate often given along with it, can both reduce immune function. Do not have immunizations/vaccinations for the duration of treatment without explicit doctor permission; likewise do not come into contact with people who have recently had live vaccinations.

The medication can also increase risk of bleeding. Use caution when shaving, brushing teeth, and so forth. Avoid contact sports or other activities where injury is likely. Any unexplained or excessive bleeding or bruising---such as nosebleeds---should be brought to the attention of a doctor. Internal bleeding, vomiting blood, coughing up blood, or blood in stools, should receive prompt medical attention.

Again this is a potent medication, and taking it may sound daunting. However, a doctor has decided that the benefits outweigh the risks. With self-care and working closely with a doctor, these risks can be minimized and patients can live as normal a life as possible.