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thioguanine
Indications:
1) acute non-lymphocytic leukemia
a) remission induction
b) consolidation
c) maintenance
2) treatment of chronic myelogenous leukemia
3) acute lymphoblastic leukemia [4]
4) acute myeloid leukemia [4]
Contraindications:
- history of previous resistance to thioguanine or 6-mercapto- purine
Dosage:
- drink plenty of liquids
- dosage reduction with renal or hepatic insufficiency
Tabs: 40 mg.
Monitor:
1) uric acid
2) complete blood count (CBC)
3) liver function tests (serum ALT, serum AST, serum bilirubin, serum alkaline phosphatase) weekly initially, then monthly [3]
Adverse effects:
1) common (> 10%)
- mild nausea/vomiting*, anorexia, stomatitis, diarrhea
- myelosuppression
- WBC & platelet: moderate
- onset 7-10 days
- nadir: 14 days
- recovery: 21 days
2) less common (1-10%)
- hyperuricemia, unsteady gait, rash
3) uncommon (< 1%)
- neurotoxicity, hepatitis, jaundice, veno-occlusive hepatic disease, photosensitivity
* emetic potential low Toxicology: not dialyzable; treatment is supportive
Drug interactions:
- busulfan
Laboratory:
- thioguanine in serum/plasma
- 6-thioguanine in erythrocytes
Interactions
drug interactions
Related
acute myeloid leukemia (AML)
chronic myeloid leukemia (CML, granulocytic leukemia)
General
mercaptopurine; thiopurine
Properties
MISC-INFO: pregnancy-category D
Database Correlations
PUBCHEM correlations
References
- Kaiser Permanente Northern California Regional Drug
Formulary, 1998
- Department of Veterans Affairs, VA National Formulary
- Prescriber's Letter 17(7): 2010
Recommended Lab Monitoring for Common Medications
Liver Function Test Scheduling
Detail-Document#: 260704
(subscription needed) http://www.prescribersletter.com
- Deprecated Reference