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Thioguanine
Leukemias, lymphomas, and other hematologic cancers
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Drug Name:

Thioguanine Rx

Generic Name and Formulations:
Thioguanine 40mg; tabs; scored.

Company:
Various generic manufacturers

Therapeutic Use:

Indications for Thioguanine:

Remission induction and remission consolidation treatment of acute nonlymphocytic leukemias. Treatment of the chronic phase of chronic myelogenous leukemia (see full labeling).

Adults and Children:

See full labeling. Initially, 2mg/kg per day. If, after 4 weeks, with no improvement, no leukocyte or platelet depression, may increase to 3mg/kg per day. Total daily dose may be given at one time.

Contraindications:

Allergy to mercaptopurine.

Warnings/Precautions:

Not recommended for maintenance therapy or long-term continuous treatments; increased risk of liver toxicity (discontinue if occurs). Pre-existing liver disease. Monitor liver function tests weekly at start of therapy, then monthly thereafter. Thiopurine S-methyltransferase (TPMT) or nucleotide diphosphatase (NUDT15) deficiency (may need to reduce dose to avoid severe bone marrow suppression); consider testing for TPMT and NUDT15 deficiency. Obtain hemoglobin, hematocrit, WBCs with differential, platelets frequently during therapy. Pregnancy (Cat.D); avoid use. Nursing mothers: not recommended.

Pharmacological Class:

Antimetabolite.

Interactions:

Avoid live vaccines (if immunocompromised). Caution with drugs that inhibit TPMT (eg, olsalazine, mesalazine, or sulphasalazine).

Adverse Reactions:

Myelosuppression, hyperuricemia, GI upset, anorexia, stomatitis, hepatotoxicity, elevated liver enzymes, jaundice (discontinue if occurs).

Note:

Formerly known under the brand name Tabloid.

How Supplied:

Contact supplier.

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