Leukemias, lymphomas, and other hematologic cancers:
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.
Thioguanine Contraindications:
Allergy to mercaptopurine.
Thioguanine 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.
Thioguanine Classification:
Antimetabolite.
Thioguanine 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.
