Thioguanine

Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab tests to check your body's response to thioguanine.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Thioguanine is a cancer medication that interferes with the growth and spread of cancer cells in the body.

Thioguanine is used to treat certain types of leukemia. Thioguanine is sometimes given with other cancer medications.

Thioguanine may also be used for purposes not listed in this medication guide.

Your doctor or pharmacist can provide more information about thioguanine.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2013 Cerner Multum, Inc. Version: 5.01. Revision date: 2/7/2011.

Your use of the content provided in this service indicates that you have read,understood and agree to the End-User License Agreement,which can be accessed by clicking on this link.

Thioguanine is a prescription medication used to treat acute nonlymphocytic leukemia. This is a type of cancer that begins in the white blood cells. Thioguanine belongs to a group of drugs called purine analogs. These work by slowing or stopping the growth of cancer cells in your body.

This medication comes in tablet form and is typically taken once daily, with or without food.

Common side effects of thioguanine include nausea, vomiting, anorexia, and inflammation in the mouth.
 

Thioguanine may be found in some form under the following brand names:

• Tabloid

Thioguanine belongs to the group of medicines known as antimetabolites. It is used to treat some kinds of cancer.

Thioguanine interferes with the growth of cancer cells, which are eventually destroyed. Since the growth of normal body cells may also be affected by thioguanine, other effects will also occur. Some of these may be serious and must be reported to your doctor. Other effects may not be serious but may cause concern. Some effects may not occur for months or years after the medicine is used.

Before you begin treatment with thioguanine, you and your doctor should talk about the good thioguanine will do as well as the risks of using it.

Thioguanine is available only with your doctor's prescription.

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Upset stomach or throwing up.
• Not hungry.
• Mouth irritation or mouth sores.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to the FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch.

If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

• Store at room temperature.
• Store in a dry place. Do not store in a bathroom.
• Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
• Check with your pharmacist about how to throw out unused drugs.

Signs and symptoms of overdosage may be immediate, such as nausea, vomiting, malaise, hypotension, and diaphoresis; or delayed, such as myelosuppression and azotemia. It is not known whether Thioguanine is dialyzable. Hemodialysis is thought to be of marginal use due to the rapid intracellular incorporation of Thioguanine into active metabolites with long persistence. The oral LD50 of Thioguanine was determined to be 823 mg/kg ± 50.73 mg/kg and 740 mg/kg ± 45.24 mg/kg for male and female rats, respectively. Symptoms of overdosage may occur after a single dose of as little as 2.0 to 3.0 mg/kg Thioguanine. As much as 35 mg/kg has been given in a single oral dose with reversible myelosuppression observed. There is no known pharmacologic antagonist of Thioguanine. The drug should be discontinued immediately if unintended toxicity occurs during treatment. Severe hematologic toxicity may require supportive therapy with platelet transfusions for bleeding, and granulocyte transfusions and antibiotics if sepsis is documented. If a patient is seen immediately following an accidental overdosage of the drug, it may be useful to induce emesis.

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Tablet, Oral:

Tabloid: 40 mg

Acute myeloid leukemia (AML): Oral: 2 mg/kg once daily for 4 weeks; if no clinical improvement after 4 weeks and ANC and platelet counts are not depressed, may increase dose to 3 mg/kg once daily with careful monitoring.

Acute lymphoblastic leukemia (ALL) (off-label use): Oral:

Children ≥1 year and Adolescents: Delayed intensification treatment phase: 60 mg/m2/day for 14 days on days 28 to 41 (in combination with vincristine, dexamethasone, doxorubicin, cyclophosphamide, cytarabine, asparaginase, and methotrexate) (Lange 2002; Nachman 1998)

Adolescents ≥15 years: Late intensification treatment phase: 60 mg/m2 once daily on days 29 to 42 (in combination with doxorubicin, vincristine, dexamethasone, cyclophosphamide, and cytarabine) (Larson 1995; Larson 1998)

Administer orally; total daily dose can be given at one time.

Store at 15°C to 25°C (59°F to 77°F). Protect from moisture.

CBC with differential and platelet count (frequently); liver function tests (weekly when beginning therapy then monthly, more frequently in patients with liver disease or concurrent hepatotoxic drugs); serum uric acid; some laboratories offer testing for TPMT deficiency

Monitor for signs/symptoms of hepatotoxicity, portal hypertension (splenomegaly, esophageal varices, thrombocytopenia), or sinusoidal obstruction syndrome (veno-occlusive disease; fluid retention, ascites, hepatomegaly with tenderness, or hyperbilirubinemia); monitor for tumor lysis syndrome

Single Agent Chemotherapy: Usual Initial dose: 2 mg/kg/day orally.
If, after 4 weeks on this dosage, there is no clinical improvement and no leukocyte or platelet depression, the dosage may be cautiously increased to 3 mg/kg per day. The total daily dose may be given at one time.

As a part of combination therapy for induction of remission in patients with acute nonlymphocytic leukemia: 75 to 200 mg/m2/day in 1 to 2 divided doses for 5 to 7 days or until remission is attained.

Because clinical studies of thioguanine did not include sufficient numbers of subjects 65 years of age or over to determine whether they respond differently from younger subjects, dose selection for elderly patients should be cautious, usually starting at the low end of the dosing range.

Data not available