Class: Chemotherapy

Generic Name: Mercaptopurine

Trade Name: Purixan™

For which conditions is this drug approved? Purixan is approved for the treatment of patients with acute lymphoblastic leukemia (ALL) as part of a combination maintenance therapy regimen.

What is the mechanism of action? Purixan belongs to a group of drugs called nucleoside metabolic inhibitors, or antimetabolites. These drugs work by slowing the growth of cancer cells, which then causes the cells to die.

How is Purixan typically given (administered)? Purixan is taken orally as a liquid. Each is dose is measured with a dosing syringe or a special dose-measuring spoon or medicine cup.

How are patients typically monitored? During treatment with Purixan, patients will be have blood counts monitored to check for bone marrow suppression (myelosuppression), which is a decrease in production of cells responsible for immunity, carrying oxygen, or normal blood clotting. Patients will also have liver and immune function monitored.

What are the common (occur in 20% or more of patients) side effects of treatment with Purixan?

  • Anemia
  • Neutropenia (abnormally low count of neutrophils, a type of white blood cell that helps fight off infections)
  • Lymphopenia (not enough lymphocytes, a type of white blood cell)
  • Thrombocytopenia (low number of platelets)

What are the less common (occur in 5% to 20% of patients) side effects of treatment with Purixan?

  • Anorexia
  • Nausea
  • Vomiting
  • Diarrhea
  • Malaise
  • Rash

This is not a complete list of side effects. Some patients may experience other side effects that are not listed here. Patients may wish to discuss with their physician the other less common side effects of this drug, some of which may be serious.

Some side effects may require medical attention. Other side effects do not require medical attention and may go away during treatment. Patients should check with their physician about any side effects that continue or are bothersome.

What can patients do to help alleviate or prevent discomfort and side effects?

  • Take Purixan only as prescribed and contact your doctor right away if you miss a dose of Purixan or think you’ve taken too much.

Are there any special precautions patients should be aware of before starting treatment?

  • Purixan may harm your unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.
  • It is not known if Purixan is secreted in breast milk. Talk to your doctor if you are breastfeeding or plan to breastfeed. You and your doctor will have to decide if you will take Purixan or breastfeed. You should not do both.

When should patients notify their physician?

Call your doctor right away if you experience fever, sore throat, jaundice, nausea, vomiting, signs of local infection, bleeding from any site, or symptoms of anemia (such as weakness, dizziness, pale skin, headache, numbness or coldness in hands and feet, or low body temperature).

What is a package insert?

A package insert is required by the FDA and contains a summary of the essential scientific information needed for the safe and effective use of the drug for healthcare providers and consumers.  A package insert typically includes information regarding specific indications, administration schedules, dosing, side effects, contraindications, results from some clinical trials, chemical structure, pharmacokinetics and metabolism of the specific drug. By carefully reviewing the package insert, you will get the most complete and current information about how to safely use this drug. If you do not have the package insert for the drug you are using, your pharmacist or physician may be able to provide you with a copy.