Tabloid (thioguanine)

Dosage of thioguanine must be based on the clinical and hematologic response and tolerance of the patient in order to obtain optimum therapeutic results with minimum adverse effects. Testing for thiopurine methytransferase (TPMT) deficiency should be considered prior to initiation of thioguanine therapy; substantial dosage reduction may be required in such patients to avoid severe hematologic toxicity.

Thioguanine is used as a component of combination chemotherapy for induction and consolidation therapy in acute myeloid leukemia. Clinicians should consult currently published protocols for the dosage of thioguanine and other chemotherapeutic agents and the method and sequence of administration. The dosage of thioguanine may need to be reduced if the drug is used with other agents whose primary toxicity is myelosuppression.

On occasions when thioguanine monotherapy is appropriate, the usual induction dosage of thioguanine for pediatric patients and adults recommended by the manufacturer is approximately 2 mg/kg daily. The total daily dose, calculated to the nearest multiple of 20 mg, may be given at one time. If there is no clinical improvement and no leukocyte or platelet count depression after a period of 4 weeks on the initial dosage recommended by the manufacturer, the dosage may be cautiously increased to 3 mg/kg daily.

Prolonged therapy with thioguanine is not recommended because of the high risk of hepatotoxicity. (See Cautions: Hepatic Effects.)

Patients with impaired renal or hepatic function should probably receive reduced doses of thioguanine in order to avoid increased accumulation; however, criteria for dosage adjustment have not been clearly defined.

Thioguanine is administered orally.

Thioguanine tablets should be stored in a tight container at 15-25degreesC.

No dosing information is available for this tab.

No dosing information is available for this tab.

There is no enhanced messaging for this drug.

There are no contraindication interactions for this drug.

There are no severe interactions for this drug.

There are no moderate interactions for this drug.

There is no enhanced messaging for this drug.

There are no contraindication contraindications for this drug.

There are no severe contraindications for this drug.

There are no moderate contraindications for this drug.

There is no enhanced messaging for this drug.

There are no severe adverse reactions for this drug.

There are no less severe adverse reactions for this drug.

No enhanced messaging available.

No enhanced messaging available.

Because thioguanine is potentially mutagenic and teratogenic, the drug may cause fetal toxicity when administered to pregnant women. Reproduction studies in rats receiving 5 times the human dosage of thioguanine on the fourth and fifth days of gestation revealed that 13% of surviving placentas did not contain fetuses and that 19% of offspring were malformed or stunted. Malformations noted in these animals included generalized edema, cranial defects, general skeletal hypoplasia, hydrocephalus, ventral hernia, situs inversus, and incomplete development of limbs. There are no adequate and controlled studies to date using thioguanine in pregnant women, and the drug should be used during pregnancy only in life-threatening situations or severe disease for which safer drugs cannot be used or are ineffective. Women of childbearing potential should be instructed not to become pregnant during thioguanine therapy. When thioguanine is administered during pregnancy or if the patient becomes pregnant while receiving the drug, the patient should be informed of the potential hazard to the fetus.

It is not known whether thioguanine is distributed into milk. Because of the carcinogenic potential of thioguanine, a decision should be made whether to discontinue nursing or the drug, taking into account the importance of the drug to the woman.

No enhanced messaging available.