Health Centres - Puri-Nethol
How does it work?
Puri-Nethol tablets contain the active ingredient mercaptopurine, which is a type of chemotherapy medicine for cancer known as a 'cytotoxic antimetabolite'.
Cancers form when cells within the body multiply abnormally and uncontrollably. These cells spread, destroying nearby tissues. Mercaptopurine works by stopping the cancer cells from multiplying. It does this by being incorporated into the cells' genetic material, DNA and RNA. Both DNA and RNA are needed for cells to grow, repair themselves and multiply. Mercaptopurine causes problems with the production of DNA and RNA in the cancer cells, and this causes the cells to grow in an unbalanced way, resulting in the death of the cells.
Mercaptopurine is used to treat various types of cancer of the white blood cells (leukaemia). It can be given to induce remission in acute leukaemia, but is particularly useful for maintenance treatment after remission is achieved. It can also be used to treat a rare type of leukaemia called chronic myeloid leukaemia.
Unfortunately, mercaptopurine can also affect normal, healthy cells, particularly those that multiply quickly, such as blood cells and hair cells. Although the aim of treating leukaemia with mercaptopurine is to kill the cancerous blood cells, the most important side effect is on the bone marrow, where blood cells are made. Mercaptopurine also decreases the production of normal blood cells, which can leave people susceptible to infection. Regular blood tests are therefore needed to monitor the levels of blood cells.
In most chemotherapy regimens, doses are administered in courses at various intervals to allow normal cells to recover from the adverse effects of the anticancer medicines between doses. However, during this period, cancer cells will also recover and start to replicate again. Successful treatment depends on the administration of the next course of therapy before the cancer has regrown to its previous size, with the aimed net effect to decrease the amount of cancer with each successive course of chemotherapy.
What is it used for?
-
Acute leukaemia, in particular, maintenance treatment for acute lymphoblastic leukaemia and acute myelogenous leukaemia
-
Chronic myeloid leukaemia
- Inflammatory bowel disease such as ulcerative colitis or Crohn's disease (unlicensed use)
Warning!
- People having treatment with this medicine will also need regular blood tests to monitor their liver function. Symptoms that may suggest a liver problem include persistent nausea and vomiting, abdominal pain, or the development of jaundice (a yellow colouring to the skin and the whites of the eyes). Tell your doctor if you or your child experience any of these symptoms.
- During treatment to induce remission of leukaemia, this medicine causes rapid cell breakdown. The products of the cell breakdown, in particular uric acid, can build up in the blood or urine and can cause kidney problems. For this reason, people having remission induction treatment will need to have regular blood and urine tests to monitor their uric acid levels. If these go too high your doctor may prescribe another medicine called allopurinol to reduce them.
- Your ability to become pregnant or father a child may be affected by this medicine. It is important to discuss fertility with your doctor before starting treatment.
- Women who are pregnant should not handle these tablets.
Use with caution in
- Decreased kidney function
- Decreased liver function
- Liver disease
Not to be used in
- Allergy to any ingredient
This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.
Pregnancy and Breastfeeding
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
- This medicine should not be used in pregnancy, unless considered essential by your doctor due to life-threatening disease, because it may be harmful to a developing baby. In addition, pregnant women should not handle this medicine. Women who could get pregnant should use effective contraception to prevent pregnancy, and men should use effective contraception to prevent fathering a child, both during treatment, and for at least a few months after treatment is finished. Seek medical advice from your doctor.
- This medicine may pass into breast milk and may be harmful to a nursing infant. Mothers who need treatment with this medicine should not breastfeed. Seek medical advice from your doctor.
Side effects
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
- Decrease in the number of white blood cells in the blood (leucopenia)
- Decrease in the number of platelets in the blood (thrombocytopenia)
- Nausea and vomiting
- Loss of appetite
- Mouth ulcers
- Diarrhoea
- Hair loss
- Skin rash
- Fever
- Ulcers in the intestines
- Temporary decrease in sperm count
- Liver problems
- Inflammation of the pancreas (pancreatitis)
The side effects listed above may not include all of the side effects reported by the drug's manufacturer.
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