Mercaptopurine (6-MP, Purinethol, Purixan)

These instructions are for Children's Hospital of Philadelphia (CHOP) patients with acute lymphoblastic leukemia (ALL) who are prescribed mercaptopurine (also called 6-MP, Purinethol ®, Purixan®).

Important information:

• Mercaptopurine is a chemotherapy that is given by mouth.

• It injures the cancer cells and causes them to die.

• It comes in tablets and liquid. The liquid formulation is known by the brand name Purixan®. Based on insurance, Purixan® may come from a retail pharmacy or a specialty pharmacy. Your oncology team will discuss pharmacy options with you. Side effects may include:

  • Nausea or vomiting

  • Irritation to the liver

  • Decreased blood counts and increased risk of infection

Instructions for taking mercaptopurine:

• If your child is prescribed a tablet, it should be swallowed whole. Your oncology team will tell you if you should follow different instructions.

• If your child is prescribed liquid, measure the dose carefully with an oral syringe provided by the pharmacy. Ask your nurse or pharmacist how to measure your child's dose.

• The liquid formulation, Purixan®, expires within 8 weeks of opening the bottle. It is recommended to write the date of opening on the bottle for awareness.

• Give at the same time every day, ideally at bedtime.

• It is recommended to wear gloves when touching this medicine and wash your hands after removing gloves. If gloves are unable to be worn, please wash your hands with soap and water very well after handling the medicine.

• It is recommended to wear gloves when touching soiled diapers and urine while your child is taking this medicine. Wash your hands after removing gloves. If gloves are unable to be worn, please wash your hands with soap and water thoroughly after handling the soiled items.

Call your CHOP oncology team with any questions or concerns, or if your child:

• Misses any doses

• Cannot swallow the tablet whole or vomits immediately after taking the medicine

• Has severe nausea or vomiting or diarrhea

• Has unusual bruising or bleeding

• Has severe mouth pain

• Has yellow coloring of the skin or eyes

• Has a rash

• Has a fever of 101.3°F (38.5°C) once, or 100.4°F (38°C) three times in a 24-hour period, taken at least 2 hours apart

If your child shows signs of a life-threatening reaction, call 911.

Oncology Contact Information

Reviewed on March 1, 2022, by Sara McDonough, CRNP-AC; Katie Oranges, MSN, CRNP, CPHON; Erika Pineda, PharmD, BCPPS