Tioguanine is used together with other medicines to treat cancer of the white blood cells known as leukaemia.
This medicine may be used to treat other conditions as decided by your doctor.
Take Tioguanine exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.
Take it on an empty stomach. Try to take it at the same time each day.
The dose of this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on your body size, condition, and response to the medication.
Tioguanine must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it unless instructed by the doctor.
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.
DO NOT double a dose under any circumstances.
If you often forget to take your medicine, let your doctor and pharmacist know.
Alert your doctor if your disease is resistant to prior therapy with Tioguanine or similar medicines such as mercaptopurine.
Do not take this medicine if you are pregnant or planning to have a baby soon. If you become pregnant while being treated with Tioguanine, alert your doctor immediately. This medicine may cause harm to your unborn child. You must use proven birth control methods while taking Tioguanine.
Do not breastfeed while you are being treated with this medicine.
Alert your doctor if you have been recently vaccinated. You must avoid any vaccinations without consulting with your doctor.
Inform your doctor if you have the following conditions:
- Lesch-Nyhan syndrome (rare genetic disorder that usually occurs in males characterised by neurological or behavioural abnormalities and high levels of uric acid in the body)
- kidney disease
- liver disease
Some genetic traits can affect an individual’s response to Tioguanine. Individuals with certain gene deficiencies in TPMT
, known as TPMT
poor metabolisers, may experience enhanced side effects of this medicine (e.g. unusual bleeding or bruising, higher risk of infection). Individuals who are intermediate or possible intermediate metabolisers may also experience these side effects. Your doctor may perform genetic testing before giving you Tioguanine to know if it is suitable for you. If you know you have this gene type, inform your doctor.
Why is it important to keep my appointments with the doctor?
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- You may need to have routine blood tests (e.g. complete blood count, liver function test, blood uric acid) before and during your treatment with this medicine.
- Regular monitoring for signs and symptoms of liver impairment, infection, and unusual bleeding or bruising may be needed.
Your doctor will advise you about how often you will need to have these tests.
Tioguanine may cause any of the following side effects: nausea, vomiting, diarrhoea, mouth ulcers, and loss of appetite.
This medicine may also make your skin more sensitive to sunlight. Apply sunscreen when going outdoors and avoid prolonged exposure to sunlight and UV lamps.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- persistent stomach pain, unusual tiredness, yellowing of the skin or eyes, dark coloured urine
- weight gain due to fluid retention or swelling in the limbs, feet or ankles
- severe joint pain, difficulty moving of the joints, redness and swelling
- fever, chills, sore throat or painful urination
- feeling very weak or tired
- abnormal heartbeat, muscle cramps
Tioguanine may cause the level of your red blood cells, white blood cells, and platelets to drop.
Red blood cells carry oxygen around your body. A fall in the level of red blood cells may make you feel tired and worn out.
White blood cells help your body to fight infections. A fall in the level of your white blood cells may put you at higher risk for infections, such as coughs, colds and flu, which may lead to more serious infections. Avoid crowded places and people who are sick. Inform your doctor if you have a fever, or a cough or flu that does not go away.
Platelets help your blood to clot when there is a cut in the skin. A fall in the level of your platelets may put you at risk of bleeding more than usual. Do not take part in activities where you may fall or get injured, such as contact sports. Inform your doctor if you get any unusual bruising (large bruises or several bruises, especially if the bruises appeared on their own) or bleeding that takes a long time to stop (for example, too much bleeding when you floss or brush your teeth).
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Avoid any vaccinations during treatment or at least 3 months after treatment with Tioguanine.
Inform your doctor and pharmacist if you are taking or using any of these medicines:
- other medicines for cancer e.g. busulfan
- medicines to treat inflammation of the bowel e.g. olsalazine mesalazine, sulfasalazine
This list does not include all medicines that may interact with Tioguanine.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements and medicines that you buy without a prescription.
Store in a cool, dry place away from the reach of children. Protect from light and moisture.
Medicines must not be used past the expiry date.
As Tioguanine is a cancer medicine, always return any unused or expired tablets to the clinic, hospital or pharmacy for disposal. Do not throw it away in the household waste.