MERTABTO Tablet 10's
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Introduction About MERTABTO TABLET
MERTABTO TABLET contains Mercaptopurine which belongs to the group of medicines called Cytotoxics. MERTABTO TABLET is used in adults and children to manage leukaemia, which is a type of blood cancer that occurs due to rapid growth of abnormal blood cells.
MERTABTO TABLET is not recommended for use in patients allergic to 6-mercaptopurine, and/or azathioprine. It is also not recommended for use in patients scheduled for vaccination.
Before taking MERTABTO TABLET, inform your doctor if you have recently been vaccinated (especially with yellow fever vaccine), and/or suffer from inherited mutation of NUDT15 gene (essential for body's breakdown of mercaptopurine), shingles, chicken pox/hepatitis B infection (virus-induced liver disease), kidney problems, and liver problems (such as hepatitis B).
MERTABTO TABLET is generally not recommended for use during pregnancy and in women planning for pregnancy since the medicine may cause harm to the foetus. It is also not recommended for use in breastfeeding women.
MERTABTO TABLET should be used with caution in children (aged below 6 years/low body mass) since it may cause low blood sugar (associated with symptoms such as nausea, dizziness, confusion). It is advised to be used with caution in elderly patients (aged 65 years and above) after consulting the doctor.
The most common side effects of taking MERTABTO TABLET are nausea/vomiting, anaemia (associated with symptoms such as tiredness, weakness, breathlessness), loss of appetite, and/or stomatitis (inflammation of mouth). Consult your doctor if any of these symptoms worsen.
Uses Of MERTABTO TABLET
- Manage leukaemia (blood cancer) in affected individuals
How MERTABTO TABLET Works
MERTABTO TABLET works by causing destruction to DNA and RNA of cancer cells which results in inhibition of growth and spread of cancerous (blood) cells in the body thus managing leukaemia in affected individuals.
How to use MERTABTO TABLET
Take MERTABTO TABLET as advised by your physician. Swallow the medicine with a glass of water. Do not crush or chew the medicine. Your doctor will decide the correct dose and duration for you depending upon your age, body weight, and disease condition.
Side Effects Of MERTABTO TABLET
Common
- nausea/vomiting
- anaemia associated with symptoms such as tiredness, weakness, breathlessness
- loss of appetite
- stomatitis (Inflammation of mouth)
Uncommon
- mouth ulcers
- pancreatitis (Inflammation of pancreas)
- joint pain
- skin rash
- fever
- permanent damage to the liver (hepatic necrosis)
Rare
- hair loss
- swollen face
Stop taking MERTABTO TABLET and contact your doctor immediately if you experience any of the following side effects:
- signs of allergic reaction such as skin rashes, high temperature, joint pain, and/or swollen face
- signs of fever/infection such as sore throat, sore mouth, or urinary problems
- any unexpected bruising/bleeding
- signs of inflamed pancreas such as feeling unwell, abdominal pain, and/or sickness
- jaundice (yellowing of skin/whites of eyes)
How To Manage Side Effects
Nausea and vomiting:
Take MERTABTO TABLET with/just after a meal. Stick to simple meals. Avoid eating oil rich/spicy foods, sugary snacks and drinks. Avoid drinking too much liquid along with your meals, and drink slowly in between meals. Consult your doctor if the condition worsens.
Skin Rash:
Do not scratch the affected area. Wear protective clothing while going outdoors. Regularly moisturize your skin. Consult and inform your doctor if the symptom gets worse.
Warning & Precautions
Pregnancy
MERTABTO TABLET is generally not recommended for use during pregnancy and in women planning for pregnancy since the medicine may cause harm to the foetus. Women of childbearing potential should use effective contraceptive methods to avoid getting pregnant while in management with MERTABTO TABLET which should be continued for next 3 months after stopping management with MERTABTO TABLET. Consult your doctor before taking the medicine.
Breastfeeding
MERTABTO TABLET is not recommended for use in breastfeeding women. Consult your doctor before taking the medicine.
Driving and Using Machines
MERTABTO TABLET is unlikely to affect your ability to drive/operate machines. Consult your doctor before taking the medicine.
Kidney
MERTABTO TABLET should be used with caution in patients with kidney problems. Consult your doctor before taking MERTABTO TABLET.
Liver
MERTABTO TABLET should be used with caution in patients with liver problems such as hepatitis B (serious liver infection caused by Hepatitis B Virus). Consult your doctor before taking MERTABTO TABLET who may advice you for a weekly liver function test to assess your liver function.
Allergy
Do not take MERTABTO TABLET if you are allergic to 6-mercaptopurine, azathioprine, and/or any other ingredients of this medicine.
Others
MERTABTO TABLET is not recommended for use if you:
- are scheduled for vaccination
Before taking MERTABTO TABLET, inform your doctor if you:
- have recently been vaccinated (especially with yellow fever vaccine)
- have a condition that cause body to produce low TPMT (thiopurine methyltransferase) enzyme (responsible to metabolize thiopurines class of drugs)
- are a man and planning for a baby (since this medicine may affect your sperm count)
- suffer from an inherited mutation of NUDT15 gene (essential for body's breakdown of mercaptopurine) associated with higher risk of infections and hair loss
- have/had shingles, chicken pox or hepatitis B infection (virus-induced liver disease)
- suffer from Lesch-Nyhan Syndrome (genetic disorder caused by a deficiency of hypoxanthine-guanine phosphoribosyltransferase enzyme) associated with symptoms such as impaired kidney function, acute gouty arthritis (joint paint), and/or self-mutilating behaviours (such as lip/finger biting)
- avoid exposure to sunlight
- suffer from certain type of arthritis
Use in Paediatrics:
MERTABTO TABLET should be used with caution in children (aged below 6 years/low body mass) since it may cause low blood sugar (associated with symptoms such as nausea, dizziness, confusion). Consult your doctor before taking the medicine.
Use in Geriatrics:
MERTABTO TABLET should be used with caution in elderly patients (aged 65 years and above). Consult your doctor before taking the medicine.
Interactions
A. Drug-Drug interactions:
Before taking MERTABTO TABLET, inform your doctor if you are taking any of the following medicine:
- ribavirin (medicine used to manage viral infections)
- other cytotoxic medicines (used in chemotherapy to manage cancer) Ex. doxorubicin, valrubicin
- allopurinol, thiopurinol, oxipurinol, febuxostat (medicines used to manage gout)
- olsalazine, mesalazine, (medicines used to manage Crohn’s Disease and ulcerative colitis)
- sulfasalazine (medicine used to manage rheumatoid arthritis or ulcerative colitis)
- methotrexate (used to manage rheumatoid arthritis or severe psoriasis)
- infliximab (medicine used to manage Crohn’s Disease, ulcerative colitis, rheumatoid arthritis, ankylosing spondylitis, and/or severe psoriasis)
- warfarin, acenocoumarol (medicines used to manage blood clots)
- Anti-epileptic medicines (used to manage epilepsy) Ex. phenytoin, carbamazepine
- live vaccine (Ex. flu vaccine, measles vaccine, BCG vaccine)
Overdosage:
If you or anyone else accidentally takes too much of MERTABTO TABLET, consult your doctor immediately or visit the nearby hospital. Symptoms of overdose are nausea, vomiting, and/or diarrhoea.
Synopsis
| Drug | : | Mercaptopurine |
| Pharmacological Category | : | Nucleic Acid Synthesis Inhibitors |
| Therapeutic Indication | : | Leukaemia (blood cancer) |
| Dosage Forms | : | Tablet |
More Information
- Keep MERTABTO TABLET out of reach of children
- Do not store MERTABTO TABLET above 25°C
FAQs About MERTABTO TABLET
Q. What is MERTABTO TABLET and why is it used?
A. MERTABTO TABLET contains Mercaptopurine which belongs to the group of medicines called Cytotoxics. It is used in adults and children to manage leukaemia, which is a type of blood cancer that occurs due to rapid growth of abnormal blood cells.
Q. How MERTABTO TABLET works?
A. MERTABTO TABLET works by causing destruction to DNA and RNA of cancer cells which results in inhibition of growth and spread of cancerous (blood) cells in the body thus managing leukaemia in affected individuals.
Q. What are the common side effects of taking MERTABTO TABLET?
A. The most common side effects of taking MERTABTO TABLET are nausea/vomiting, anaemia (associated with symptoms such as tiredness, weakness, breathlessness), loss of appetite, and/or stomatitis (inflammation of mouth). Consult your doctor if any of these symptoms worsen.
Q. How MERTABTO TABLET should be taken?
A. Take MERTABTO TABLET as advised by your physician. Swallow the medicines with a glass of water. Do not crush or chew the medicine. Your physician will decide the correct dose and duration for you depending upon your age, body weight and disease condition.
Q. Can MERTABTO TABLET be used in pregnant women?
A. No, MERTABTO TABLET is not recommended for use during pregnancy and in women planning for pregnancy since the medicine may cause harm to the foetus. Consult your doctor before taking the medicine.
References
1. K.D. Tripathi. Chemotherapy of Neoplastic diseases. Essentials of medical pharmacology. Seventh edition. 2013. Page – 863.
2. Hala Sharma; Roopma Wadhwa. Mercaptopurine. NIH National Library of Medicine. National Center for Biotechnology Information. PMC PubMed Central. May 2022. [Accessed on 13th August 2022] https://www.ncbi.nlm.nih.gov/books/NBK557620/
3. Akhil Kapoor, Surender Kumar Beniwal, Ashok Kalwar, Mukesh Kumar Singhal, Raj Kumar Nirban, Harvindra Singh Kumar. Metronomic therapy with oral 6-mercaptopurine in elderly acute myeloid leukemia: A prospective pilot study. NIH National Library of Medicine. National Center for Biotechnology Information. PMC PubMed Central. June 2016. [Accessed on 13th August 2022] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4873702/
4. Aspen Pharma Trading Limited. Electronic Medicines Compendium (EMC). [Revised in October 2022] [Accessed on 13th August 2022] https://www.medicines.org.uk/emc/files/pil.4655.pdf
Useful Diagnostic Tests
- Complete blood count
- Peripheral smear examination
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