6-Mercaptopurine
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| ID | DRUG-MERCAPTOPURINE |
|---|---|
| Tipo | Fármaco |
| Alegais | 6-МеркаптопуринAçúcarAçúcarAçúcar |
| Estado | reviewed 2026-04-27 | pending_clinical_signoff |
| Doenças | DIS-B-ALL |
| Fontes | SRC-NCCN-BCELL-2025 |
Fatos sobre as drogas
| Classe | Antineoplásico — análogo da purina (tiopurina) |
|---|---|
| Mecanismo | Purine antagonist; converted by HGPRT to thio-IMP, which inhibits de novo purine biosynthesis and incorporates into DNA/RNA as thio-dGTP, causing chain termination and triggering apoptosis. Backbone of B-ALL maintenance (POMP / vincristine + MTX + 6-MP + prednisone) for 2-3 years post-induction-consolidation. |
| Dose típica | B-ALL maintenance: 50-75 mg/m² PO daily (continuous), titrated to ANC 0.75-1.5 × 10⁹/L and platelets >75 × 10⁹/L. Dose adjusted by TPMT/NUDT15 genotype if measured (intermediate metabolizers ~50% reduction; poor metabolizers ~10% of standard dose or avoid). |
| Ucrânia registada | Verdade |
| NSZU reembolsado | Verdade |
| Ucrânia verificada pela última vez | 2026-04-27 |
Avisos
- Severe myelosuppression (especially in TPMT- or NUDT15-deficient patients) — genotype testing recommended before initiation
- Hepatotoxicidade, incluindo doença veno-oclusiva hepática
Notas
Cornerstone of B-ALL maintenance (POMP regimen, 2-3 years post-induction- consolidation). TPMT and NUDT15 genotyping should be performed pre-initiation when available — poor metabolizers require dramatic dose reduction or alternative therapy. Take on empty stomach (food + dairy reduce absorption ~25%). Avoid allopurinol coadministration without dose reduction. Bedtime dosing improves tolerance.
Usado por
Esquema terapêutico
REG-POMP-B-ALL-MAINTENANCE- POMP manutenção — B-ALL após a indução-consolidação (vincristine + 6-MP + MTX + prednis...