Mercaptopurine is a nucleoside metabolic inhibitor indicated for treatment of adult and pediatric patients with acute lymphoblastic leukemia (ALL) as part of a combination chemotherapy maintenance regimen. It is available as oral suspension and tablets. MedsAcross supplies Mercaptopurine for export from India to licensed hospitals, importers and physicians acting for named patients, with the documents each country requires.
Information from the US FDA prescribing information, retrieved 12 November 2026. Not yet medically reviewed.How we review
From the regulator-approved product information. Each section names its source.
Mercaptopurine tablets is a nucleoside metabolic inhibitor indicated for treatment of adult and pediatric patients with acute lymphoblastic leukemia (ALL) as part of a combination chemotherapy maintenance regimen.
Source: US FDA prescribing information
Mercaptopurine is a purine analog that undergoes intracellular transport and activation to form metabolites including thioguanine nucleotides (TGNs). Incorporation of TGNs into DNA or RNA results in cell-cycle arrest and cell death. TGNs and other mercaptopurine metabolites are also inhibitors of de novo purine synthesis and purine nucleotide interconversions. Mercaptopurine was cytotoxic to proliferating cancer cells in vitro and had antitumor activity in mouse tumor models. It is not known which of the biochemical effects of mercaptopurine and its metabolites are directly or predominantly responsible for cell death.
Source: US FDA prescribing information
The recommended starting dose of mercaptopurine tablets is 1.5 mg/kg to 2.5 mg/kg orally once daily as part of a combination chemotherapy maintenance regimen. Adjust dose to maintain desirable absolute neutrophil count and for excessive myelosuppression. Renal Impairment: Use the lowest recommended starting dose or increase the dosing interval. Hepatic Impairment: Use the lowest recommended starting dose.
Source: US FDA prescribing information
None. None.
Source: US FDA prescribing information
Myelosuppression: Monitor complete blood count (CBC) and adjust the dose of mercaptopurine tablets for excessive myelosuppression. Consider testing in patients with severe myelosuppression or repeated episodes of myelosuppression for thiopurine S -methyltransferase (TPMT) or nucleotide diphosphatase (NUDT15) deficiency. Patients with homozygous or homozygous TPMT or NUDT15 deficiency may require a dose reduction. Hepatotoxicity: Monitor transaminases, alkaline phosphatase and bilirubin. Withhold mercaptopurine tablets at onset of hepatotoxicity. Immunosuppression: Response to all vaccines may be diminished and there is a risk of infection with live virus vaccines. Consult immunization guidelines for immunocompromised patients. Treatment Related Malignancies: Aggressive and fatal cases of hepatosplenic T-cell lymphoma have occurred.
Source: US FDA prescribing information
The following clinically significant adverse reactions are described elsewhere in the labeling: Myelosuppression Hepatotoxicity Immunosuppression Treatment related malignancies Macrophage activation syndrome The most common adverse reaction (>20%) is myelosuppression, including anemia, leukopenia and thrombocytopenia. Adverse reactions occurring in 5% to 20% of patients include anorexia, nausea, vomiting, diarrhea, malaise and rash.
Source: US FDA prescribing information
Allopurinol: Reduce the dose of mercaptopurine tablets when co-administered with allopurinol. Warfarin: Mercaptopurine tablets may decrease the anticoagulant effect.
Source: US FDA prescribing information
Store at 20°C to 25°C (68°F to 77°F), excursions permitted to 15°C to 30°C (59°F to 86°F). Store in a dry place.
Source: US FDA prescribing information
For healthcare professionals and buyers. This is not medical advice. Treatment decisions belong to the prescriber.
2 presentations of Mercaptopurine, sorted by availability.
| Medicine | Manufacturer | Register | Availability |
|---|---|---|---|
| Mercaptopurine 50 mg tabletOralGeneric name | — | US FDA | Available on request |
| Mercaptopurine 20 mg/mL oral suspensionOralGeneric name | — | US FDA | Available on request |
Approval facts from US FDA, EMA and CDSCO data, and registration status by country where we hold register data.
Conditions linked to Mercaptopurine in public data. This is not a list of approved uses, see the clinical information.
Yes, on request. MedsAcross lists 2 presentations of Mercaptopurine and sources them for licensed hospitals, importers and physicians against valid import documents.
Yes. The US FDA first approved Mercaptopurine on 11 September 1953, according to Drugs@FDA.
Yes. Mercaptopurine has a central EU marketing authorisation (status: authorised), according to European Medicines Agency data.
No listed presentation of Mercaptopurine is recorded as needing a cold chain. Storage conditions are shown on each presentation page.
Mercaptopurine is classified under ATC code L01BB02 (Mercaptopurine).
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