Consumer Medicine Information
What is in this leaflet?
Please read this leaflet carefully before you take Puri-Nethol.
This leaflet answers some common questions about Puri-Nethol. It does not contain all of the available information.
It does not take the place of talking to your doctor or pharmacist.
All medicines have risks and benefits. Your doctor has weighed the expected benefits of you taking Puri-Nethol against the risks this medicine could have for you.
If you have any concerns about taking this medicine, ask your doctor or pharmacist.
Keep this leaflet with the medicine. You may need to read it again.
What is Puri-Nethol used for?
Puri-Nethol is used to treat cancer of certain blood cells; this condition is known as leukaemia.
Puri-Nethol belongs to a group of medicines called cytotoxics.
Cytotoxic medicines are mainly used in the treatment of cancer.
Puri-Nethol works by killing cancer cells.
Your doctor may have prescribed Puri-Nethol for another reason.
Puri-Nethol is not addictive. If you take too much Puri-Nethol or if someone else takes your medicine by mistake, tell your doctor immediately.
Before you take Puri-Nethol
Do not take if:
You must not take Puri-Nethol if:
you have ever had an allergic reaction to mercaptopurine or any of the ingredients listed toward the end of this leaflet. (See "Ingredients")
the 'use by' or expiry date (EXP) printed on the pack has passed.
the packaging is torn or shows signs of tampering
Tell your doctor if:
You must tell your doctor if:
you are allergic to foods, dyes, preservatives or any other medicines.
you are taking any other medicines (especially allopurinol, warfarin, olsalazine, mesalazine or sulphasalazine), including medicines you buy without a prescription.
you suffer from liver or kidney disease.
you have a rare hereditary condition, where you have too little of the natural body chemical thiopurine methyltransferase (TPMT) enzyme in your body.
you are breastfeeding, pregnant or trying to become pregnant (this applies to both men and women)
you have recently been vaccinated, or are planning to be vaccinated.
The use of Puri-Nethol during pregnancy should be avoided if possible, especially in the first three months of pregnancy. If you are pregnant or are thinking about becoming pregnant, you should discuss with your doctor, whether the benefit of taking Puri-Nethol tablets outweigh the possible risks of problems with your pregnancy, BEFORE starting your tablets.
As with all cytotoxic chemotherapy, contraceptive precautions should be taken if either partner is taking Puri-Nethol tablets.
How do I take Puri-Nethol?
How much to take
Take Puri-Nethol as directed by your doctor or pharmacist.
It is important to take your medicine at the right time. The label on the pack will tell you how many tablets to take and how often to take them. If the label doesn't say or if you are not sure, ask your doctor or pharmacist.
The dose is very variable and it may be changed for no apparent reason, ask your doctor.
The usual starting dose for adults and children is worked out by your doctor based on your body weight or your body surface area. Elderly patients will have their kidney and liver function tested and if necessary the dose may need to be reduced.
Your doctor may reduce your dose of Puri-Nethol if you have kidney or liver disease or you are taking any other medicines that can cause a decrease in the body's ability to produce white blood cells and platelets, such as other cytotoxic medicines.
If you are taking allopurinol, your doctor should decrease your dose of Puri-Nethol to a quarter of the usual dose.
How to take it
Take Puri-Nethol with a glass of water.
From time to time while you are taking Puri-Nethol, your doctor will want you to have a blood test. This is to check your blood cell count and to change your dose if necessary.
Puri-Nethol belongs to a group of medicines called cytotoxics, which are irritant to the eyes and skin. To prevent irritation it is important to wash your hands immediately after handling or halving the tablets, to avoid contact with the eyes and be careful not to inhale any particle of the tablet.
How long to take it for
The dose and duration of treatment will depend on the nature and dosage of other cytotoxic agents given in conjunction with Puri-Nethol. The dosage should be carefully adjusted to suit the individual patient.
Do not stop taking Puri-Nethol, or change the dose without first checking with your doctor.
Use in elderly patients
No specific studies have been carried out in the elderly. However, it is advisable to monitor renal and hepatic function in these patients, and if there is any impairment, consideration should be given to reduce the Puri-Nethol dosage.
What do I do if I take too much? (Overdose)
Immediately telephone your doctor or Poisons Information Centre (telephone 13 11 26) for advice, if you think you or anyone else may have taken too much Puri-Nethol, even if there are no signs of discomfort or poisoning.
If you are not sure what to do, contact your doctor, pharmacist or nearest hospital.
While you are taking Puri-Nethol
Things you must do
Tell your doctor if, for any reason, you have not taken your medicine exactly as directed.
If you forget to take a dose tell your doctor. DO NOT DOUBLE YOUR NEXT DOSE. Otherwise, your doctor may think that it was not working as it should and change your treatment unnecessarily.
Things you must not do
Do not give this medicine to anyone else, even if their symptoms seem similar to yours.
Do not use Puri-Nethol to treat any other complaints unless your doctor says to.
Things to be careful of
Be careful driving or operating machinery until you know how Puri-Nethol affects you.
What are the side effects?
Check with your doctor as soon as possible if you think you are experiencing any side effects or allergic reactions due to taking Puri-Nethol, even if the problem is not listed below.
Like other medicines, Puri-Nethol can cause some side effects. If they occur, they are most likely to be minor and temporary. However, some may be serious and need medical attention.
Puri-Nethol may cause side effects in some people, mainly reduced cell production in the bone marrow.
During your treatment your doctor will take blood tests to check your liver function. Your doctor may take other blood and urine tests to monitor your uric acid levels, a natural body chemical of which levels may rise while being treated with Puri-Nethol.
As with all cytotoxic medicines, there is an increased risk of damage to the genes in some cells.
The reported side-effects include:
mild gastrointestinal discomfort (vomit, diarrhoea, loss of appetite, abdominal pain)
jaundice (your skin or the whites of your eyes turn yellow)
rash, fever or an infection
unexpected bruising or bleeding
Tell your doctor immediately if you notice any of the following:
Wheezing, swelling of the lips/mouth, difficulty in breathing, hayfever, lumpy rash (hives) or fainting. These could be a symptom of an allergic reaction.
This is not a complete list of all possible side effects. Others may occur in some people and there may be some side effects not yet known.
Tell your doctor or pharmacist if you notice any side effects from your medicine which are not mentioned here.
Do not be alarmed by this list of possible side effects. You may not experience any of them.
How do I store Puri-Nethol?
Keep this medicine where children cannot reach it, such as in a locked cupboard.
Store Puri-Nethol in a dry place where it stays below 25 °C. Keep away from light.
Do not leave in a car, on window sill or in bathroom.
Keep Puri-Nethol in its bottle until time to take.
If your doctor tells you to stop taking the tablets, please return any unused or expired medicine to your pharmacist. Only keep them if your doctor tells you to.
What Puri-Nethol looks like
Puri-Nethol tablets are pale yellow, round tablets, biconvex, scored on one side, engraved GX above the score and EX2 below the score and plain on the other side.
Puri-Nethol contains the active ingredient mercaptopurine.
Puri-Nethol also contains lactose, starch-maize, starch-hydrolysed maize, stearic acid and magnesium stearate.
Your Puri-Nethol is supplied by:
GlaxoSmithKline Australia Pty Ltd
1061 Mountain Highway
Boronia Victoria 3155
Where to go for further information
Pharmaceutical companies are not in a position to give people an individual diagnosis or medical advice. Your doctor or pharmacist is the best person to give you advice on the treatment of your condition.
This leaflet was prepared on 4 November 2004.
The information provided applies only to: Puri-Nethol®.
®Puri-Nethol is a registered trade mark of the GlaxoSmithKline group of companies.
Puri-Nethol: AUST R 10993.
Issue No. 4