This information from Lexicomp® explains what you need to know about this medication, including what it’s used for, how to take it, its side effects, and when to call your healthcare provider.
- It is used to treat a type of leukemia.
- It may be given to your child for other reasons. Talk with the doctor.
- If your child is allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell the doctor about the allergy and what signs your child had.
- If your child has taken this drug or a drug called thioguanine to treat cancer before and the cancer did not respond to it.
- If your child is taking allopurinol.
If your child is breast-feeding a baby:
- Be sure your child does not breast-feed a baby while taking this drug and for 1 week after the last dose.
- If your child has trouble swallowing.
This is not a list of all drugs or health problems that interact with this drug.
Tell the doctor and pharmacist about all of your child’s drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for your child to take this drug with all of his/her drugs and health problems. Do not start, stop, or change the dose of any drug your child takes without checking with the doctor.
- Tell all of your child’s health care providers that your child is taking this drug. This includes your child’s doctors, nurses, pharmacists, and dentists.
- Have your child’s blood work checked often. Talk with your child’s doctor.
- Talk with the doctor before your child gets any vaccines. Use of some vaccines with this drug may either raise the chance of very bad infection or make the vaccine not work as well.
- Very bad and sometimes life-threatening blood and bone marrow problems like anemia, low platelet counts, or low white blood cell counts have happened with this drug. Change in dose or even stopping the drug may be needed if any of these side effects happen. Talk with the doctor.
- Your child may have more chance of getting infections. Have your child wash hands often. Avoid crowds and people with infections, colds, or flu.
- Your child may bleed or clot more easily. Have him/her be more careful and avoid injury. Keep your child from rough-housing or playing contact sports.
- If your child has thiopurine S-methyltransferase (TPMT) or nucleotide diphosphatase (NUDT15) deficiency, talk with your child’s doctor.
- Your child may get sunburned more easily. Avoid lots of sun, sunlamps, and tanning beds. Use sunscreen and dress your child in clothing and eyewear that protects him/her from the sun.
- This drug may add to the chance of getting some types of cancer. Talk with the doctor.
- A rare type of cancer called hepatosplenic T-cell lymphoma (HSTCL) has happened with this drug. These cases have been deadly. Most of the time, these cases happened in teenagers or young adults. Most of these patients were using this drug to treat certain types of bowel problems like Crohn disease and ulcerative colitis. This drug is not approved for use to treat bowel problems like these. Tell your child’s doctor if your child has ever had any type of cancer. If you have questions, talk with your child’s doctor.
- A very bad and sometimes life-threatening problem called Macrophage Activation Syndrome (MAS) may rarely happen in people with autoimmune diseases. Talk with the doctor.
- Low blood sugar has happened in people taking this drug, especially children. Signs may be dizziness, headache, feeling sleepy, feeling weak, shaking, a fast heartbeat, confusion, hunger, or sweating. Call your child’s doctor right away if your child has any of these signs.
- This drug may affect fertility. Fertility problems may lead to not being able to get pregnant or father a child.
- If your child is of childbearing age, a pregnancy test will need to be done before starting this drug to make sure she is not pregnant.
If your child is or may be sexually active:
- This drug may cause harm to the unborn baby or loss of the unborn baby if your child takes it during pregnancy.
- Have your child use birth control while taking this drug and for some time after the last dose. Ask the doctor how long your child must use birth control. If your child becomes pregnant, call the doctor right away.
- Males with a partner who may get pregnant must use birth control while taking this drug and for some time after the last dose. Ask your child’s doctor how long to use birth control. If your child’s partner gets pregnant, call the doctor right away.
WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your child’s doctor or get medical help right away if your child has any of the following signs or symptoms that may be related to a very bad side effect:
- Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
- Signs of infection like fever, chills, very bad sore throat, ear or sinus pain, cough, more sputum or change in color of sputum, pain with passing urine, mouth sores, or wound that will not heal.
- Signs of bleeding like throwing up or coughing up blood; vomit that looks like coffee grounds; blood in the urine; black, red, or tarry stools; bleeding from the gums; abnormal vaginal bleeding; bruises without a cause or that get bigger; or bleeding you cannot stop.
- Signs of kidney problems like unable to pass urine, change in how much urine is passed, blood in the urine, or a big weight gain.
- Change in color of skin.
- Redness or white patches in mouth or throat.
- Shortness of breath.
- Very bad belly pain or soreness.
- A skin lump or growth.
- Very bad and sometimes deadly liver problems have happened with this drug. Call your child’s doctor right away if your child has signs of liver problems like dark urine, feeling tired, not hungry, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes.
All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your child’s doctor or get medical help if any of these side effects or any other side effects bother your child or do not go away:
- Feeling tired or weak.
- Diarrhea, throwing up, upset stomach, and feeling less hungry are common with this drug. If these happen, talk with your child’s doctor about ways to lower these side effects. Call your child’s doctor right away if any of these effects bother your child, do not get better, or are severe.
These are not all of the side effects that may occur. If you have questions about side effects, call your child’s doctor. Call your child’s doctor for medical advice about side effects.
You may report side effects to your national health agency.
Give this drug as ordered by your child’s doctor. Read all information given to you. Follow all instructions closely.
- Give this drug at the same time of day.
- Give this drug with or without food but give it the same way each time. Always give with food or always give on an empty stomach.
- Have your child drink lots of noncaffeine liquids every day unless told to drink less liquid by your child’s doctor.
- The doctor will tell you how to give this drug to your child. Be sure you know how much to give, how often to give this drug, and how to store this drug. If the doctor does not tell you how to give this drug or if you are not sure how to give it, talk with the doctor.
- You will need to take special care when handling this drug. Check with the doctor or pharmacist to see how to handle this drug.
- Shake well for at least 30 seconds before each use.
- Measure liquid doses carefully. Use the measuring device that comes with this drug.
- Clean the measuring device as you have been told. If you have questions about cleaning the measuring device, talk with the doctor or pharmacist.
- This drug is pink to brown in color. This is normal.
- If this drug is spilled, you will need to clean it up in a special way. Check with the doctor or pharmacist if you are not sure how to clean it up.
- Call your child’s doctor to find out what to do.
- Store at room temperature in a dry place. Do not store in a bathroom.
- Protect from heat.
- Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
- Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.
- Throw away any part not used 8 weeks after opening.
- If your child’s symptoms or health problems do not get better or if they become worse, call your child’s doctor.
- Do not share your child’s drug with others and do not give anyone else’s drug to your child.
- Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your child’s doctor, nurse, pharmacist, or other health care provider.
- If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.
This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from the healthcare provider. You must talk with the healthcare provider for complete information about the risks and benefits of using this medicine.
© 2020 UpToDate, Inc. and its affiliates and/or licensors. All rights reserved.