Tabloid
Tabloid (thioguanine) is a chemotherapy medication. It’s FDA-approved to treat acute nonlymphocytic leukemia, such as acute myeloid leukemia (AML). But Tabloid (thioguanine) isn't a recommended option in current guidelines, likely because there are other medications that work better and are less likely to cause serious side effects. Tabloid (thioguanine) is a tablet that's taken by mouth once daily. Some side effects of this medication include lower blood cell count (myelosuppression) and serious liver problems.
What is Tabloid (thioguanine)?
What is Tabloid (thioguanine) used for?
- Acute nonlymphocytic leukemia (including acute myeloid leukemia, or AML) during induction and consolidation treatment phases
How Tabloid (thioguanine) works
Tabloid (thioguanine) is an antimetabolite known as a purine analog. A purine is one of the building blocks of genetic material called deoxyribonucleic acid (DNA).
Tabloid (thioguanine) works by acting like a purine. It goes into cancer cells and sneaks into their DNA. Once there, Tabloid (thioguanine) prevents the cancer cells from making copies of themselves, which can lead to cell death. As a result, the cancer cells can’t grow or spread as well.
Drug facts
Side effects of Tabloid (thioguanine)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Lower blood cell counts
- High uric acid
- Nausea
- Vomiting
- Lower appetite
- Mouth sores
Tabloid (thioguanine) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Serious infections: temperature of 100.4 degrees Fahrenheit, with or without other symptoms, such as chills, cough, muscle aches, very fast heartbeat, confusion
- Serious bleeds: severe tiredness, bruising that won't go away or bleeding that's difficult to stop
- Serious liver problems: nausea, vomiting, tiredness, stomach pain or swelling, pale-colored stool, dark-colored urine, yellowing of the whites of the eyes or skin
The following Tabloid (thioguanine) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Black, tarry stools
blood in the urine or stools
chills
hoarseness
joint pain, stiffness, or swelling
lower back, side, or stomach pain
painful or difficult urination
pinpoint red spots on the skin
swelling of the feet or lower legs
unusual bleeding or bruising
Incidence not known
Bloody, black, or tarry stools
decrease in the amount of urine
indigestion
noisy, rattling breathing
right upper abdominal pain and fullness
severe stomach pain, cramping, or burning
stomach bloating
swelling of the fingers or hands
trouble breathing
troubled breathing at rest
vomiting of material that looks like coffee grounds, severe and continuing
yellow eyes or skin
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of overdose
Blurred vision
cloudy urine
confusion
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
general feeling of discomfort or illness
increased sweating
unusual tiredness or weakness
vomiting
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Tabloid (thioguanine)
Pros
- Taken by mouth, so good for people who don’t like needles
- Taken once daily
Cons
- Can raise your risk of serious infections
- Brand name only
Pharmacist tips for Tabloid (thioguanine)
- Taking Tabloid (thioguanine) can raise your risk of getting a serious infection because this medication can lower white blood cell (WBC) counts as a side effect. During treatment, you can help prevent infections by washing your hands often, avoiding crowds, and washing raw fruits and vegetables thoroughly before eating them.
- Check your body temperature regularly while you're taking Tabloid (thioguanine), ideally once a day. Call your oncologist immediately if your temperature is 100.4 degrees Fahrenheit or higher because this means you have a fever. Sometimes, a fever might be the only sign that you’re sick.
- Tabloid (thioguanine) can raise your risk of serious bleeds because this medication can cause your platelet level to drop. If appropriate, your oncologist might recommend you avoid taking other medications that can raise your risk of bleeding, such as aspirin or ibuprofen (Advil). You might also avoid shaving with a blade razor, and use an electric razor instead.
- Tabloid (thioguanine) sometimes causes nausea and vomiting. Your oncologist will prescribe antiemetics, like ondansetron (Zofran) or prochlorperazine (Compazine), for you to take at home (if they haven’t already). If the nausea or vomiting becomes too bothersome, contact your oncology care team.
- Females who are taking Tabloid (thioguanine)] should avoid breastfeeding during treatment. It's unclear whether Tabloid (thioguanine)] can get into breast milk and whether it affects breastfed babies, but there’s a possible risk of harm if it does.
- Ask your oncologist about the best way to handle and store Tabloid (thioguanine) safely. Anticancer medications can be harmful to people who handle or come in contact with them. Store Tabloid (thioguanine) in a safe place away from children and pets.
- If you have leftover medication, ask your oncologist how to dispose of it. They might allow you or a family member to bring it to their office or clinic for proper disposal.
Common questions about Tabloid (thioguanine)
Tabloid (thioguanine) is approved to treat acute nonlymphocytic leukemia, such as acute myeloid leukemia (AML). But in general, it’s no longer a recommended treatment option in current guidelines. This is likely because there are other medications that are safer or work better at treating AML. But your oncologist might consider Tabloid (thioguanine) as an option depending on different factors, such as how your cancer is doing and what other anticancer medications you're able to take. If you have questions about taking Tabloid (thioguanine), talk to your oncology care team.
The most common side effect of Tabloid (thioguanine) is lower blood cell counts, including lower white blood cells (WBC), red blood cells (RBC), and platelets. Having lower blood cell counts can lead to more serious problems, such as serious infections, anemia, and bleeding that’s difficult to stop. Because of these risks, your oncologist order blood draws regularly while you’re taking Tabloid (thioguanine) to see if your blood cell counts are within a safe range. If needed, they’ll lower your dose of Tabloid (thioguanine) or ask you to stop treatment. If you have any unexpected bruising, bleeding, or you feel very tired, contact your oncologist, since these can be signs of low blood cell counts.
Yes, Tabloid (thioguanine) can cause a rare, but serious side effect called tumor lysis syndrome (TLS). This is a complication that occurs when cancer cells are destroyed and release what was inside them into the bloodstream. TLS can be dangerous because it can lead to high levels of potassium and uric acid in the blood, which can cause problems with your heart and kidneys. TLS is most common in certain cancers such as lymphoma and leukemia. Your oncologist will monitor you closely through blood tests, especially at the beginning of treatment. Let your oncology care team know right away if you have symptoms of TLS, such as muscle cramps, nausea, or numbness.
After attacking cancer cells in your body, Tabloid (thioguanine) is broken down by two proteins: theopurine methyltransferase (TPMT) and nucleotide diphosphatase (NUDT15). Though not common, some people have conditions where one of these proteins don't work well. This means their body can't break down Tabloid (thioguanine) properly, which puts them at higher risk for serious side effects related to Tabloid (thioguanine), such as infections. Before you start Tabloid (thioguanine), your oncologist might order a lab test to see if your TMPT and NUDT15 proteins are working properly. If not, they'll likely recommend that you take a lower dose of Tabloid (thioguanine) to lower the risk of side effects.
Tabloid (thioguanine) hasn’t been studied in human pregnancy, but based on animal studies and the way the medication works, it might cause harm to an unborn baby. If you’re able to become pregnant, your oncologist will likely recommend that you take birth control while taking Tabloid (thioguanine). If you become pregnant while taking Tabloid (thioguanine), contact your oncologist right away.
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Risks and warnings for Tabloid (thioguanine)
Tabloid (thioguanine) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Liver toxicity
Some people taking Tabloid (thioguanine) have developed serious liver problems such as veno-occlusive disease or portal hypertension. Liver problems were more commonly reported in children taking Tabloid (thioguanine) as maintenance therapy for acute lymphoblastic leukemia (ALL). Because of this risk, Tabloid (thioguanine) isn’t recommended to be used as maintenance treatment. Your oncologist will monitor your liver health with lab tests. If results suggest liver problems, they might ask you to pause treatment while they look into it. Contact your oncology team right away if you have stomach pain, a swollen stomach, or yellowish eyes or skin.
Lower blood cell counts
Tabloid (thioguanine) commonly causes low blood cell counts, including white blood cells (WBCs), red blood cells (RBCs), and platelets. This can lead to problems like feeling more tired (from low RBCs) and higher risk for bleeding (from low platelets). It can also raise your risk for serious and life-threatening infections (from low WBCs). Your oncologist will check your blood cell counts often during treatment. If your counts are too low, your oncologist might make adjustments to your treatment to give your body time to make new blood cells.
To lower your risk of getting sick, it’s important to wash your hands often and avoid crowds. Also, check your temperature regularly, and call your oncologist right away if your temperature is 100.4 degrees Fahrenheit or higher. In addition, let your oncology team know right away if you notice bruises that won’t go away or bleeding that’s difficult to stop; these might be signs that your platelet level is too low.
Serious risk for people with a specific genetic condition
Tabloid (thioguanine) is broken down by two specific proteins: theopurine methyltransferase (TPMT) and nucleotide diphosphatase (NUDT15). Though uncommon, some people have abnormalities in one of these proteins. If these proteins don’t work correctly, they might not break down Tabloid (thioguanine) like they’re supposed to, which means Tabloid (thioguanine) stays active in your body for longer. This can lead to worse side effects. Because of this, if you have an abnormality in one of these proteins, your oncologist will lower your dose of Tabloid (thioguanine). Before you start treatment, they can check if you have either of these conditions with a lab test.
Harm to unborn baby
- Risk factors: Pregnancy Tabloid (thioguanine) hasn’t been well-studied in pregnancy. But based on animal studies and the way Tabloid (thioguanine) works, it’ll likely cause harm to an unborn baby or pregnancy loss (miscarriage). If you’re able to have babies, you should use birth control while taking Tabloid (thioguanine). If you become pregnant while taking Tabloid (thioguanine), contact your oncologist right away.
Tabloid (thioguanine) dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 40mg | 25 tablets | $12,981.45 | $519.26 |
Typical dosage for Tabloid (thioguanine)
Your oncologist will determine your dose of Tabloid (thioguanine) based on what other anticancer medications you’re taking and your body surface area (BSA), which takes into account your height and weight.
An example of Tabloid (thioguanine) dose is 40 mg/m2 by mouth once daily for 3 weeks during induction treatment for AML.
Your oncology care team will let you know how long you need to take Tabloid (thioguanine).
Interactions between Tabloid (thioguanine) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
How much does Tabloid (thioguanine) cost?
$12,981.45
Tabloid (thioguanine) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Tabloid (thioguanine) will not be safe for you to take.
- Cancer that doesn’t respond to treatment with mercaptopurine
What are alternatives to Tabloid (thioguanine)?
Tabloid (thioguanine) images
