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Why is Tabloid prescribed?

Tabloid (Thioguanine) is a chemotherapy agent prescribed for induction of remission and remission-consolidation treatment in adults and children with acute nonlymphocytic leukemias, most notably acute myeloid leukemia (AML).

What does it do?

Thioguanine is a purine analogue of guanine that, once metabolized, becomes incorporated into DNA and RNA of rapidly dividing cells. This “faulty” nucleic acid incorporation blocks DNA/RNA synthesis and halts cancer cell replication.

How should I take it?

Take Tabloid exactly as prescribed by your oncologist, typically as a single oral dose once daily. Swallow the 40 mg scored tablet whole, without crushing, chewing, or splitting, unless instructed otherwise. It can be taken with or without food but should always be taken at the same time each day.

The standard dose is often 2 mg/kg/day initially, and it is weight-based and protocol-specific, with possible adjustments after four weeks, depending on response and blood counts.

What if I missed a dose?

If you miss your daily dose of Tabloid, take it as soon as you remember. However, if your next scheduled dose is approaching, skip the missed dose and proceed with your usual dosing routine. Do not take extra or double doses to make up for the missed dose.

What are the special precautions before taking Tabloid?

Inform your doctor about all the medications you are taking, your current and previous medical history. Before taking Tabloid, here are several important precautions to keep in mind:

• Disclose all your current or past medical conditions to your doctor, particularly if you have:
• Liver problems
• Enzyme thiopurine methyltransferase (TPMT) deficiency or nudix hydrolase 15 (NUDT15)
• Treatment with thioguanine or mercaptopurine
• Never share this medication with others, even if their condition seems similar, as it could lead to unforeseen health risks or harmful side effects.
• If you are pregnant, considering pregnancy, or breastfeeding, consult your doctor to understand the potential risks and benefits of taking this medication.

Does it have any side effects?

It is important to note that all drugs have corresponding side effects and adverse reactions. Additional information may be obtained when you ask your doctor or pharmacist.

Common side effects may include:
• Nausea or vomiting
• Diarrhea
• Upset stomach
• Loss of appetite
• Hair loss

Serious side effects may include:
• Difficulty breathing
• Swelling of the face, lips or throat
• Low red blood cell levels (anemia)
• Fever
• Yellowing of the skin or eyes (jaundice)

This is not a complete list of potential side effects, and additional reactions may occur. For detailed information and medical guidance, consult your healthcare provider.

Is it safe to take it with another drug?

Tabloid (Tioguanine) can interact with various medications, so it's important to check for potential interactions before taking it with another drug. Some interactions may increase side effects or reduce effectiveness.

Before taking Tabloid, consult your doctor if you are using any of the following medications:

• Mercaptopurine
• Aminosalicylates
• Immunosuppressants
• Other chemotherapy agents
• Live vaccines

How should I store it?

Tabloid should be stored in its original container at room temperature, ideally between 20°C and 25°C (68°F to 77°F). Keep the medication in a cool, dry place, away from direct sunlight, and ensure it is kept out of reach of children and pets.

What action should I take in case of overdose?

If you suspect an overdose of Tabloid (Tioguanine), it's important to act quickly and seek immediate medical attention. Contact emergency services or go to the nearest hospital.

Overdose symptoms may include severe nausea, diarrhea, unusual bleeding or bruising, extreme fatigue, signs of infection (like fever or sore throat), or yellowing of the skin/eyes (jaundice).

Is it safe for pregnant or breastfeeding women?

Tabloid (Thioguanine) is not considered safe during pregnancy or breastfeeding unless the potential benefits clearly outweigh the risks. Thioguanine is classified as FDA Pregnancy Category D, meaning there is evidence of risk to the fetus based on human or animal studies.

Additionally, thioguanine and its metabolites can pass into breast milk, and most guidelines recommend avoiding breastfeeding during chemotherapy due to potential effects on the infant’s immune system and bone marrow.

If you are pregnant, planning to become pregnant, or breastfeeding, consult your healthcare provider for guidance on its use to ensure safety for both you and your baby.

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