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PURI-NETHOL Information: Common uses -This medicine is an antimetabolite used along with other medicines to treat certain types of cancer (acute lymphatic leukemia). It may also be used to treat other conditions as determined by your doctor. Before using -Some medicines or medical conditions may interact with this medicine. INFORM YOUR DOCTOR OR PHARMACIST of all prescription and over-the-counter medicine that you are taking. DO NOT TAKE THIS MEDICINE if you are taking azathioprine. ADDITIONAL MONITORING OF YOUR DOSE OR CONDITION may be needed if you are taking alkylating agents (such as cyclophosphamide, chlorambucil, or melphalan), allopurinol, angiotensin converting enzyme inhibitors (such as enalapril or lisinopril), anticoagulants (such as warfarin), aminosalicylates (such as olsalazine, mesalazine, or sulfasalazine), disease modifying antirheumatic drugs (such as methotrexate or adalimumab), doxorubicin, hydantoins (such as phenytoin), or trimethoprim/sulfamethoxazole. DO NOT START OR STOP any medicine without doctor or pharmacist approval. Inform your doctor of any other medical conditions including infection, or a history frequent or prolonged infections; recent chicken pox infection; blood problems (such as anemia, unusual bruising or bleeding, low white blood cell counts, or low platelet counts); bone marrow problems; certain enzyme deficiencies (such as thiopurine methyltransferase or xanthine oxidase deficiency); gout; liver or kidney problems; recent blood transfusions; recent vaccinations; allergies; pregnancy; or breast-feeding. USE OF THIS MEDICINE IS NOT RECOMMENDED if you have previously taken this medicine or thioguanine and your cancer did not respond. Contact your doctor or pharmacist if you have any questions or concerns about taking this medicine. Directions -Follow the directions for using this medicine provided by your doctor. This medicine may be taken on an empty stomach or with food. DRINKING EXTRA FLUIDS while you are taking this medicine is recommended. Check with your doctor or nurse for instructions. ASK YOUR DOCTOR if you should follow any special guidelines for handling this medicine. STORE THIS MEDICINE at room temperature between 68 and 77 degrees F (20 and 25 degrees C) in a tightly-closed container, away from heat, moisture and light. IF YOU MISS A DOSE OF THIS MEDICINE, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. DO NOT take 2 doses at once. Cautions -DO NOT TAKE THIS MEDICINE if you have had an allergic reaction to it or are allergic to any ingredient in this product. Laboratory and/or medical tests, including liver function tests, complete blood cell counts, and TPMT enzyme activity may be performed to monitor your progress or to check for side effects. KEEP ALL DOCTOR AND LABORATORY APPOINTMENTS while you are taking this medicine. BEFORE YOU HAVE ANY MEDICAL OR DENTAL TREATMENTS, EMERGENCY CARE, OR SURGERY, tell the doctor or dentist that you are taking this medicine. CHECK WITH YOUR DOCTOR BEFORE HAVING IMMUNIZATIONS (VACCINATIONS) while you are taking this medicine. THIS MEDICINE MAY REDUCE THE NUMBER OF BLOOD CELLS NEEDED FOR CLOTTING. To prevent bleeding, avoid situations where bruising or injury may occur. THIS MEDICINE MAY LOWER YOUR RESISTANCE TO INFECTION. Prevent infection by avoiding contact with people with colds or other infections. Do not touch your eyes or the inside of your nose unless you have thoroughly washed your hands first. THIS MEDICINE MAY INCREASE YOUR RISK OF developing a tumor or other cancer. Contact your doctor right away if you notice any unusual growths or lumps. Discuss any questions or concerns with your doctor. AN ENZYME CALLED TPMT helps to break this medicine down in the body. Infrequently, some patients may have decreased TPMT enzyme activity. This may increase the risk of developing serious side effects (such as bone marrow problems). Patients with decreased TPMT activity enzyme may need a lower dose of this medicine. Discuss any questions or concerns with your doctor. BEFORE YOU BEGIN TAKING ANY NEW MEDICINE, either prescription or over-the-counter, check with your doctor or pharmacist. FOR WOMEN: THIS MEDICINE HAS BEEN SHOWN TO CAUSE HARM to the human fetus. Avoid becoming pregnant while you are taking this medicine. IF YOU THINK YOU MAY BE PREGNANT, contact your immediately. IT IS UNKNOWN IF THIS DRUG IS EXCRETED in breast milk. 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