Thioguanine | Side Effects, Dosage, Uses & More
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Generic Name:

thioguanine, Oral tablet

All Brands

  • Tabloid
SECTION 1 of 5

Highlights for thioguanine

Oral tablet
1

Thioguanine is used to treat certain types of leukemia. These are cancers that affect your blood cells.

2

This drug comes in the form of a tablet you take by mouth.

3

This drug is available as the brand-name drug Tabloid. It is not available as a generic drug.

4

The most common side effect of thioguanine is bone marrow suppression. This means that it prevents your bone marrow from making enough blood cells. These include cells that deliver oxygen to your body (red blood cells), help fight off infections (white blood cells), and allow your blood to clot (platelets).

5

If you are a woman of childbearing age, avoid becoming pregnant while taking thioguanine. This drug can harm a fetus.

IMPORTANT INFORMATION

Liver damage

This drug can increase your risk of serious liver disease if you use it for a long period. Your doctor will do blood tests before and during your treatment with this drug to check your liver function. If your liver test results are abnormal, your doctor may reduce your dosage or stop your use of the drug.

Blood cell counts warning

This drug can severely suppress the function of your bone marrow. This means that it prevents your bone marrow from making enough blood cells. These include cells that deliver oxygen to your body (red blood cells), help fight off infections (white blood cells), and allow your blood to clot (platelets). Your doctor will monitor your blood cell counts throughout your treatment with this drug. If your blood cell counts become too low, your doctor may decrease your dosage or stop your use of this drug. Call your doctor right away if you have unexpected bleeding or bruising, blood in your urine or stools, extreme tiredness, fever, or signs of an infection.

Intestinal wall tears warning

This drug may cause tears in the walls of your intestines. Tell your doctor or get medical help right away if you have fever, nausea, vomiting, or new or worsening pain in your abdomen while taking this drug. These may be signs of a tear in your intestinal wall.

What is thioguanine?

Thioguanine is a prescription drug. It comes as a tablet that you take by mouth.

Thioguanine is available as the brand-name drug Tabloid. It is not available as a generic drug. Only a healthcare provider who is experienced with the use of this drug and other drugs used for cancer should prescribe it.

Thioguanine may be used as part of a combination therapy. This means you may need to take it with other medications to treat your condition.

Why it's used

Thioguanine is used to treat certain types of cancer that affect your blood cells. These types of cancer include acute nonlymphocytic leukemia and chronic myelogenous leukemia.

How it works

This drug belongs to a class of drugs called antimetabolites. These are a type of anticancer drug. A class of drugs is a group of medications that work in a similar way.

See Details

How it works

This drug belongs to a class of drugs called antimetabolites. These are a type of anticancer drug. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Thioguanine helps prevent cancer cells from continuing to form and grow. This eventually leads to the destruction of these cancer cells.

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SECTION 2 of 5

thioguanine Side Effects

Oral tablet

More common side effects

The more common side effects of thioguanine can include:

  • decreased number of blood cells

  • increased uric acid levels

  • nausea

  • vomiting

  • lack of appetite

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 9-1-1 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Tear in your intestinal wall or other stomach problems. Symptoms can include:

    • new or worsening pain in your abdomen
    • chills
    • fever
    • nausea
    • vomiting
    • loss of appetite
  • Stomatitis (small ulcer or persistent soreness around your mouth)

  • Liver problems. Symptoms can include:

    • yellowing of your skin or the white part of your eyes
    • dark-colored urine
    • nausea or vomiting
    • pain in the upper right side of your abdomen
    • tiredness
  • Infections. Symptoms can include:

    • fever
    • cold symptoms that don’t go away, such as runny nose or sore throat
    • flu symptoms, such as cough, tiredness, and body aches
    • pain during urination
    • white patches in your mouth or throat
  • Abnormal bleeding. Symptoms can include:

    • unexplained bruising
    • unexpected bleeding or bleeding that lasts a long time, such as:
      • unusual bleeding from your gums
      • frequent nosebleeds
      • periods that are heavier than normal
    • coughing up blood
    • vomit that contains blood or that looks like coffee grounds
    • bloody urine
    • dark or bloody stools
    • headaches
    • weakness
    • dizziness
  • Anemia. Symptoms can include:

    • pale skin
    • extreme tiredness
    • lightheadedness
    • fast heart rate
  • Tumor lysis syndrome. This occurs because of the fast breakdown of cancer cells during treatment with this drug. Symptoms can include:

    • nausea
    • vomiting
    • diarrhea
    • lack of energy
    • extreme tiredness
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

This drug doesn’t cause drowsiness.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
SECTION 3 of 5

thioguanine May Interact with Other Medications

Oral tablet

Thioguanine can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Medications that might interact with this drug

Interactions that increase the risk of side effects

Taking thioguanine with certain drugs increases your risk of side effects from thioguanine. This is because the amount of thioguanine in your body is increased when you take it with these drugs. Examples of these drugs include:

  • Aminosalicylate derivatives, such as mesalazine, olsalazine, and sulfasalazine
    • Increased side effects can include bone marrow suppression. This means your bone marrow doesn’t make enough blood cells. Your doctor may need to adjust your dosage of thioguanine if you develop certain side effects of this condition.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Thioguanine warnings
liver disease warning
People with liver disease

Thioguanine can cause serious damage to your liver. Taking this drug can make your liver disease worse. Talk to your doctor about your liver disease before taking this drug.

enzyme deficiency warning
People with a certain enzyme deficiency

If your body doesn’t make enough of an enzyme called thiopurine methyltransferase, you may be more sensitive to bone marrow suppression. This can result in a dangerously low number of white blood cells, red blood cells, and platelets. Talk to your doctor before taking this drug. Your doctor will reduce your dosage of thioguanine.

pregnancy warning
Pregnant women

Thioguanine a category D pregnancy drug. That means two things:

  1. Research in humans has shown adverse effects to the fetus when the mother takes the drug.
  2. This drug should only be used during pregnancy in serious cases where it's needed to treat a dangerous condition in the mother.

If you are of reproductive age, avoid becoming pregnant while taking thioguanine. This drug can harm your fetus if you take it during pregnancy. Speak to your doctor about birth control options that are best for you.

breast feeding warning
Women who are breast-feeding

It’s not known whether thioguanine passes into breast milk or causes side effects in a child who is breastfed.

Talk to your doctor if you breastfeed your child. You may need to decide whether to stop breastfeeding or stop taking this medication.

senior warning
For seniors

The liver and kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.

call the doctor
Call the doctor

Call your doctor right away if you become pregnant while taking this drug.

allergy warning
Allergies

Thioguanine can cause a severe allergic reaction. Symptoms can include:

  • trouble breathing
  • swelling of your throat or tongue

If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room.

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How to Take thioguanine (Dosage)

Oral tablet

All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

Acute nonlymphocytic leukemia

Brand: Tabloid

Form: Oral tablet
Strength: 40 mg
Adult dosage (ages 18 years and older)
  • The typical starting dosage is 2 mg/kg of body weight per day.
  • If there is no improvement and no serious effect on your blood cell counts, your doctor may increase your dosage to 3 mg/kg of body weight per day.
  • Your dosage may be different if you are receiving thioguanine in combination with other anticancer medications.
Child dosage (ages 0–17 years)
  • The typical starting dosage is 2 mg/kg of body weight per day.
  • If there is no improvement and no serious effect on your blood cell counts, your doctor may increase your dosage to 3 mg/kg of body weight per day.
  • Your dosage may be different if you are receiving thioguanine in combination with other anticancer medications.

Chronic myelogenous leukemia

Brand: Tabloid

Form: Oral tablet
Strength: 40 mg
Adult dosage (ages 18 years and older)
  • The typical starting dosage is 2 mg/kg of body weight per day.
  • If there is no improvement and no serious effect on your blood cell counts, your doctor may increase your dosage to 3 mg/kg of body weight per day.
  • Your dosage may be different if you are receiving thioguanine in combination with other anticancer medications.
Child dosage (ages 0–17 years)

It has not been confirmed that thioguanine is safe and effective for use in people with this condition who are younger than 18 years.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

Thioguanine comes with serious risks if you don’t take it as prescribed.

If you stop taking the drug suddenly or don’t take it at all

The symptoms of your cancer may get worse and your disease will progress over time. If your cancer remains untreated, it can lead to death.

If you miss doses or don’t take the drug on schedule

Your cancer might not be treated effectively and your condition may get worse.

If you take too much

You could have dangerous levels of the drug in your body. Signs and symptoms of an overdose of this drug can include:

  • nausea
  • vomiting
  • tiredness
  • lightheadedness
  • dizziness
  • fainting
  • sweating
  • pale skin
  • fast heart rate
  • fever
  • cold symptoms that do not go away, such as runny nose or sore throat
  • flu symptoms, such as cough, tiredness, and body aches
  • pain during urination
  • white patches in your mouth or throat

If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room right away.

What to do if you miss a dose

Call your doctor right away for instructions on what to do.

How to tell if the drug is working

You probably won’t be able to tell if the drug is working. Your doctor will do tests to make sure the drug is working to treat your cancer.

Thioguanine is used for short-term treatment

Important considerations for taking thioguanine
ask your doctor
Ask your doctor if you can take this drug with food
timing considerations
Take this drug at the time(s) recommended by your doctor
do not crush
Do not crush the tablet
storage considerations
Store this drug carefully
See Details
medication is refillable
A prescription for this medication is refillable
See Details
travel considerations
Travel
See Details
self management considerations
Self-management
See Details
clinical monitoring considerations
Clinical monitoring
See Details
not usually stocked
Not every pharmacy stocks this drug. When filling your prescription, be sure to call ahead
prior authorization needed
Insurance
See Details

Store this drug carefully

  • Store thioguanine at room temperature between 59°F and 77°F (15°C and 25°C).
  • Don’t store this medication in moist or damp areas, such as bathrooms.

A prescription for this medication is refillable

You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport x-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Self-management

Your doctor will give you instructions on how to handle thioguanine.

Clinical monitoring

Your doctor should monitor certain health issues. This can help make sure you stay safe while you take this drug. These issues include:

  • Number of blood cells. Blood tests can check your blood cell counts (including white blood cells, red blood cells, and platelets). If your blood cell counts become too low, your doctor may decide to lower your dosage or stop your treatment with thioguanine.
  • Liver function. Blood tests can help your doctor check how well your liver is working. Your doctor will likely do blood tests before starting your treatment with thioguanine and every week throughout your treatment. If your results are stable, your doctor may check your liver function on a monthly basis.

Insurance

Many insurance companies require a prior authorization for this drug. This means your doctor may need to get approval from your insurance company before your insurance company will pay for the prescription.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

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How Much Does thioguanine Cost?

Oral tablet

We've partnered with GoodRx so you can compare prices, find discounts and save up to 80% on your next prescription. Check out the low coupon prices below — no insurance required.

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Lowest price for thioguanine

Kroger Pharmacy $789.59
Walmart $826.00
Sams Club $826.00
These prices represent the lowest priced national pharmacies for thioguanine on GoodRx. They may be lower than your insurance.

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These prices represent the lowest priced national pharmacies for thioguanine on GoodRx. They may be lower than your insurance.

Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on February 5, 2016

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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