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The product code(s) for this leaflet is: PLGB 13581/0002.
Xaluprine 20 mg/ml oral suspension
Xaluprine 20 mg/ml oral suspension
mercaptopurine
1. What Xaluprine is and what it is used for
2. What you need to know before you take Xaluprine
3. How to take Xaluprine
4. Possible side effects
5. How to store Xaluprine
6. Contents of the pack and other information
Xaluprine contains mercaptopurine. This belongs to a group of medicines called cytotoxics (also called chemotherapy).
Xaluprine is used for acute lymphoblastic leukaemia (also called acute lymphocytic leukaemia or ALL). This is a fast-growing disease which increases the number of new white blood cells. These new white blood cells are immature (not fully formed) and unable to grow and work properly. They therefore cannot fight infections and may cause bleeding.
Ask your doctor if you would like more explanation about this disease.
Talk to your doctor, pharmacist or nurse before taking Xaluprine
If you are receiving immunosuppressive therapy, taking Xaluprine could put you at greater risk of:
Taking Xaluprine could put you at greater risk of:
Some patients with inflammatory bowel disease who have received 6-mercaptopurine have developed a rare and aggressive type of cancer called Hepatosplenic T-cell Lymphoma (see section 4, Possible side effects).
Infections
When you are treated with Xaluprine the risk of viral, fungal and bacterial infections is increased and the infections may be more serious. See also section 4.
Tell your doctor before starting treatment whether or not you have had chickenpox, shingles or hepatitis B (a liver disease caused by a virus).
NUDT15-gene mutation
If you have an inherited mutation in the NUDT15-gene (a gene which is involved in the break-down of Xaluprine in the body), you have a higher risk of infections and hair loss and your doctor may in this case give you a lower dose.
Avoid contact of Xaluprine with your skin, eyes or nose. If you accidentally get some in your eyes or nose, flush the area with water.
If you are not sure if any of the above applies to you, talk to your doctor or pharmacist before taking Xaluprine.
Low blood sugar has sometimes been seen in children, mainly in children under the age of six or with a low body mass index. Talk to your child´s doctor if this happens.
Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.
In particular, tell your doctor, nurse or pharmacist if you are taking any of the following:
If you are going to have a vaccination it is important to speak to your doctor or nurse before you have it. Vaccination with live vaccines (like polio, measles, mumps and rubella) is not recommended, as these vaccines may give you an infection if you have them whilst you are taking Xaluprine.
Xaluprine may be taken with food or on an empty stomach. However, the choice of method should be consistent from day to day.
Do not take Xaluprine at the same time as milk or dairy products, as they can make the medicine less effective. Xaluprine should be taken at least 1 hour before or 2 hours after milk or dairy products.
Do not take Xaluprine if you are planning to have a baby without first speaking to your doctor for advice. This applies to both men and women. Xaluprine may harm your sperm or eggs. Reliable contraception must be used to avoid pregnancy whilst you or your partner are taking Xaluprine. Both men and women should continue to use effective contraception for at least 3 months after stopping treatment. If you are already pregnant, you must talk to your doctor before taking Xaluprine.
Xaluprine should not be handled by women who are or planning to be pregnant or breast-feeding.
Do not breast-feed while taking Xaluprine. Ask your doctor, pharmacist or midwife for advice.
It is not expected that Xaluprine will affect your ability to drive or use machines but no studies have been done to confirm this.
This medicine contains 3 mg aspartame (E951) in each 1 ml. Aspartame is a source of phenylalanine. It may be harmful if you have phenylketonuria (PKU), a rare genetic disorder in which phenylalanine builds up because the body cannot remove it properly.
Xaluprine also contains sodium methyl parahydroxybenzoate (E219) and sodium ethyl parahydroxybenzoate (E215) which may cause allergic reactions (possibly delayed).
Xaluprine contains sucrose. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product. May be harmful to the teeth.
Xaluprine should only be given to you by a specialist doctor who is experienced in treating blood problems.
Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure. The usual starting dose for adults, adolescents and children is between 25-75 mg/m2 body surface area each day. Your doctor will prescribe the correct dose for you. Sometimes the doctor may change your dose of Xaluprine for example as a result of different tests. If you are not sure how much medicine to take, always ask your doctor or nurse.
It is important to take Xaluprine in the evening to make the medicine more effective.
You can take your medicine with food or on an empty stomach but the choice of method should be consistent from day to day. You should take your medicine at least 1 hour before or 2 hours after having milk or dairy products.
Your pack of Xaluprine contains a bottle of medicine, a cap, a bottle adaptor and two dosing syringes (a 1 ml syringe and a 5 ml syringe). Always use the syringes provided to take your medicine.
It is important that you use the correct dosing syringe for your medicine. Your doctor or pharmacist will advise which syringe to use depending on the dose that has been prescribed.
The smaller 1 ml syringe , marked from 0.1 ml to 1 ml, is for measuring doses of less than or equal to 1 ml. You should use this one if the total amount you have to take is less than or equal to 1 ml (each graduation of 0.1 ml contains 2 mg of mercaptopurine).
The larger 5 ml syringe , marked 1 ml to 5 ml, is for measuring doses of more than 1 ml. You should use this one if the total amount you have to take is more than 1 ml (each graduation of 0.2 ml contains 4 mg of mercaptopurine).
If you are a parent or care giver administering the medicine, wash your hands before and after administering a dose. Wipe up spillages immediately. To decrease the risk of exposure disposable gloves should be used when handling Xaluprine.
If Xaluprine comes into contact with skin, eyes or nose, it should be washed immediately and thoroughly with soap and water.
When you use the medicine follow the instructions below:
1. Put on disposable hand gloves before handling Xaluprine.
2. Shake the bottle vigorously for at least 30 seconds to ensure the medicine is well mixed (figure 1).
3. Remove the bottle cap (figure 2) and push the adaptor firmly into the top of the bottle and leave in place for future doses (figure 3).
4. Push the tip of the dosing syringe into the hole in the adaptor (figure 4). Your doctor or pharmacist will advise you of the correct syringe to use, either the 1 ml or the 5 ml in order to give the correct dose.
5. Turn the bottle upside down (figure 5).
6. Pull the plunger of the syringe back so that the medicine is drawn from the bottle into the syringe. Pull the plunger back to the point on the scale that corresponds to the dose prescribed (figure 5). If you are not sure about how much medicine to draw into the syringe, always ask your doctor or nurse for advice.
7. Turn the bottle back the right way up and carefully remove the syringe from the adaptor, holding it by the barrel rather than the plunger.
8. Gently put the tip of the syringe into your mouth and to the inside of your cheek.
9. Slowly and gently push the plunger down to gently squirt the medicine into the inside of your cheek and swallow it. DO NOT forcefully push down the plunger, or squirt the medicine to the back of your mouth or throat, as you may choke.
10. Remove the syringe from your mouth.
11. Swallow the dose of oral suspension then drink some water, making sure no medicine is left in your mouth.
12. Put the cap back on the bottle with the adaptor left in place. Ensure that the cap is tightly closed.
13. Wash the syringe with warm water and rinse well. Hold the syringe under water and move the plunger up and down several times to make sure the inside of the syringe is clean. Let the syringe air dry completely before you use that syringe again for dosing. Do not wipe dry. Store the syringe in a hygienic place with the medicine.
Repeat the above for each dose as instructed by your doctor or pharmacist.
If you take more Xaluprine than you should, tell your doctor or go to a hospital immediately. You may feel sick, vomit or have diarrhoea. Take the medicine pack and this leaflet with you.
Tell your doctor. Do not take a double dose to make up for a forgotten dose.
Do not stop taking your medicine unless your doctor tells you to or you may get a relapse of your condition.
If you have any further questions on the use of this medicine, ask your doctor or pharmacist.
Like all medicines, this medicine can cause side effects, although not everybody gets them.
Talk to your doctor if you have any of the following side effects which may also happen with this medicine:
Very common (affects more than 1 in 10 people)
Common (affects less than 1 in 10 people)
Uncommon (affects less than 1 in 100 people)
Rare (affects less than 1 in 1,000 people)
Very rare (affects less than 1 in 10,000 people)
Other side effects (the frequency is unknown)
Low blood sugar (hypoglycaemia) - the frequency is unknown.
If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.
If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via
United Kingdom
or search for MHRA Yellow Card in the Google Play or Apple App Store
By reporting side effects you can help provide more information on the safety of this medicine.
Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.
The active substance is mercaptopurine (as monohydrate). One ml of suspension contains 20 mg of mercaptopurine monohydrate.
The other ingredients are xanthan gum, aspartame (E951), concentrated raspberry juice, sucrose, sodium methyl parahydroxybenzoate (E219), sodium ethyl parahydroxybenzoate (E215), potassium sorbate (E202), sodium hydroxide and purified water (see section 2 Xaluprine contains aspartame, sodium methyl parahydroxybenzoate (E219), sodium ethyl parahydroxybenzoate (E215) and sucrose).
Xaluprine is a pink to brown oral suspension. It comes in glass bottles of 100 ml capped with a child-resistant closure. Each pack contains one bottle, a bottle adaptor and two dosing syringes (a syringe graduated to 1 ml and a syringe graduated to 5 ml). Your doctor or pharmacist will advise which syringe to use depending on the dose that has been prescribed.
This leaflet was last revised in 05/2023
Other sources of information
Detailed information on this medicine is available on the European Medicines Agency web site: http://www.ema.europa.eu