This medicine is an antimetabolite used in combination with other medicines to help prevent rejection after a kidney transplant. It may also be used to treat signs and symptoms of active rheumatoid arthritis and other conditions as determined by your doctor.
Follow the directions for using this medicine provided by your doctor. TAKE THIS MEDICINE by mouth with or without food. If stomach upset occurs, take with food to reduce stomach irritation. ASK YOUR DOCTOR if you should follow any special guidelines for handling this medicine. STORE THIS MEDICINE at room temperature, between 59 and 77 degrees F (15 and 25 degrees C), in a tightly closed container, away from heat, moisture, and light. Do not store in the bathroom. KEEP THIS MEDICINE out of the reach of children and away from pets. IF THIS MEDICINE IS NO LONGER NEEDED, ask your doctor or pharmacist how to dispose of it properly. 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.
WARNING: LONG-TERM USE OF THIS MEDICINE INCREASES THE RISK OF DEVELOPING CERTAIN TYPES OF CANCERS (eg, leukemia, lymphoma, skin cancer). A rare type of cancer called hepatosplenic T-cell lymphoma (HSTCL) has been reported in patients treated with this medicine. These cases have been fatal. Most of these cases occurred in teenagers and young adults who had Crohn disease or ulcerative colitis. Some patients who developed this cancer were using this medicine along with certain other medicines called TNF blockers (eg, infliximab). Tell your doctor if you have or ever had any type of cancer. This medicine may also cause serious blood disorders (eg, anemias, low white blood cell or platelet levels). Discuss any questions or concerns with your doctor. CONTACT YOUR DOCTOR AT ONCE if you develop changes in the appearance or size of a mole; easy bruising or bleeding; unusual growths; unusual lumps or swelling (eg, in your neck, armpit, or groin); persistent unexplained itching; night sweats; signs of infection (eg, fever, chills, persistent sore throat); stomach pain or tenderness; unusual tiredness or weakness; or unexplained weight loss. 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 febuxostat or mercaptopurine. DO NOT TAKE THIS MEDICINE if you have rheumatoid arthritis and have taken alkylating agents (eg, cyclophosphamide, chlorambucil, melphalan) in the past. ADDITIONAL MONITORING OF YOUR DOSE OR CONDITION may be needed if you are taking alkylating agents (eg, cyclophosphamide, chlorambucil, melphalan), allopurinol, aminosalicylates (eg, mesalazine, olsalazine, sulfasalazine), angiotensin-converting enzyme (ACE) inhibitors (eg, enalapril, lisinopril), anticoagulants (eg, warfarin), disease-modifying antirheumatic drugs (DMARDs) (eg, methotrexate, adalimumab), doxorubicin, ribavirin, TNF blockers (eg, certolizumab, etanercept), or trimethoprim/sulfamethoxazole . DO NOT START OR STOP any medicine without doctor or pharmacist approval. Inform your doctor of any other medical conditions, including an infection, kidney or liver problems, certain bowel problems (eg, Crohn disease, ulcerative colitis), certain enzyme deficiencies (thiopurine methyltransferase / TPMT, xanthine oxidase), allergies, pregnancy, or breast-feeding. Tell your doctor if you have a history of frequent, recurrent, or prolonged infections; cancer; bone marrow problems; anemia; low white blood cell or platelet levels; or unusual bruising or bleeding. Tell your doctor if you have recently had a blood transfusion or if you have recently had or are scheduled to receive a vaccination. Contact your doctor or pharmacist if you have any questions or concerns about taking this medicine.
SIDE EFFECTS that may occur while you are taking this medicine include mild nausea or vomiting. If they continue or are bothersome, check with your doctor. CONTACT YOUR DOCTOR IMMEDIATELY if you experience chest pain or tightness; dark, tarry, or bloody stools; unusual bleeding or bruising; fatty stools; symptoms of liver problems (eg, dark urine, loss of appetite, pale stools, right-sided stomach pain, yellowing of the eyes or skin); symptoms of infection (eg, chills, fever, persistent sore throat; increased or painful urination; warm, red, swollen, or painful skin); severe or persistent nausea, vomiting, or diarrhea; dizziness; muscle or joint pain or aches; painful red bumps or blisters on the arms, face, neck, or back; shortness of breath; stomach pain; unusual growths or lumps; or unusual weakness or tiredness. An allergic reaction to this medicine is unlikely, but seek immediate medical attention if it occurs. Symptoms of an allergic reaction include rash; hives; itching; difficulty breathing; tightness in the chest; or swelling of the mouth, face, lips, or tongue. If you notice other effects not listed above, contact your doctor, nurse, or pharmacist. This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your healthcare provider. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
If overdose is suspected, contact your local poison control center or emergency room immediately. Symptoms of overdose may include fever, chills, or sore throat; or severe or persistent nausea, vomiting, or diarrhea.
DO NOT SHARE THIS MEDICINE with others for whom it was not prescribed. DO NOT USE THIS MEDICINE for other health conditions. IF USING THIS MEDICINE FOR AN EXTENDED PERIOD OF TIME, obtain refills before your supply runs out. CHECK WITH YOUR PHARMACIST about how to dispose of unused medicine.