[For mercaptopurine use in the treatment of neoplastic disease see Statement on Chemotherapy]
Issues for Surgery
Risk of perioperative flare in disease activity if omitted.
Risk of post-operative infection if continued.
Advice in the Perioperative period
Elective and Emergency Surgery
Monitor the patient for signs of infection – consider withholding mercaptopurine if a patient develops a significant systemic infection and contact patient’s specialist for advice.
Close monitoring of renal function is important so that inadvertent drug accumulation does not occur1, 2. Withhold mercaptopurine if renal function deteriorates in the post-operative period2 and contact patient’s specialist for advice.
Monitor liver function tests (LFTs) – see under Interaction(s) with other Common Medicines used in the Perioperative Period
Interaction(s) with Common Anaesthetic Agents
None1, 3, 4, 5.
Interaction(s) with other Common Medicines used in the Perioperative Period
Hepatotoxicity (also see under Antimicrobials below)
Mercaptopurine is hepatotoxic and liver function tests (LFTs) should be monitored weekly during treatment – more frequent monitoring may be advisable in those receiving potentially hepatotoxic therapy1, 4. Discontinue if jaundice develops and contact patient’s specialist for advice2.
Hepatotoxicity (also see above under Hepatotoxicity)
Whilst single surgical prophylactic doses should not pose a problem, continued post-operative treatment may require close monitoring of LFTs and / or haematological abnormalities. Consult current product literature.