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Journal of Oncology Pharmacy Practice, Vol. 13, No. 4, 237-240 (2007)
DOI: 10.1177/1078155207080802

Interaction between mercaptopurine and milk

Mário L. de Lemos, PharmD MSc Oncol

Provincial Systemic Therapy Program, British Columbia Cancer Agency, Canada, mdelemos{at}bccancer.bc.ca

Linda Hamata, BSc Pharm

Provincial Systemic Therapy Program, British Columbia Cancer Agency, Canada

Sarah Jennings, BSc Biomed, BSc Pharm

Provincial Systemic Therapy Program, British Columbia Cancer Agency, Canada

Tanya Leduc, BSP

Provincial Systemic Therapy Program, British Columbia Cancer Agency, Canada

Mercaptopurine is a purine analog used for acute lymphoblatic leukemia and chronic myelogenous leukemias. Since it is inactivated by xanthine oxidase (XO), concurrent intake of substances containing XO may potentially reduce bioavailability of mercaptopurine. Cow's milk is known to contain a high level of XO. In vitro and in vivo data suggest that concurrent intake of cow's milk may reduce the bioavailability of mercaptopurine. This interaction may be clinically significant. Therefore most patients should try to separate the timing of taking mercaptopurine and drinking milk. J Oncol Pharm Practice (2007) 13: 237—240.

Key Words: mercaptopurine • milk • drug interaction • xanthine oxidase


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