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The following safety information outlines important considerations for the use of Tabloid (thioguanine). It is essential to discuss any concerns with your healthcare provider to ensure safe and effective treatment.

• Liver Toxicity: There have been reports of serious liver issues, such as veno-occlusive disease or portal hypertension, particularly in children using Tabloid (thioguanine) for maintenance therapy in acute lymphoblastic leukemia (ALL). Due to these risks, it is not recommended for maintenance treatment. Your oncologist will conduct regular liver function tests, and treatment may be paused if liver issues are detected. Immediate consultation with your oncology team is advised if you experience symptoms like stomach pain, abdominal swelling, or yellowing of the skin or eyes.

• Reduced Blood Cell Counts: This medication often leads to decreased levels of white blood cells, red blood cells, and platelets. Such reductions can cause fatigue, increase bleeding risk, and heighten susceptibility to infections. Regular monitoring of blood cell counts is necessary, and treatment adjustments may be made if counts drop significantly.

• Genetic Conditions Impacting Drug Metabolism: Tabloid (thioguanine) is metabolized by the proteins thiopurine methyltransferase (TPMT) and nucleotide diphosphatase (NUDT15). Individuals with abnormalities in these proteins may experience prolonged drug activity and increased side effects. Genetic testing can identify these conditions, and dosage adjustments will be made accordingly.

• Risks During Pregnancy: Although not extensively studied in pregnant individuals, animal studies suggest that Tabloid (thioguanine) could harm an unborn baby or lead to miscarriage. Effective contraception is recommended during treatment. If pregnancy occurs, notify your oncologist immediately.

• Contraindications: Do not use this medication if you have cancer that is unresponsive to treatment with mercaptopurine. Consult your healthcare provider if this condition applies to you.

These points highlight critical safety measures and warnings associated with Tabloid (thioguanine). Always follow your healthcare provider's guidance and report any adverse effects promptly.

When taking this medication, some common side effects you might experience include nausea, vomiting, reduced appetite, and mouth sores. These effects are usually mild, but if they persist or worsen, consult your healthcare provider for advice.

There are more serious side effects that require immediate medical attention. These include joint pain or swelling, black stools, and vomit that resembles coffee grounds, which may indicate internal bleeding. Symptoms of liver issues, such as persistent nausea, stomach pain, yellowing of the skin or eyes, and dark urine, should also be reported promptly to your healthcare provider. Additionally, this medication can reduce bone marrow function, leading to lower blood cell counts. This may cause anemia, increased susceptibility to infections, and easy bruising or bleeding. Look out for signs like unusual tiredness, pale skin, fever, sore throat, and chills.

Rarely, a serious allergic reaction may occur. Seek emergency medical help if you notice symptoms such as a rash, severe dizziness, itching or swelling, especially of the face, tongue, or throat, and trouble breathing. This is not a comprehensive list of all possible side effects. If you experience any unusual effects not mentioned here, reach out to your healthcare provider for guidance.