Thiopurine antimetabolite
Tioguanine (Specialist drug)
Adult dose
Dose: Specialist initiation only — refer to BNF/SmPC
Route: PO
Frequency: per protocol
Clinical pearls
- AML maintenance (paeds), refractory IBD
- TPMT testing recommended
Contraindications
- Severe myelosuppression
- Severe hepatic impairment
- Pregnancy
- TPMT deficiency (severe)
Side effects
- Severe myelosuppression
- Hepatotoxicity (VOD)
- GI upset
- Hyperuricaemia
- Secondary malignancy
Interactions
- Allopurinol (avoid; or reduce dose 25%)
- Trimethoprim/co-trimoxazole
- Live vaccines
Monitoring
- FBC
- LFTs
- TPMT
Reference: BNF; SmPC; https://bnf.nice.org.uk/drugs/tioguanine-specialist-drug/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- Vancomycin Dosing Calculator · Drug Dosing
- Phenytoin Correction for Albumin / Renal Failure · Drug Dosing
- Local Anaesthetic Maximum Dose Calculator · Drug Dosing
- Tisdale Risk Score for QT Prolongation · Arrhythmia
- Bazett Corrected QT Interval (QTc) Calculator · Arrhythmia
- DAPT Score for Dual Antiplatelet Therapy Duration · Antiplatelet Therapy
Pathways
- Major Haemorrhage / Massive Transfusion · BCSH; RCOA; RCEM; RCS — BCSH Guidelines
- Anaemia Investigation · BSH / NICE
- Splenomegaly Workup · BSH; BMJ Best Practice
- Deep Vein Thrombosis Diagnosis and Treatment · NICE CG144 / NICE NG158
- Sickle Cell Crisis · BSH 2021 / BCSH
- Neutropenic Sepsis · NICE CG151 2012 / ESMO