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Home > LEU APL - Pethema LPA2005 induction and consolidations 1, 2 and 3 followed by maintenance [70 years and under] [intermediate risk] > LEU - Pethema LPA2005 maintenance [70 years and under] [intermediate risk]

This regimen is a component of LEU APL - Pethema LPA2005 induction and consolidations 1, 2 and 3 followed by maintenance [70 years and under] [intermediate risk]

Pethema LPA2005 [70 years and under] [intermediate risk] - Maintenance (LEU APL - Pethema LPA2005 induction and consolidations 1, 2 and 3 followed by maintenance [70 years and under] [intermediate risk])

Treatment Overview

Start one month after count recovery from Consolidation 3.

Cycle 1 - 90 days

Cycle length:

metHOTREXATe: Adjust dose (between 5 mg/m² and 15 mg/m² ONCE a week) to target neutrophil count above 1.5 x 10⁹/L.

mercaptOPURine:

Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L.
Consider thiopurine methyltransferase (TPMT) testing.

Cycles 2 to 8 - 90 days

Cycle length:

tretinoin:

Consider dose reduction of tretinoin to 25 mg/m² daily in TWO divided doses in patients under 20 years of age to reduce risk of pseudotumour cerebri.
Teratogenic—Ensure pregnant women are not exposed to tretinoin. Consult prescribing information.

metHOTREXATe: Adjust dose (between 5 mg/m² and 15 mg/m² ONCE a week) to target neutrophil count above 1.5 x 10⁹/L.

mercaptOPURine:

Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L.
Consider thiopurine methyltransferase (TPMT) testing.

Cycle details

Cycle 1 - 90 days

Medication	Dose	Route	Days	Max Duration
metHOTREXATe *	15 mg/m² Once a week	oral administration	1, 8, 15, 22, 29, 36, 43, 50, 57, 64, 71, 78, 85
mercaptOPURine	50 mg/m² Once daily	oral administration	1 to 90

metHOTREXATe: Adjust dose (between 5 mg/m² and 15 mg/m² ONCE a week) to target neutrophil count above 1.5 x 10⁹/L.

mercaptOPURine:

Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L.
Consider thiopurine methyltransferase (TPMT) testing.

Cycles 2 to 8 - 90 days

Medication	Dose	Route	Days
tretinoin *	45 mg/m² Daily in divided doses	oral administration	1 to 15
metHOTREXATe *	15 mg/m² Once a week	oral administration	16, 23, 30, 37, 44, 51, 58, 65, 72, 79, 86
mercaptOPURine	50 mg/m² Once daily	oral administration	16 to 90

tretinoin:

Consider dose reduction of tretinoin to 25 mg/m² daily in TWO divided doses in patients under 20 years of age to reduce risk of pseudotumour cerebri.
Teratogenic—Ensure pregnant women are not exposed to tretinoin. Consult prescribing information.

metHOTREXATe: Adjust dose (between 5 mg/m² and 15 mg/m² ONCE a week) to target neutrophil count above 1.5 x 10⁹/L.

mercaptOPURine:

Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L.
Consider thiopurine methyltransferase (TPMT) testing.

Full details

Cycle 1 - 90 days

Day: 1

Medication	Dose	Route	Max duration	Details
metHOTREXATe *	15 mg/m² Once a week	oral administration		Instructions: Adjust dose (between 5 mg/m² and 15 mg/m² ONCE a week) to target neutrophil count above 1.5 x 10⁹/L. Round dose to closest multiple of 2.5 mg tablets. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 2

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 3

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 4

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 5

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 6

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 7

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 8

Medication	Dose	Route	Max duration	Details
metHOTREXATe *	15 mg/m² Once a week	oral administration		Instructions: Adjust dose (between 5 mg/m² and 15 mg/m² ONCE a week) to target neutrophil count above 1.5 x 10⁹/L. Round dose to closest multiple of 2.5 mg tablets. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 9

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 10

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 11

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 12

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 13

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 14

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 15

Medication	Dose	Route	Max duration	Details
metHOTREXATe *	15 mg/m² Once a week	oral administration		Instructions: Adjust dose (between 5 mg/m² and 15 mg/m² ONCE a week) to target neutrophil count above 1.5 x 10⁹/L. Round dose to closest multiple of 2.5 mg tablets. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 16

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 17

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 18

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 19

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 20

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 21

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 22

Medication	Dose	Route	Max duration	Details
metHOTREXATe *	15 mg/m² Once a week	oral administration		Instructions: Adjust dose (between 5 mg/m² and 15 mg/m² ONCE a week) to target neutrophil count above 1.5 x 10⁹/L. Round dose to closest multiple of 2.5 mg tablets. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 23

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 24

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 25

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 26

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 27

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 28

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 29

Medication	Dose	Route	Max duration	Details
metHOTREXATe *	15 mg/m² Once a week	oral administration		Instructions: Adjust dose (between 5 mg/m² and 15 mg/m² ONCE a week) to target neutrophil count above 1.5 x 10⁹/L. Round dose to closest multiple of 2.5 mg tablets. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 30

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 31

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 32

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 33

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 34

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 35

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 36

Medication	Dose	Route	Max duration	Details
metHOTREXATe *	15 mg/m² Once a week	oral administration		Instructions: Adjust dose (between 5 mg/m² and 15 mg/m² ONCE a week) to target neutrophil count above 1.5 x 10⁹/L. Round dose to closest multiple of 2.5 mg tablets. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 37

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 38

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 39

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 40

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 41

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 42

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 43

Medication	Dose	Route	Max duration	Details
metHOTREXATe *	15 mg/m² Once a week	oral administration		Instructions: Adjust dose (between 5 mg/m² and 15 mg/m² ONCE a week) to target neutrophil count above 1.5 x 10⁹/L. Round dose to closest multiple of 2.5 mg tablets. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 44

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 45

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 46

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 47

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 48

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 49

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 50

Medication	Dose	Route	Max duration	Details
metHOTREXATe *	15 mg/m² Once a week	oral administration		Instructions: Adjust dose (between 5 mg/m² and 15 mg/m² ONCE a week) to target neutrophil count above 1.5 x 10⁹/L. Round dose to closest multiple of 2.5 mg tablets. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 51

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 52

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 53

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 54

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 55

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 56

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 57

Medication	Dose	Route	Max duration	Details
metHOTREXATe *	15 mg/m² Once a week	oral administration		Instructions: Adjust dose (between 5 mg/m² and 15 mg/m² ONCE a week) to target neutrophil count above 1.5 x 10⁹/L. Round dose to closest multiple of 2.5 mg tablets. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 58

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 59

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 60

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 61

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 62

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 63

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 64

Medication	Dose	Route	Max duration	Details
metHOTREXATe *	15 mg/m² Once a week	oral administration		Instructions: Adjust dose (between 5 mg/m² and 15 mg/m² ONCE a week) to target neutrophil count above 1.5 x 10⁹/L. Round dose to closest multiple of 2.5 mg tablets. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 65

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 66

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 67

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 68

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 69

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 70

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 71

Medication	Dose	Route	Max duration	Details
metHOTREXATe *	15 mg/m² Once a week	oral administration		Instructions: Adjust dose (between 5 mg/m² and 15 mg/m² ONCE a week) to target neutrophil count above 1.5 x 10⁹/L. Round dose to closest multiple of 2.5 mg tablets. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 72

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 73

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 74

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 75

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 76

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 77

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 78

Medication	Dose	Route	Max duration	Details
metHOTREXATe *	15 mg/m² Once a week	oral administration		Instructions: Adjust dose (between 5 mg/m² and 15 mg/m² ONCE a week) to target neutrophil count above 1.5 x 10⁹/L. Round dose to closest multiple of 2.5 mg tablets. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 79

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 80

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 81

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 82

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 83

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 84

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 85

Medication	Dose	Route	Max duration	Details
metHOTREXATe *	15 mg/m² Once a week	oral administration		Instructions: Adjust dose (between 5 mg/m² and 15 mg/m² ONCE a week) to target neutrophil count above 1.5 x 10⁹/L. Round dose to closest multiple of 2.5 mg tablets. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 86

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 87

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 88

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 89

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 90

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m²ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Cycles 2 to 8 - 90 days

Day: 1

Medication	Dose	Route	Max duration	Details
tretinoin *	45 mg/m² Daily in divided doses	oral administration		Instructions: Daily in TWO divided doses. Take with food. Swallow whole do not crush or chew. Consider dose reduction to 25 mg/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Additional details: Section 1: Teratogenic effects

Day: 2

Medication	Dose	Route	Max duration	Details
tretinoin *	45 mg/m² Daily in divided doses	oral administration		Instructions: Daily in TWO divided doses. Take with food. Swallow whole do not crush or chew. Consider dose reduction to 25 mg/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Additional details: Section 1: Teratogenic effects

Day: 3

Medication	Dose	Route	Max duration	Details
tretinoin *	45 mg/m² Daily in divided doses	oral administration		Instructions: Daily in TWO divided doses. Take with food. Swallow whole do not crush or chew. Consider dose reduction to 25 mg/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Additional details: Section 1: Teratogenic effects

Day: 4

Medication	Dose	Route	Max duration	Details
tretinoin *	45 mg/m² Daily in divided doses	oral administration		Instructions: Daily in TWO divided doses. Take with food. Swallow whole do not crush or chew. Consider dose reduction to 25 mg/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Additional details: Section 1: Teratogenic effects

Day: 5

Medication	Dose	Route	Max duration	Details
tretinoin *	45 mg/m² Daily in divided doses	oral administration		Instructions: Daily in TWO divided doses. Take with food. Swallow whole do not crush or chew. Consider dose reduction to 25 mg/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Additional details: Section 1: Teratogenic effects

Day: 6

Medication	Dose	Route	Max duration	Details
tretinoin *	45 mg/m² Daily in divided doses	oral administration		Instructions: Daily in TWO divided doses. Take with food. Swallow whole do not crush or chew. Consider dose reduction to 25 mg/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Additional details: Section 1: Teratogenic effects

Day: 7

Medication	Dose	Route	Max duration	Details
tretinoin *	45 mg/m² Daily in divided doses	oral administration		Instructions: Daily in TWO divided doses. Take with food. Swallow whole do not crush or chew. Consider dose reduction to 25 mg/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Additional details: Section 1: Teratogenic effects

Day: 8

Medication	Dose	Route	Max duration	Details
tretinoin *	45 mg/m² Daily in divided doses	oral administration		Instructions: Daily in TWO divided doses. Take with food. Swallow whole do not crush or chew. Consider dose reduction to 25 mg/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Additional details: Section 1: Teratogenic effects

Day: 9

Medication	Dose	Route	Max duration	Details
tretinoin *	45 mg/m² Daily in divided doses	oral administration		Instructions: Daily in TWO divided doses. Take with food. Swallow whole do not crush or chew. Consider dose reduction to 25 mg/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Additional details: Section 1: Teratogenic effects

Day: 10

Medication	Dose	Route	Max duration	Details
tretinoin *	45 mg/m² Daily in divided doses	oral administration		Instructions: Daily in TWO divided doses. Take with food. Swallow whole do not crush or chew. Consider dose reduction to 25 mg/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Additional details: Section 1: Teratogenic effects

Day: 11

Medication	Dose	Route	Max duration	Details
tretinoin *	45 mg/m² Daily in divided doses	oral administration		Instructions: Daily in TWO divided doses. Take with food. Swallow whole do not crush or chew. Consider dose reduction to 25 mg/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Additional details: Section 1: Teratogenic effects

Day: 12

Medication	Dose	Route	Max duration	Details
tretinoin *	45 mg/m² Daily in divided doses	oral administration		Instructions: Daily in TWO divided doses. Take with food. Swallow whole do not crush or chew. Consider dose reduction to 25 mg/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Additional details: Section 1: Teratogenic effects

Day: 13

Medication	Dose	Route	Max duration	Details
tretinoin *	45 mg/m² Daily in divided doses	oral administration		Instructions: Daily in TWO divided doses. Take with food. Swallow whole do not crush or chew. Consider dose reduction to 25 mg/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Additional details: Section 1: Teratogenic effects

Day: 14

Medication	Dose	Route	Max duration	Details
tretinoin *	45 mg/m² Daily in divided doses	oral administration		Instructions: Daily in TWO divided doses. Take with food. Swallow whole do not crush or chew. Consider dose reduction to 25 mg/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Additional details: Section 1: Teratogenic effects

Day: 15

Medication	Dose	Route	Max duration	Details
tretinoin *	45 mg/m² Daily in divided doses	oral administration		Instructions: Daily in TWO divided doses. Take with food. Swallow whole do not crush or chew. Consider dose reduction to 25 mg/m²daily in patients under 20 years. Round dose to closest multiple of 10 mg capsules. Additional details: Section 1: Teratogenic effects

Day: 16

Medication	Dose	Route	Max duration	Details
metHOTREXATe *	15 mg/m² Once a week	oral administration		Instructions: Adjust dose (between 5 mg/m² and 15 mg/m² ONCE a week) to target neutrophil count above 1.5 x 10⁹/L. Round dose to closest multiple of 2.5 mg tablets. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 17

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 18

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 19

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 20

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 21

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 22

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 23

Medication	Dose	Route	Max duration	Details
metHOTREXATe *	15 mg/m² Once a week	oral administration		Instructions: Adjust dose (between 5 mg/m² and 15 mg/m² ONCE a week) to target neutrophil count above 1.5 x 10⁹/L. Round dose to closest multiple of 2.5 mg tablets. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 24

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 25

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 26

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 27

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 28

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 29

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 30

Medication	Dose	Route	Max duration	Details
metHOTREXATe *	15 mg/m² Once a week	oral administration		Instructions: Adjust dose (between 5 mg/m² and 15 mg/m² ONCE a week) to target neutrophil count above 1.5 x 10⁹/L. Round dose to closest multiple of 2.5 mg tablets. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 31

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 32

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 33

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 34

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 35

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 36

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 37

Medication	Dose	Route	Max duration	Details
metHOTREXATe *	15 mg/m² Once a week	oral administration		Instructions: Adjust dose (between 5 mg/m² and 15 mg/m² ONCE a week) to target neutrophil count above 1.5 x 10⁹/L. Round dose to closest multiple of 2.5 mg tablets. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 38

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 39

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 40

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 41

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 42

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 43

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 44

Medication	Dose	Route	Max duration	Details
metHOTREXATe *	15 mg/m² Once a week	oral administration		Instructions: Adjust dose (between 5 mg/m² and 15 mg/m² ONCE a week) to target neutrophil count above 1.5 x 10⁹/L. Round dose to closest multiple of 2.5 mg tablets. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 45

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 46

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 47

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 48

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 49

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 50

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 51

Medication	Dose	Route	Max duration	Details
metHOTREXATe *	15 mg/m² Once a week	oral administration		Instructions: Adjust dose (between 5 mg/m² and 15 mg/m² ONCE a week) to target neutrophil count above 1.5 x 10⁹/L. Round dose to closest multiple of 2.5 mg tablets. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 52

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 53

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 54

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 55

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 56

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 57

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 58

Medication	Dose	Route	Max duration	Details
metHOTREXATe *	15 mg/m² Once a week	oral administration		Instructions: Adjust dose (between 5 mg/m² and 15 mg/m² ONCE a week) to target neutrophil count above 1.5 x 10⁹/L. Round dose to closest multiple of 2.5 mg tablets. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 59

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 60

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 61

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 62

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 63

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 64

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 65

Medication	Dose	Route	Max duration	Details
metHOTREXATe *	15 mg/m² Once a week	oral administration		Instructions: Adjust dose (between 5 mg/m² and 15 mg/m² ONCE a week) to target neutrophil count above 1.5 x 10⁹/L. Round dose to closest multiple of 2.5 mg tablets. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 66

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 67

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 68

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 69

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 70

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 71

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 72

Medication	Dose	Route	Max duration	Details
metHOTREXATe *	15 mg/m² Once a week	oral administration		Instructions: Adjust dose (between 5 mg/m² and 15 mg/m² ONCE a week) to target neutrophil count above 1.5 x 10⁹/L. Round dose to closest multiple of 2.5 mg tablets. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 73

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 74

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 75

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 76

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 77

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 78

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 79

Medication	Dose	Route	Max duration	Details
metHOTREXATe *	15 mg/m² Once a week	oral administration		Instructions: Adjust dose (between 5 mg/m² and 15 mg/m² ONCE a week) to target neutrophil count above 1.5 x 10⁹/L. Round dose to closest multiple of 2.5 mg tablets. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 80

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 81

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 82

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 83

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 84

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 85

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 86

Medication	Dose	Route	Max duration	Details
metHOTREXATe *	15 mg/m² Once a week	oral administration		Instructions: Adjust dose (between 5 mg/m² and 15 mg/m² ONCE a week) to target neutrophil count above 1.5 x 10⁹/L. Round dose to closest multiple of 2.5 mg tablets. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 87

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 88

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 89

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Day: 90

Medication	Dose	Route	Max duration	Details
mercaptOPURine	50 mg/m² Once daily	oral administration		Instructions: Adjust dose (between 50 mg/m² and 90 mg/m² ONCE daily) to target neutrophil count above 1.5 x 10⁹/L. Take each dose on an empty stomach – one hour before OR three hours after food or milk. Round dose to closest multiple of 25 mg. Consider thiopurine methyltransferase (TPMT) testing.

Additional details

Section 1: Teratogenic effects

Ensure pregnant women are not exposed to tretinoin. Consult prescribing information.

Supportive Care Factors

Factor	Value
Antiviral prophylaxis for herpes virus:	Routine antiviral prophylaxis may be considered
Emetogenicity:	Minimal to low

Antiviral prophylaxis for hepatitis B virus: Guidance is limited to high-risk anti-cancer medicines. Clinicians will need to assess individual patient risk for other anti-cancer medicines.

References

Pharmaco (NZ) Ltd Vesanoid® New Zealand data sheet 21 April 2022 https://www.medsafe.govt.nz/profs/datasheet/v/Vesanoidcap.pdf (accessed 15 July 2022).

* The medicines, doses, combinations, and schedule in this treatment regimen have been carefully reviewed against international best practice guidelines by specialists in medical oncology around New Zealand and this advice has been accepted for publication by Te Aho o Te Kahu (the Cancer Control Agency). Sometimes medicines that are used in routine clinical practice have not been through a formal review process by the NZ Medicines Regulator Medsafe and are therefore considered unapproved or off-label. These medicines are legally able to be prescribed through sections 25 and 29 of the Medicines Act and by obtaining informed consent from patients. All treatment regimens listed on this website have been through robust peer review and are considered an accepted standard of care, whether prescribed through sections 25 or 29 or carrying formal Medsafe Approval.

s29: This symbol indicates that some formulations of the associated medicine are legally only able to be prescribed under section 29 of the Medicines Act. You can see which formulations are section 29 by hovering over the s29 symbol. You can access full medication details from the New Zealand Formulary by clicking on the medication name. Each clinician retains full responsibility for ensuring they have complied with all relevant obligations and requirements of section 29 including obtaining informed patient consent prior to prescribing the applicable medicine.

Cancer Type —

Systemic Anti-Cancer Therapy Regimen Library

Pethema LPA2005 [70 years and under] [intermediate risk] - Maintenance (LEU APL - Pethema LPA2005 induction and consolidations 1, 2 and 3 followed by maintenance [70 years and under] [intermediate risk])

Treatment Overview

Cycle 1 - 90 days

Cycles 2 to 8 - 90 days

Cycle details

Cycle 1 - 90 days

Cycles 2 to 8 - 90 days

Full details

Cycle 1 - 90 days

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Cancer Type
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