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Systemic Anti-Cancer Therapy Regimen Library

Home > LEU ALL - HyperCVAD with pegaspargase Part A and B followed by POMP Maintenance [under 40 years] > LEU - HyperCVAD POMP Maintenance
This regimen is a component of LEU ALL - HyperCVAD with pegaspargase Part A and B followed by POMP Maintenance [under 40 years]

POMP Maintenance (LEU ALL - HyperCVAD with pegaspargase Part A and B followed by POMP Maintenance [under 40 years])

Treatment Overview

Follows HyperCVAD Cycle 4B.

Not used for transplant patients.

Cycles 1 to 8 - 84 days

Cycle length:
84

Intrathecal metHOTREXATe: For Ommaya reservoir reduce dose to 6 mg intraventricularly.


mercaptOPURine: Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Cycle details

Cycles 1 to 8 - 84 days

Medication Dose Route Days Max Duration
vinCRISTine 2 mg flat dosing intravenous 1 10 minutes
metHOTREXATe 12 mg flat dosing intrathecal injection 1
prEDNISone 200 mg flat dosing Once daily oral administration 1 to 5
mercaptOPURine 150 mg flat dosing Once daily oral administration 1 to 84
metHOTREXATe * 20 mg/m² Once a week oral administration 1, 8, 15,
22, 29, 36,
43, 50, 57,
64, 71, 78

Intrathecal metHOTREXATe: For Ommaya reservoir reduce dose to 6 mg intraventricularly.


mercaptOPURine: Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Full details

Cycles 1 to 8 - 84 days

Day: 1

Medication Dose Route Max duration Details
vinCRISTine 2 mg flat dosing intravenous 10 minutes
Instructions:
  • Diluted in a minibag.
  • FOR INTRAVENOUS USE ONLY – fatal if given by any other routes.
  • Warning vesicant—ensure vein is patent prior to administration, administer vesicant as per institutional policy and monitor for signs of extravasation throughout administration.
metHOTREXATe 12 mg flat dosing intrathecal injection
Instructions:
  • Adhere to local institution policy for intrathecal administration.
  • For Ommaya reservoir reduce dose to 6 mg intraventricularly.
prEDNISone 200 mg flat dosing Once daily oral administration
Instructions:

Take in the morning with food.
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.
metHOTREXATe * 20 mg/m² Once a week oral administration
Instructions:
  • Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
  • Round dose to closest multiple of 2.5 mg tablets.

Day: 2

Medication Dose Route Max duration Details
prEDNISone 200 mg flat dosing Once daily oral administration
Instructions:

Take in the morning with food.
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 3

Medication Dose Route Max duration Details
prEDNISone 200 mg flat dosing Once daily oral administration
Instructions:

Take in the morning with food.
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 4

Medication Dose Route Max duration Details
prEDNISone 200 mg flat dosing Once daily oral administration
Instructions:

Take in the morning with food.
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 5

Medication Dose Route Max duration Details
prEDNISone 200 mg flat dosing Once daily oral administration
Instructions:

Take in the morning with food.
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 6

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 7

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 8

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.
metHOTREXATe * 20 mg/m² Once a week oral administration
Instructions:
  • Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
  • Round dose to closest multiple of 2.5 mg tablets.

Day: 9

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 10

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 11

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 12

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 13

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 14

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 15

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.
metHOTREXATe * 20 mg/m² Once a week oral administration
Instructions:
  • Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
  • Round dose to closest multiple of 2.5 mg tablets.

Day: 16

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 17

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 18

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 19

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 20

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 21

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 22

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.
metHOTREXATe * 20 mg/m² Once a week oral administration
Instructions:
  • Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
  • Round dose to closest multiple of 2.5 mg tablets.

Day: 23

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 24

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 25

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 26

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 27

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 28

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 29

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.
metHOTREXATe * 20 mg/m² Once a week oral administration
Instructions:
  • Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
  • Round dose to closest multiple of 2.5 mg tablets.

Day: 30

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 31

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 32

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 33

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 34

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 35

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 36

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.
metHOTREXATe * 20 mg/m² Once a week oral administration
Instructions:
  • Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
  • Round dose to closest multiple of 2.5 mg tablets.

Day: 37

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 38

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 39

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 40

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 41

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 42

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 43

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.
metHOTREXATe * 20 mg/m² Once a week oral administration
Instructions:
  • Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
  • Round dose to closest multiple of 2.5 mg tablets.

Day: 44

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 45

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 46

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 47

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 48

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 49

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 50

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.
metHOTREXATe * 20 mg/m² Once a week oral administration
Instructions:
  • Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
  • Round dose to closest multiple of 2.5 mg tablets.

Day: 51

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 52

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 53

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 54

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 55

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 56

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 57

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.
metHOTREXATe * 20 mg/m² Once a week oral administration
Instructions:
  • Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
  • Round dose to closest multiple of 2.5 mg tablets.

Day: 58

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 59

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 60

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 61

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 62

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 63

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 64

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.
metHOTREXATe * 20 mg/m² Once a week oral administration
Instructions:
  • Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
  • Round dose to closest multiple of 2.5 mg tablets.

Day: 65

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 66

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 67

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 68

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 69

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 70

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 71

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.
metHOTREXATe * 20 mg/m² Once a week oral administration
Instructions:
  • Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
  • Round dose to closest multiple of 2.5 mg tablets.

Day: 72

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 73

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 74

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 75

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 76

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 77

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 78

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.
metHOTREXATe * 20 mg/m² Once a week oral administration
Instructions:
  • Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
  • Round dose to closest multiple of 2.5 mg tablets.

Day: 79

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 80

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 81

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 82

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 83

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Day: 84

Medication Dose Route Max duration Details
mercaptOPURine 150 mg flat dosing Once daily oral administration
Instructions:
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk at night.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing and NUDT15 screening for specific patients.

Supportive Care Factors

Factor Value
Antiviral prophylaxis for herpes virus: Routine antiviral prophylaxis recommended
Constipation risk: Consider prescribing laxatives with this treatment
Emetogenicity: Minimal to low
Gastroprotection: Gastroprotection is recommended
Pneumocystis jirovecii pneumonia (PJP) prophylaxis: Routine antibiotic prophylaxis recommended

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.


Gastroprotection: Gastroprotective agents are only intended for short term use while patient is receiving corticosteroid treatment doses.


PJP prophylaxis: If trimethoprim + sulfamethoxazole is used as prophylaxis, it is recommended to avoid on the days oral metHOTREXATe is administered.

References

No references

* 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.