Lanvis (Tioguanine)

• Lanvis is a thiopurine antimetabolite that acts on rapidly dividing cells in hematologic malignancies and immune‑mediated disorders.
• Acute myeloid leukemia: used as part of induction or consolidation therapy to reduce leukemic cell proliferation.
• Chronic myelogenous leukemia: incorporated into treatment regimens to achieve cytoreduction.
• Inflammatory bowel disease: employed to maintain remission by suppressing immune activity.

• Tioguanine is metabolized intracellularly to thioguanine nucleotides, which inhibit de novo purine synthesis and become incorporated into DNA and RNA. This incorporation disrupts nucleic acid function, leading to cytotoxicity of proliferating lymphocytes and malignant cells, thereby providing immunosuppressive and antineoplastic effects.

Adverse reactions may occur with Tioguanine therapy and should be monitored.

Common Side Effects

• Nausea or vomiting
• Diarrhea or abdominal discomfort
• Fatigue or lethargy
• Mild leukopenia or neutropenia
• Rash or mild skin irritation
• Elevated liver enzymes

Serious or Rare Side Effects

• Severe bone‑marrow suppression (pancytopenia)
• Hepatotoxicity or hepatic failure
• Life‑threatening infections
• Pancreatitis
• Secondary malignancies
• Severe hypersensitivity reactions (e.g., Stevens‑Johnson syndrome)

Tioguanine requires careful monitoring and patient education before and during therapy.

• Blood count monitoring: regular CBC to detect leukopenia or anemia.
• Liver function: periodic LFTs to identify hepatotoxicity.
• Infection risk: avoid use in patients with active severe infections.
• Dose adjustment: consider renal or hepatic impairment when dosing.
• Pregnancy and lactation: safety not established; use only if benefits outweigh risks.
• Storage: Store below 25°C: keep in the original container, protect from moisture and light.

Tioguanine may interact with several medicines, altering its efficacy or toxicity.

Major Interactions (Avoid)

• Allopurinol or other xanthine oxidase inhibitors: can markedly increase thioguanine toxicity.
• Azathioprine: additive myelosuppression risk.
• Warfarin: may enhance anticoagulant effect.

Moderate Interactions (Monitor Closely)

• NSAIDs: may increase risk of gastrointestinal irritation.
• Sulfonamide antibiotics: potential for additive bone‑marrow suppression.
• Antiviral agents (e.g., acyclovir): may affect hepatic metabolism.
• Methotrexate: combined immunosuppression may require closer monitoring.