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The Effect of Milk on the Bioavailability of 6-mercaptopurine

Journal of the Korean Pediatric Society 1994;37(12):1732-1737.
Published online December 15, 1994.
The Effect of Milk on the Bioavailability of 6-mercaptopurine
Sun Kyu Park, Ran Ju Kim, Pyoung Ha Hwang, Soo Chul Cho, Jung Soo Kim
Department of Pediatrics, School of Medicine, Chonbuk National University, Seoul, Korea
우유가 6-mercaptopurine Bioavailabity에 미치는 영향
박선규, 김란주, 황평한, 조수철, 김정수
전북대학교 의과대학 소아과학교실
Abstract
The purine antimetabolite 6-Mercaptopurine (6-MP) has been in clinical use for over 30 years and is still a widely used agent in the treatment of childhood acute lymphoglastic leukemia. The bioavailibility, clinical effecacy and toxicity of 6-MP administered orally for maintenance therapy of children with acute lymphoblastic leukemia are highly variable in many studies, as well as at different times in same patient. There are many factors affecting the bioavailibility of 6-MP. The most notably factor being that concomitantly administered drugs and foods might contribute to a decrease in the bioavailibity of this drug. In our sociocultural environment milk is a major constituent of child's foods. Cow's milk contains a high concentration of xanthine oxidase, which could potentially transform 6-MP into 6-thioxanthine (6-TX) and 6-thiouric acid(6-TUA) which have no more therapeutic effects. In this study, we evaluated the effect of various milk products on the bioavailability of 6-MP. Incubation at 37℃ for 30min with raw or pasteurized milk resulted in transformation of a large quantity of clinically relevant concentration of 6- MP into 6-TUA. The concomitant adminstration of clinically relevant concentrations. These observations may help to optimize modalities of administration of 6-MP for the treatment of patients with childhood leukemia.
Key Words: 6-MP, Milk, Bioavailability


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