Lanvis

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Medically reviewed

Marina Burgos

Last updated on 10/01/2026

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Lanvis

Property Description
Active ingredient Tioguanine (6-Thioguanine)
Form Oral tablet
Pharmacological class Cytotoxic Antineoplastic Agent
General Use Systemic cellular control (Chemotherapy)
Origin Synthetic compound (Purine analogue)

What Type of Medicine is Lanvis (Tioguanine)?

Lanvis is a prescription-only medicine whose active ingredient is Tioguanine (also known as 6-Thioguanine or 6-TG). It is fundamentally classified as a cytotoxic antineoplastic agent, a class of drugs utilized in therapeutic settings to manage conditions characterized by rapid, uncontrolled cell growth. Within this pharmacological class, Tioguanine is chemically defined as a purine analogue and antimetabolite. This confirms Lanvis as a synthetic chemical compound. Its designation as an antineoplastic agent is clinically recognized for its critical role in systemic therapy.


Composition and Pharmaceutical Form of Lanvis

The sole therapeutic component of this medication is Tioguanine, which is prepared for patient consumption as an oral tablet. This pharmaceutical form defines the route of administration as oral, allowing the compound to be absorbed into the bloodstream from the digestive system. The composition is a single-ingredient product, comprising the active agent, Tioguanine, alongside necessary excipients required for tableting. The oral form is a differentiating feature for patient management, providing a delivery mechanism distinct from many injectable cytotoxic treatments. The classification of Tioguanine as a purine antimetabolite is consistently noted in pharmacological literature.


General Purpose and High-Level Action

The general purpose of Lanvis is to achieve systemic cellular control by interfering with the reproductive mechanisms of fast-growing cells. Tioguanine works as an antimetabolite by mimicking the body’s natural building blocks for genetic material. This mimicry allows the synthetic compound to be incorporated into new DNA and RNA. This fundamental interference causes a disruption of DNA synthesis and ultimately leads to cell cycle arrest and cytotoxicity—meaning the abnormal cells are stopped from proliferating and eventually perish. This highly specific mechanism underpins its critical role as a core agent in chemotherapy protocols.

Regulatory References

  1. cytotoxic agent
  2. WHO Model List of Essential Medicines
  3. Tioguanine: MedlinePlus Drug Information

What side effects are possible with Lanvis?

Possible Side Effects and Safety Information

The safety profile of Lanvis (Tioguanine), a cytotoxic agent, is strictly defined by regulatory documents, reflecting its impact on rapidly dividing cells. The most significant and Very Common expected adverse reaction across all regimens is myelosuppression—a reduction in blood cell counts including leukopenia, thrombocytopenia, and anemia. This effect represents the primary, dose-limiting toxicity.


Serious Adverse Reactions and Systemic Effects

Adverse effects are documented across several System-Organ Classes. Hepatobiliary disorders are a major safety concern, with Veno-Occlusive Disease (VOD) and Nodular Regenerative Hyperplasia (NRH) listed as serious adverse reactions. Other Common effects include gastrointestinal issues such as stomatitis, nausea, vomiting, and diarrhea.


Time-Related Patterns and Genetic Risks

Regulatory labeling specifies that severe liver toxicity is highly associated with prolonged, continuous daily use, which is a key restriction on long-term treatment. Furthermore, the maximum suppression of blood cell counts, or nadir, typically occurs in the first two weeks following treatment initiation, necessitating close observation during this period. A critical population-specific safety consideration is the significant risk of life-threatening severe myelosuppression in patients with an inherited Thiopurine S-Methyltransferase (TPMT) or NUDT15 deficiency.


Safety Restrictions

The medicine is strictly contraindicated in patients with a known hypersensitivity to the active ingredient. Additionally, due to the drug’s immunosuppressive properties, the use of live organism vaccines is not recommended while undergoing therapy.

Overdose and Emergency Response

Overdose and When to Seek Help

An overdose of Lanvis (Tioguanine) is documented to present with signs of toxicity that can be both immediate and delayed. Initial manifestations may involve acute gastrointestinal symptoms such as nausea, vomiting, abdominal pain, and diarrhea. However, the most critical effects are often delayed, revolving around haematological abnormalities and bone-marrow suppression, which can lead to leucopenia and thrombocytopenia.

Overdose poses a high risk for potentially life-threatening outcomes, particularly severe bone marrow depression and significant hepatotoxicity, which may include signs of portal hypertension. Due to the high risk of severe delayed toxicity, regulatory authorities mandate that patients seek immediate medical attention upon any suspected overdose. Official guidelines also recommend contacting a national poisons centre or control center for specialized advice.

Regulatory documentation states that no specific antidote is known for Tioguanine overdose. Management is therefore focused on symptomatic and supportive treatment. This includes necessary procedures like gastrointestinal decontamination and intensive, careful monitoring. Monitoring requires frequent checks of full blood counts (FBCs) and liver function tests (LFTs) during hospital observation. Individuals with Thiopurine S-methyltransferase (TPMT) deficiency are noted to be at a significantly increased risk for developing severe toxicity.

Therapeutic Uses of Lanvis

Lanvis (Tioguanine) is generally used as a relevant therapeutic component in oncology to manage acute hematologic malignancies. This medication is applied in addressing the pathological pattern of uncontrolled proliferation of abnormal cells within the bone marrow, the core issue in conditions like Acute Myeloid Leukemia (AML), Acute Non-lymphocytic Leukemia (ANLL), and the severe blast crises of Chronic Granulocytic Leukemia (CGL).

The principal goal is to achieve both remission induction and remission consolidation. Its use in these comprehensive, systemic regimens assists in achieving the overall therapeutic objective and plays a role in managing the overall therapeutic objective. This provides a key therapeutic benefit and supports the objective of long-term disease management.

“The medication is generally considered a relevant component of established, multi-agent chemotherapy protocols and is applied to both adult and pediatric patients with acute leukemia.”


Quick Fact: Supports Management of Systemic Imbalance

This agent plays a role in managing symptoms related to systemic imbalance by supporting the goal of assisting in achieving the objective of sustained management. It is commonly used in clinical settings that involve acute or unstable symptom patterns and is generally considered relevant for contributes to easing the overall symptom load during challenging episodes.

Regulatory References

  1. National Cancer Institute overview

Eligibility and Restrictions for Use

Eligibility for Lanvis (Mercaptopurine) — Official Regulatory Information

Lanvis (mercaptopurine) is authorized for use in adult and pediatric patients as a component of combination chemotherapy maintenance regimens, primarily for acute lymphoblastic leukemia (ALL). However, eligibility is subject to several strict regulatory constraints.

Contraindications and Restrictions

Classification Population/Condition
Contraindicated Patients with known hypersensitivity to mercaptopurine or any component of the formulation.
Conditional Use Patients with inherited TPMT or NUDT15 enzyme deficiency (homozygous deficiency typically requires le 10% of the standard dose due to severe toxicity risk).
Restricted Use Pregnancy: Use should be avoided, especially in the first trimester, due to the risk of fetal harm. Lactation: Breastfeeding is not recommended. Females and males of reproductive potential must use effective contraception during and after treatment.
Conditional Use Patients with existing hepatic or renal impairment may require close monitoring and a reduced starting dose due to potential for slower elimination of the drug.

Patients on this medicine must also avoid live organism vaccines due to the immunosuppressive nature of the therapy, which can diminish vaccine response and increase the risk of severe infection. Eligibility is conditional on the management of these risks.

What should I know about interactions with other medicines?

Interaction Map: Interactions with other medicines and products — official regulatory information for Lanvis (Tioguanine)


Interaction scope

Category Official Regulatory Documentation
Medicinal product categories with documented interactions: Myelotoxic substances, Aminosalicylate derivatives, Live organism vaccines.
Specific interacting medicines (if explicitly listed): Aminosalicylate derivatives (e.g., olsalazine, mesalazine, sulfasalazine), Allopurinol (noted non-interaction), Anti-TNF agents.
Mechanistic basis of interactions (only if stated in label): Inhibition of the Thiopurine S-methyltransferase (TPMT) enzyme; Additive toxicity.
Timing-based interaction rules (if applicable): None explicitly stated in regulatory documents.
Population-specific interaction notes (if applicable): Inherited TPMT deficiency, Nudix Hydrolase 15 (NUDT15) deficiency, Impaired Hepatic Function.
Interaction-related restrictions: Live organism vaccines are not recommended; Co-administration with myelotoxic agents increases toxicity risk.

Interaction classifications (high-level)

Category Official Regulatory Documentation
Interaction severity classification (as defined in official documents): Contraindicated/Not Recommended (Live vaccines); Use With Caution/Increased Risk (Myelotoxic agents, Aminosalicylates).
Regulatory basis (EMA / FDA / etc.): SmPC (Summary of Product Characteristics) / FDA Prescribing Information.
Interaction-context constraints (as defined in official documents): Risk of severe toxicity in patients with genetic deficiencies; Risk of hepatic necrosis when combined with alcohol.

Resulting interaction structure

Official interaction statements:

  • Immunisation with live organism vaccines is not recommended due to the potential to cause severe infection in immunocompromised hosts.
  • Co-administration with other myelotoxic substances or radiation therapy is documented to increase the overall risk of myelosuppression.
  • Aminosalicylate derivatives may inhibit the TPMT enzyme in vitro, which is associated with an increase in active metabolite exposure.
  • The metabolism of tioguanine is not inhibited by allopurinol, which distinguishes it from related thiopurines.
  • The risk of hepatic necrosis has been reported in rare cases involving high-dose therapy and alcohol consumption.
  • Inherited TPMT or NUDT15 deficiencies are formally recognized as increasing the risk of severe toxicity from conventional doses.

Connection to the overall interaction profile (2–4 sentences): The official interaction profile is defined by restrictions on additive pharmacodynamic toxicity (myelosuppression and vaccine risk) and constraints related to metabolic compromise via the TPMT/NUDT15 pathways. This regulatory framework establishes the necessary boundaries for co-administration with other cytotoxic agents and highlights substances and patient conditions that formally influence drug exposure or heighten the risk of documented serious outcomes.

Mechanism of Action

The mechanism of Lanvis (Tioguanine) operates by selectively interfering with the biological processes that govern cell division. This action is centered around two core mechanistic domains:

1. Purine Mimicry and Enzymatic Activation

Tioguanine functions as a structural antimetabolite, mimicking the natural purine base, guanine. Inside the cell, the enzyme HGPRT activates Tioguanine into its cytotoxic form, Thio-Guanine Nucleotides (TGNs). These TGNs competitively block the cell’s natural purine synthesis pathway and are falsely incorporated into new DNA and RNA strands. This mechanism establishes the drug's action as highly dependent on cells that are actively attempting to replicate their genetic material.


2. Genetic Corruption and Selective Cytotoxicity

The structural damage caused by the incorporated TGNs compromises the genetic material's stability, impairing accurate division. This structural flaw triggers the cell's internal checkpoints, resulting in Cell Cycle Arrest specifically in the S-phase (DNA synthesis). The replication failure activates cellular self-destruction pathways (apoptosis). This results in cytoreduction—the systemic reduction of rapidly dividing cell populations. The rate of drug inactivation is also constrained by the TPMT enzyme, which introduces variability in the mechanism's duration of action.

Dosage and Administration Information

How Lanvis (Tioguanine) is Used in Clinical Practice

Lanvis is administered through the oral route, delivered as a 40 mg tablet. Its usage pattern is structured, being restricted to defined phases of systemic treatment for hematologic malignancies.


Official Dosing and Frequency

The standard adult and pediatric dosing regimen is calculated based on body parameters, with an initial daily dose of approximately 2 mg/kg of body weight, or between 60 and 200 mg/m^2 of body surface area. The medicine is administered once daily. The exact dosage and duration are dependent on the specific multi-agent chemotherapy protocol being employed.


Administration Requirements and Timing

The tablet is taken preferably on an empty stomach, as food intake may reduce absorption. In cases where a dose is missed, the dose is taken as soon as remembered, unless it is almost time for the next scheduled dose; taking two doses together is prohibited.


Population-Specific Adjustments

Dose reduction is considered for patients with established renal or hepatic impairment. A substantial dose reduction, often 10% or less of the standard dose, is typically necessary for patients with known or suspected deficient activity of the TPMT or NUDT15 enzymes.


Duration of Use

Lanvis is used in short-term courses specifically for remission induction and remission consolidation. It is not recommended for continuous, long-term use in maintenance therapy.

Recent Clinical Evidence

Research Evidence / Overview of Studies for Lanvis

The research evidence for Lanvis (tioguanine) focuses on its application as a component of multi-agent therapeutic protocols. The available data primarily comes from large-scale studies that evaluate entire combination regimens, rather than isolating the effect of tioguanine alone.


Evidence for Use in Acute Myeloid and Non-Lymphocytic Leukemias (AML/ANLL)

  • What researchers studied: Large, cooperative Randomized Controlled Trials (RCTs) and Systematic Reviews evaluated the use of tioguanine within multi-drug regimens, including broad populations of adults and distinct cohorts of the elderly. Researchers focused on measured outcomes such as Complete Remission (CR) rates, Survival metrics (OS), and the rate of disease relapse.
  • What the studies reported: Studies describe patterns related to measurements of Complete Remission rates when tioguanine is used as part of the intensive induction and consolidation cycles. Findings also indicate that tioguanine was studied for use in short-term, intensive cycles but not for continuous, long-term maintenance protocols. Long-term studies track survival measurements over multi-year periods.
  • What remains uncertain: The research structure makes it difficult to isolate the independent effect of tioguanine from the other concurrent agents. Data for the elderly cohort often reflects complications due to co-morbidities, meaning data for this group remains insufficient to generalize broadly.

Comparative Research for Acute Lymphoblastic Leukemia (ALL)

  • What researchers studied: Research includes RCTs and subsequent Meta-analyses conducted primarily in pediatric populations undergoing long-term maintenance therapy. These studies explored how outcomes such as Survival metrics (EFS) and Survival metrics (OS) differed between regimens using tioguanine versus those using a related drug, mercaptopurine.
  • What the studies reported: Systematic reviews aggregating trial data reported mixed findings regarding the measurements of overall Survival metrics (EFS) when tioguanine was evaluated against mercaptopurine. Subgroup findings indicated that the pattern of measured changes in EFS was associated with specific patient groups in some studies, but did not show a difference in overall survival measurements across the broader group.
  • What remains uncertain: Due to inconsistency and heterogeneity across the multiple comparative trials, broad conclusions about comparative outcomes for all patient groups remain uncertain. Follow-up durations were limited in some aspects, and long-term effects are not fully established for every aspect of the research.

Frequently Asked Questions (FAQ)

Common questions about Lanvis (FAQ)


Q: How long does it usually take to see the effect of Lanvis?

A: Lanvis is monitored primarily by observing blood cell counts. The point at which blood cell counts reach their lowest levels, known as the nadir, typically occurs within the first one to two weeks after starting treatment. This monitoring reflects the drug's activity on rapidly dividing cells.


Q: Does Lanvis cause hair loss?

A: Official safety information lists hair loss, known medically as alopecia, as an adverse reaction associated with the use of this medication.


Q: What happens if I forget to take a dose of Lanvis?

A: Regulatory guidance advises that if a dose is missed, it should be taken as soon as it is remembered, unless it is nearly time for the next scheduled dose. Regulatory guidance states that two doses should not be taken together to make up for a forgotten one.


Q: Does Lanvis interact with common over-the-counter pain relievers?

A: The official interaction profile focuses on prescription drugs and vaccines. However, regulatory information suggests that certain nonsteroidal anti-inflammatory drugs (NSAIDs) or aspirin may increase the risk of bleeding due to their effects on blood clotting.


Q: What kind of follow-up monitoring is standard when taking Lanvis?

A: Standard monitoring includes regular and frequent blood counts to track cell suppression, especially during the initial weeks of therapy. Because of the risk of liver damage, monitoring of liver function tests is also required.


Q: What is the purpose of the black box warning on Lanvis (if applicable)?

A: The FDA uses Boxed Warnings (sometimes referred to as a 'Black Box' warning) to highlight serious risks. For Lanvis, the most severe official warnings are related to the risk of life-threatening low blood cell counts (myelosuppression) and the risk of severe liver toxicity, particularly when used continuously or in patients with certain enzyme deficiencies.


Q: Is Lanvis typically used as a short-term or long-term treatment?

A: According to official documentation, Lanvis is generally used in short-term cycles for treatment phases like remission induction and consolidation. It is officially not recommended for long-term continuous maintenance therapy due to the increased risk of severe liver damage.


Q: Is Lanvis appropriate for patients with liver disease?

A: Official labeling requires that dose reduction must be taken into account for patients who have established hepatic impairment (liver disease). Furthermore, the drug carries a risk of serious liver toxicity, such as Veno-Occlusive Disease, which is a key safety consideration.


Q: Can Lanvis be taken with food, or does it matter?

A: Official administration instructions state that the tablet should preferably be taken on an empty stomach. This is because taking the medication with food may decrease the amount of the drug absorbed into the body.


Q: Is Lanvis considered a targeted therapy?

A: Lanvis is chemically classified as an antimetabolite, which is a traditional type of chemotherapy. Its mechanism works by interfering with the DNA synthesis process in rapidly dividing cells, which is a method distinct from modern, molecularly targeted therapies.


Q: Is feeling tired a common side effect of Lanvis treatment?

A: Official patient information often notes unusual tiredness or weakness as a possible side effect. This can be a sign of anemia or low red blood cell counts, which are a common adverse effect resulting from the drug's impact on blood cell production.


Q: Are the side effects of Lanvis permanent?

A: Certain severe adverse reactions, such as specific types of liver damage (e.g., Nodular Regenerative Hyperplasia and Veno-Occlusive Disease), are serious health concerns associated with this medication. The long-term status of these or other serious effects is often a matter of medical concern that should be discussed with a specialist.


Q: Do I need to change my diet while taking Lanvis?

A: The only specific restriction concerning administration is the recommendation to take the tablet on an empty stomach. Separately, official warnings indicate that consuming alcohol may increase the risk of severe liver toxicity, a risk noted in official warnings.


Q: What are the major drug categories that Lanvis is known to interact with?

A: Official product information emphasizes interactions involving myelotoxic substances, which increase the risk of low blood cell counts; Aminosalicylate derivatives, which may affect metabolism; and Live organism vaccines, which are typically not recommended due to immunosuppression.


Q: What should I do if I experience an unexpected reaction to Lanvis?

A: Official guidance describes conditions requiring immediate medical help, such as signs of a severe allergic reaction (e.g., difficulty breathing, swelling) or signs of life-threatening toxicity (e.g., severe liver problems or sudden drops in blood cell counts).


Q: Does Lanvis need to be stored in the refrigerator?

A: No, regulatory information specifies that the product is typically required to be stored at room temperature, generally between 15 C and 25 C (59 F and 77 F), in a dry place, away from heat and moisture.


Q: Can Lanvis affect fertility?

A: Official safety information indicates the drug has the potential to affect reproductive capacity (fertility effects are likely), as is common with many cytotoxic agents. Discussing appropriate measures is important.


Q: Is Lanvis associated with a risk of secondary cancers?

A: Official documentation notes that tioguanine, like other cytotoxic agents, may cause damage to the genetic material in cells. This is associated with a theoretical risk of carcinogenesis (cancer development) as noted in the safety warnings.


Q: Is there a generic version of Lanvis available?

A: Yes, the active ingredient in Lanvis, which is thioguanine, is available under both various brand names and as a generic formulation from different manufacturers.


Q: How quickly is Lanvis eliminated from the body?

A: Pharmacokinetic data available in official prescribing information indicates that the drug is eliminated from the body with a terminal elimination half-life generally ranging between 5 and 9 hours.


Q: Does Lanvis cause sensitivity to sunlight?

A: Increased sensitivity to sun exposure (photosensitivity) is listed in patient safety information as a potential side effect.


Q: Is Lanvis prescribed for conditions other than [Main Indication]?

A: The drug holds official regulatory indications solely for the treatment of acute leukemias (e.g., AML/ANLL). Any uses for conditions outside of these indications are not detailed in the core regulatory documentation.


Q: What are the potential risks if Lanvis is taken during pregnancy?

A: Official warnings generally describe the drug as having positive evidence of human fetal risk and potential to cause fetal harm. For this reason, it is typically not recommended during pregnancy.


Q: Can Lanvis be used by people with kidney problems?

A: Official regulatory labeling requires that the prescribed dose must be reduced for patients with established renal impairment (kidney problems). This is necessary to help mitigate the risk of excessive drug exposure and toxicity.


Q: What are the signs of an allergic reaction to Lanvis?

A: Signs of a severe allergic reaction that warrant immediate medical attention include difficulty breathing, swelling of the face, lips, tongue, or throat, and the sudden appearance of hives or a rash.

How should Lanvis be stored and disposed of?

How to Store and Dispose of Lanvis (Thioguanine)

Lanvis (thioguanine) tablets must be stored at a controlled room temperature between 15°C and 25°C (59°F and 77°F). It is mandatory to keep the medication in its original container, tightly closed, and to protect it from light and moisture. To ensure child safety, Lanvis must be stored out of the sight and reach of children.

Storage Restriction Disposal Requirement
Do not refrigerate or store in damp areas. Do not throw into household trash or wastewater.
Keep container tightly closed. Dispose of according to local hazardous waste regulations.

As a cytotoxic agent, unused or expired Lanvis must be returned to a pharmacist or a recognized drug collection program for proper handling and disposal.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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