6mp

My 7 year old son has not long been diagnosed with crohns. On mesalazine at the min but starting 6mp on saturday, is scaring the livin daylights out of me!!  what can i expect??  thanx.

Some people complain about 6MP, but I've now been on it for 6-1/2 years, with no noticeable side effects (except for those that may have to do with the disease, rather than the drug). It shrank the inflammation in my intestine, so that a long section that had shown on my x-rays as narrowed to half its width showed up as open and clear two years later. I don't know whether it's still working, but I know that, at the very least, it's bought me years of surgery-free time.

As Nanners has mentioned, you'll need to make sure that he gets the required blood tests. They'll probably test him after the first few weeks and then extend to quarterly blood tests.

Good luck!

I started 6MP at the end of September. The most noticeable side-effect for me was feeling tired, so I take the pill at night. That tired feeling went away after about a month. Last week I had the blood test to make sure I'm at the correct dosage, and my doc increased me from 50mg (the lowest dosage) to 75mg and again I feel sleepy about an hour after taking it. The only downside is the drug can and probably will take several months (3 or 4) in order for any affect to be felt. For me personally, I feel no different but it's only been 2 months. I'm hoping this is a long-term solution for my Crohns.

thanx everyone for your comments.  He starts it tomorrow and i know its for the best. Its just all so new to me as its only been a couple of months since he was diagnosed.  I will defo be giving him the med at night now,  would you reccomend just before he goes to bed ?  he has weekly bloods for 8 weeks then monthly then every 3 months.  hope all you guys are well. xx

I take it right before bed. Not a few hours before or anything but right when I'm ready for bed and haven't had any problems doing that. Good luck to him!!

Hi Dodie -

My son was diagnosed with CD when he was 10. He was on 6-MP for about 18 months - including 6 months on 6-MP and Humira at the same time. He didn't have any problems with the medication - it just wasn't enough.

6-MP can take up to 4 months before you know if it's working for sure so you will need to be patient. It works by calming down one part of the immune system. It causes one particular kind of cell to die a little earlier than it would otherwise. One doctor put it to me this way - with CD the immune system is revving it's engine too high - it's in overdrive. The meds hopefully bring it back to close to the normal levels instead. But it's a delicate balance and this approach works best with close supervision and regular doctor visits.

Here is a list of info/advice that I have compiled over the past 5 years about administering Imuran/6-MP/AZA that I have put together from various sources including articles, doctors, prescribing info and other parents. Hope you find it helpful -

Possible drug interactions include:

Mesalamine (Pentasa, Asacol, Rowasa)
NSAIDS

Ideally give on empty stomach 1 hour before meal or 2 hours after meal however it may be taken with food if needed to avoid nausea

Do not give with milk or milk based products; there’s an enzyme in milk products that breaks down 6-MP

Contains Lactose

Ideally, give at same time each day

Missed dose: give within 12 hours otherwise wait for next regular dose

Give at bedtime to minimize nausea if this is a problem

If the child vomits after taking it:
If it is within 15 minutes give a second dose
If it is more than 15 minutes wait for next regular dose

Call the doctor for fevers:
If 101.5 or higher once within 12 hours
If 100.5 twice within 12 hours

Call doctor and report:
Vomiting
Rashes
Unusual bruising
Chicken pox exposure

Side effects may include nausea, hair loss, rashes, low blood counts, liver damage, pancreatitis


Expert recommendation (Dubinsky) regarding how often to monitor for low blood counts with CBC w/diff:
every 2 weeks x 2 then
every 4 weeks x 3 then
every 8 weeks x 4 then
every 3 months

Dubinsky recommends following the same schedule for liver panel (ALT, ALP, AST, Billirubin, Albumin, Total protein and possibly GGT); others check liver function less frequently once dose titration is finished but most watch liver function closely during dose titration.

Theraputic/toxic ranges of prometheus values for 6-TGN (therapeutic metabolite) and 6-MMP (potentially toxic metabolite) are generally quoted as:

6-TGN below therapeutic range <235
optimal range of 235 to 450
toxic range >450
6-MMP below 6000 generally believed to be OK
above 6000 generally viewed as potentially toxic levels

Not all doctors agree that Prometheus metabolite testing is needed and not all insurance companies approve this testing.

Some doctors use allopurinol in combination with Imuran to boost 6-TGN levels. Allopurinol blocks one of the pathways for inactivation of 6-TGN thus increasing the amount of circulating 6-TGN. When used in combination with Allopurinol, the Imuran dose must be reduced to 1/3 to 1/4 of usual prescribed levels.