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Ulcerative Colitis
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Posted 10/27/2016 3:38 PM (GMT 0)
Hello - I just joined this forum and was wondering what others thought of the 6-MP drug (Mercaptopurine)? I was diagnosed with Left sided UC 9 years ago and have gone through almost all of the 5-ASA's (Lialda, Asipro, Asacol and Rowasa) so my Dr. thinks I've plateaued on them. I'm just getting through a flare and am tapering off of Prednisone. about 10 days ago my Dr. put me on Imuran since the other drugs weren't working. After 8 days on Imuran I had horrible joint pain to where I was unable to get out of bed so he stopped the Imuran and has now prescribed 6-MP. I'm a little reluctant to go on this one because of the side effects (mostly the HSTCL side effect and the bleeding/bruising). I noticed there were a few threads about this drug but they were older threads so I was wondering if there have been improvements since 2008 - 2010? Or if anyone that was unsure of taking it during that time ended up going on it and has any information. Any information would be appreciated.  
Posted 10/27/2016 3:50 PM (GMT 0)
Hi and welcome to the forum. I have been on 6-MP (Mercaptopurine) for over three years and have not had any serious side effects from it. The only side effect I have experienced is that I more easily sunburn when I'm outside for extended periods of time, so I take precautions and wear sunscreen or cover up.

Imuran is metabolized into 6MP within your body, so they are similar medications. I cannot say with any certainty whether you'll experience the same joint pains, as it really depends what component you were reacting to.

The most concerning side effect of these medications is lymphoma which has odds of 4 in 10,000 (or 0.04 percent) compared to 2 in 10,000 (or 0.02 percent) for the general population. Of those who get lymphoma, 66 percent are able to put it into remission. To put those odds into perspective, the odds of death in car crash within the USA are 1 in 133, and death via heart troubles are 1 in 5. So, you're talking very small odds with the 6-MP. The Crohn's and Colitis Foundation of America is the source for these statistics:
Webcast: programs.rmei.com/CCFA139VL/presentation/player.html
Transcript: http://www.ccfa.org/assets/pdfs/risk-and-benefits-transcript.pdf
Posted 10/27/2016 5:13 PM (GMT 0)
I am on 6MP with no side effects at all
Posted 10/27/2016 5:33 PM (GMT 0)
I have been on 6mp 75mg/day since Sept. 2013. Before that I was on prednisone for 9 months. I could not start 6mp as I was schedule for parathyroid surgery so stayed on prednisone.

I must admit, I have more joint pain than I used to but not bad. It is hard to tell, it is UC or 6 mp or prednisone.

It took while but 6 mp put me in remission.It will take 2-3 months before you feel better. I don't see anyother major side effects from 6 mp but prednisone gave me diabetes and some other issues. So if 5-ASA not working for you, you are better off on 6mp than on prednison.

Make sure you get your regular liver function and CBC done.

Wish you get in remission soon.
Posted 10/28/2016 2:38 AM (GMT 0)
I was on 6mp for 3 years with no flares and no side effects. Added simponi for the past 9 months and have no issues.

Ive never noticed any problems using 6 mp.
Posted 10/28/2016 2:43 AM (GMT 0)
I was scared to get on Imuran (known you're stopping this one) but my dr put my mind at ease. He said yes there are scary side effects to these medications but you are much safer taking these, then being on prednisone for long term. Prednisone side effects are much more dangerous and common, as per what he told me. Hope this helps!
Posted 10/28/2016 1:44 PM (GMT 0)
Thank you to everyone for your responses. I guess I'm still a bit worried but I'm hoping it will be fine. I start the medication tomorrow and am going to keep my fingers crossed that I won't get the major side effects because I don't know which direction my GI will go in if he has to take me off this medication also.
Posted 10/28/2016 2:38 PM (GMT 0)
Good luck, I hope it goes well for you.

It's only human nature to assume the worst case scenario in everything, as we're all nervous when starting a new treatment. In my case the initial worry was all for naught.

If the 6MP doesn't work then your gastroenterologist will likely discuss biologics with you (remicade, humira, simponi, or entyvio). Really a similar list of very small but serious risks, like immunomodulators, as biologics also lower immune response. It's always about benefits versus risks whenever you're treating chronic illness patients, and improving one's quality of life is what we all want. The benefits far outweigh tiny risks. It's good to be aware of what could happen, but don't let 0.04 percent odds (for the worst side effects) keep you awake at night.
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