Monday, May 9, 2011

Mercaptopurine (6MP)

My experience with 6MP has a bit of a curious storyline. I first used this medication as a senior in high school, less than a year from the time of my diagnosis. The frequent blood tests were the only complaint I might have made about it since I would have to occasionally miss or be late for some after-school activities. I was very secretive about my disease at this point as I didn't want most people to know that I had a disease that involved frequent and bloody bowel movements. I was sure that no boy or man would ever be interested in me if they knew about any of that. But, having 81 absences in my senior year and taking the AP exams in a "special" room with extra allotted time to allow for my frequent trips to the bathroom was not an easy thing to hide. Nor was my two month-long absence from school when I was initially diagnosed, or my tardiness for after school activities to allow for frequent trips to doctors or for the 6MP blood tests.

I took myself off of 6MP when I went to college as I had experienced the longest remission yet (a little under 1 year) and, quite frankly, the drug scared me. It was only when I began experiencing more frequent flares that I was prescribed 6MP again. It worked. For a while. I had frequent mild flares, including a fairly severe one while studying abroad in Rome. At the end of my senior year of college I had a very severe flare and was hospitalized for a week just 2 days after my graduation. After moving to Washington D.C., my gastroenterologist down there (Dr. Ginsberg) noticed the sudden appearance of around 25 small moles on the palms of my hands. He asked how long they had been there. I told him the appeared a few months prior. He and a team of dermatologists ran some tests and determined that they were dysplastic nevi and were a rare side effect of 6MP.

Because of a strong family history of melanoma (both my mother and father and quite a few of their siblings), combined with the fact that the 6MP was losing its efficacy and failing to keep my UC under control, both my D.C. gastroenterologist and my primary gastroenterologist in NY decided to take me off of the 6MP, at first thinking they could just treat my flares with Prednisone as I only had one more class of drugs to try before surgery would be on the table. They quickly found that my disease was too severe to treat with intermittent steroids and after another week-long hospital stay and a fight with a C. Difficile, I was faced with my last hope to save my colon. I was put on a TNF-blocker called Remicade....


  1. How long were you on the 6MP? I have been prednisone dependent for 9 months (with a 2 month gap where I was fine). Anyway, I'm curious as to what side effects you experienced on the 6MP too.


    1. Hi Matt,

      I was on and off 6MP for about 5 years. The only major side effect I had from the medication was that I developed a ton of dysplastic nevi (pre-cancerous moles) on the palms of my hands and they believe this was caused from this medication (when the med was DC'd the moles stopped appearing). Other than that I found it to be a very tolerable drug, other than having to have regular blood tests. Prednisone is the real killer drug! I was largely prednisone dependent for almost 9 years.


  2. Katie,
    I came across your post while researching side effects of 6MP and Remicade. I showed symptoms of UC in April 2014 and was diagnosed with UC in July. Have been on Prednisone, Lialda, 6MP, Basalazide and Sulfasalazine.....all which have not worked. In fact, I have progressed from mild to severe UC while on those meds over the last 3 months. After being on 6MP, I was not getting any better and the side effects were killing me while trying to keep working full time. That brings me to the TNF blocker my GI just put me on, Remicade. I had my first treatment 11 days ago. It has almost stopped the bleeding already and I have gone from having bad D to loose bits of stool. But the progress stops there. I am still having to go 12-15 times a day. I am scheduled for my next treatment in a few days and was wondering how the Remicade treatments worked for you. Did the Remicade have any effect on your UC in the beginning? Or did it end up making things worst for you.