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Severe Jont and back pain associated with Meraptopurine

I have been using Mercaptopurine since `March 2007 as prescribed by my Dr. for Ulcerative Colitis. My Dr. has me on !00mg once a day. I achieved remission in June. My Dr. Started weening me off predisone slowly. I stopped it August 4 and August 8 I st...
by Anthony Spinelli in Saten Island NY, 08/30/2007


Mercaptopurine (Purinethol)
6-Mercaptopurine (Purinethol)
(mer-kap-toe- PYOUR-een)
Pregnancy Category: D Purinethol (Abbreviation: 6-MP) (Rx)

Classification: Antineoplastic, antimetabolite (purine analog)

See Also: See also Antineoplastic Agents .

Action/Kinetics: Cell-cycle specific for the S phase of cell division. Converted to thioinosinic acid by the enzyme hypoxanthine-guanine phosphoribosyltransferase. Thioinosinic acid then inhibits reactions involving inosinic acid. Also, both thioinosinic acid and 6-methylthioinosinate (also formed from mercaptopurine) inhibit RNA synthesis. About 50% absorbed from GI tract. Plasma t 1/2: 47 min in adults and 21 min in children. Metabolites are excreted in urine with up to 39% excreted unchanged. Cross-resistance with thioguanine has been observed.

Uses: Acute lymphocytic or myelocytic leukemia. Lymphoblastic leukemia, especially in children. Acute myelogenous and myelomonocytic leukemia. Effectiveness varies depending on use. The drug is not effective for leukemia of the CNS, solid tumors, lymphomas, or chronic lymphatic leukemia. Investigational: Inflammatory bowel disease, chronic myelocytic leukemia, polycythemia vera, non-Hodgkin's lymphoma, psoriatic arthritis.

Contraindications: Use in resistance to mercaptopurine or thioguanine. To treat CNS leukemia, chronic lymphatic leukemia, lymphomas (including Hodgkin's disease), solid tumors. Lactation.

Special Concerns: Use with caution in clients with impaired renal function. Use during lactation only if benefits clearly outweigh risks. Severe bone marrow depression (anemia, leukopenia, thrombocytopenia) may occur. There is an increased risk of pancreatitis when used for inflammatory bowel disease.

Additional Side Effects: Hepatotoxicity, oral lesions, drug fever, hyperuricemia. Produces less GI toxicity than folic acid antagonists, and side effects are less frequent in children than in adults. Pancreatitis (when used for inflammatory bowel disease).

Overdose Management: Symptoms: Immediate symptoms include N&V, diarrhea, and anorexia while delayed symptoms include myelosuppression, gastroenteritis, and liver dysfunction. Treatment: Induction of emesis if detected soon after ingestion. Supportive measures.

Drug Interactions: Allopurinol / Methotrexate effect R/T liver breakdown (reduce methotrexate dose by 25%-33%) Trimethoprim-Sulfamethoxazole / Risk of bone marrow suppression

How Supplied: Tablet: 50 mg

Highly individualized: 2.5 mg/kg/day. Adults, usual: 100-200 mg; pediatric: 50 mg. Dosage may be increased to 5 mg/kg/day after 4 weeks if beneficial effects are not noted. Dosage is increased until symptoms of toxicity appear. Maintenance after remission: 1.5-2.5 mg/kg/day.

Mercaptopurine Ratings

Overall Rating:



(based on 2 reviews)



Ease of Use:


Overall Satisfaction:





Effectiveness: ****

Ease of Use: ***

Overall Satisfaction: **


Percy, Percy - 01/13/2014

.Letting her know that she is not alone and that eventually thngis will improve will really help her. It is scary at first but after a little time, it just becomes the norm . The bad times can be bad but Crohn's Disease has also made me who I am. I wouldn’t change the fact I have had it (I would love to be cured though). It has made me stronger; I appreciate life a lot more and I do much more to help others.I have met some fantastic people. Some of my Crohn's friends have controlled their symptoms with diet, others have had operations. We all differ and so does the disease.It is not the end of the world. As my blog has shown over the past few years, it can be funny, it can be sad, it can be painful and it can be all OK.The Gaul bladder thing has never happened. I’m sure it could be linked with Crohn’s (My GP likes to blame my Crohn's for every little thing even if I broke my leg I’m sure Crohn's would be the cause!! he he)It’s a shame your local NACC group doesn’t have any sufferer's. Are there any other's within easy access? Our group has a very high attendance of sufferer's and family members. We get a good mix. All ages too Children up to OAPs.We do a local newsletter 2/3 times a year. Have a look through these and maybe print one out for your mum. It shows all the thngis we get up to as well as some member's stories.NACC also has some very useful telephone numbers for a variety of different callers. Make use of them.My only advice is to be strong. Sometimes she will find it difficult to talk to you (I sometimes try not to discuss everything with my partner) but stick it out. She may get angry and frustrated, sometimes you have to be a punch bag but I can guarantee that she will appreciate every moment you offer herAny questions, Tweet, blog or email me. If I can offer any help I may be able to point you in a good directionThankyou for your messageKeep WellBen x@mrawesomeben