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How to use 6-MP

Brand Name(s): 6-MP, Purinethol

Generic Name Mercaptopurine

What are mercaptopurine tablets?

MERCAPTOPURINE (6-MP, Purinethol®) is a type of chemotherapy for treating cancer. Mercaptopurine interferes with the growth of cancer cells. It is used for treating acute lymphocytic leukemia (ALL). Mercaptopurine may also be used to treat inflammatory bowel conditions such as ulcerative colitis or Crohn's disease. Generic mercaptopurine tablets are available.

What should my health care professional know before I take mercaptopurine?

They need to know if you have any of these conditions:

  • biliary disease (cholestasis)
  • bleeding problems
  • blood disorders
  • dental disease
  • infection (especially virus infection such as chickenpox or herpes)
  • kidney disease
  • liver disease
  • recent radiation therapy
  • thiopurine methyltransferase (TPMT) deficiency
  • an unusual or allergic reaction to mercaptopurine, other chemotherapy, other medicines, foods, dyes, or preservatives
  • pregnant or trying to get pregnant
  • breast-feeding

How should I take this medicine?

Take mercaptopurine tablets by mouth. Follow the directions on the prescription label. Swallow the tablets with a drink of water. Do not take your medicine more often than directed. Finish the full course prescribed by your doctor or health care professional, even if the tablets make you feel unwell. Do not stop taking except on your prescriber's advice.

Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed.

What if I miss a dose?

If you miss a dose, skip that dose unless your prescriber or health care professional tells you otherwise. Do not take double or extra doses. If you vomit after taking a dose, call your prescriber or health care professional for advice.

What drug(s) may interact with mercaptopurine?

  • agents that treat or prevent blood clots (example: warfarin)
  • allopurinol
  • balsalazide
  • mesalamine, 5-ASA
  • olsalazine
  • sulfasalazine
  • vaccines

Talk to your prescriber or health care professional before taking any of these medicines:

  • acetaminophen
  • aspirin
  • ibuprofen
  • naproxen
  • ketoprofen

Tell your prescriber or health care professional about all other medicines you are taking, including nonprescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

What side effects may I notice from taking mercaptopurine?

The side effects you may experience with mercaptopurine therapy depend upon the dose, other types of chemotherapy or radiation therapy given, and the disease being treated. Not all of these effects occur in all patients. Discuss any concerns or questions with your prescriber or health care professional.

Side effects that you should report to your prescriber or health care professional as soon as possible:

  • blood in the urine
  • low blood counts - mercaptopurine may decrease the number of white blood cells, red blood cells and platelets. You may be at increased risk for infections and bleeding.
  • signs of infection - fever or chills, cough, sore throat, pain or difficulty passing urine
  • signs of decreased platelets or bleeding - bruising, pinpoint red spots on the skin, black, tarry stools, nosebleeds
  • signs of decreased red blood cells - unusual weakness or tiredness, fainting spells, lightheadedness
  • difficulty breathing
  • mouth or lip sores
  • swelling of the abdomen, lower legs or feet
  • yellowing of the eyes or skin

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):

  • darkening of the skin
  • diarrhea
  • loss of appetite
  • nausea, vomiting
  • rash

What should I watch for while taking mercaptopurine?

Visit your prescriber or health care professional for checks on your progress. You will need to have regular blood checks. The side effects of mercaptopurine can continue after you finish your treatment; report side effects promptly.

Mercaptopurine may make you feel generally unwell. This is not uncommon because mercaptopurine affects good cells as well as cancer cells. Report any side effects as above, but continue your course of medicine even though you feel ill, unless your prescriber or health care professional tells you to stop.

Mercaptopurine may decrease your body's ability to fight infections. Call your prescriber or health care professional if you have a fever, chills, sore throat, or other symptoms of a cold or flu. Do not treat these symptoms yourself. Try to avoid being around people who are sick. Mercaptopurine may increase your risk to bruise or bleed. Call your prescriber or health care professional if you notice any unusual bleeding. Be careful not to cut, bruise or injure yourself because you may get an infection and bleed more than usual.

Avoid taking aspirin, acetaminophen (Tylenol®), ibuprofen (Advil®), naproxen (Aleve®), or ketoprofen (Orudis® KT) products as these may hide a fever, unless instructed to by your prescriber or health care professional.

Mercaptopurine can harm your unborn child if taken during pregnancy. Women who are able to have children should avoid becoming pregnant while taking mercaptopurine.

Be careful brushing and flossing your teeth or using a toothpick while receiving mercaptopurine because you may get an infection or bleed more easily. If you have any dental work done, tell your dentist you are receiving mercaptopurine.

If you are going to have surgery, tell your prescriber or health care professional that you are taking mercaptopurine.

Where can I keep my medicine?

Keep out of the reach of children in a container that small children cannot open.

Store at room temperature between 15 and 25 °C (59 and 77 °F). Protect from moisture. Keep container tightly closed. Throw away any unused medicine after the expiration date.


(Note: The above information is not intended to replace the advice of your physician, pharmacist, or other healthcare professional. It is not meant to indicate that the use of the product is safe, appropriate, or effective for you.)

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