WHY AM I TAKlNG 6-MP?
There are several situations where this drug is useful
in treating Ulcerative Colitis and Crohn's Disease. We often use
6-MP in patients with active disease which is not completely responding
to treatment with other drugs. Many patients are intolerant to
other drugs. We may also be concerned about side effects of drugs
such as Prednisone. 6-MP may help reduce disease activity and
allow the dosage of Prednisone to be decreased or eliminated.
Side effects of long term prednisone use include weight gain,
high blood pressure, diabetes, osteoporosis, hip disease, and
cataracts. Certain complications of Crohn's disease are specific
indications for 6-MP. These include arthritis, fistulas, and perirectal
disease.
HOW DO I TAKE 6-MP?
Most patients are maintained on a dose of one 50
mg tablet daily, taken after breakfast. This is for "average"
patients. The dose is calculated as approximately 1.5 mg./kg body
weight per day. Higher doses may be necessary in some patients,
but require careful monitoring.
HOW LONG DO I TAKE 6-MP?
After starting 6-MP about 60-70% patients will respond
in 3-6 months. Some patients can be completely weaned from prednisone,
and in others the dosage can be significantly reduced. We prefer
to continue the drug until the disease is clearly in remission.
6-MP is then continued in hopes of maintaining the remission.
If the disease is well controlled on 6-MP, it can be continued
indefinitely. If a patient has responded and the drug is stopped,
the disease is likely to recur.
ARE THERE SIDE EFFECTS?
Bone marrow toxicity may occur but is not common
at the usual dose. We recommend having a blood test (CBC) drawn
weekly for the first three weeks and then monthly while on the
drug. Our office will call you or mail a reminder to you when
these tests are due. If marrow toxicity occurs, you may become
anemic, develop bleeding problems, or a low white blood cell count.
This could predispose you to serious infections. If you develop
fever, a cold, or any infection while taking the drug, stop the
6-MP immediately and contact our office. We may resume the drug
when the infection has cleared. Headaches and nausea are the most
common side effects we have observed. If intolerable, they require
stopping 6-MP. Pancreatitis occurs in a very small number of patients.
This may be a very serious illness. Symptoms include severe abdominal
pain and vomiting. Hospitalization could be required. Increased
cancer risk is at least a theoretical risk of 6-MP, but large
series of patients have not shown any measurable increase in the
occurrence of cancer. Teratogenicity, or damage to an unborn child,
is a possible risk of 6-MP. Women should be using an effective
method of contraception (birth control) while on 6-MP. If a woman
wishes to become pregnant, we feel she should be off 6-MP for
at least 3 months before attempting to conceive. This is good
advice for a prospective father as well. |
