6-MP Consent Form


Please correct the errors described below.

Intro: 6-MP (6-Mercaptopurine) is a medication that is originally used for leukemia. 6-MP is a medication that is known as an “immunomodulator because of the many ways that it affects the immune system

Uses: 6-MP has been used for many years in patients with Crohn’s and Ulcerative colitis for

  • Remission of the disease (to remain symptom-free) , Decreasing and ultimately removing the use of steroids and therefore decreasing the serious potential side effects of steroids.

Remission can occur in up to 80% of people that take 6-MP.

Side effects: (these are the most common)

  • Allergic reactions
  • Decrease in white blood cells, red cells and platelets
  • Nausea
  • Increased risk of infections.
  • Pneumonia
  • Pancreatitis (rare, 6%)
  • Hepatitis (rare)
  • Skin cancer
  • Risk of lymphoma will be one in 2,500. In general population the risk is one in 10,000

Need Follow up:

  • Office visit every 3 months is required along with periodic CBC
  • Hepatitis B/C test
  • PPD/Chest X-ray before Rx.
  • Also need pneumonia v accine-flu shot as indicated.
  • Annual skin exam looking for any precancerous lesions on the skin.

Do not take Allopurinol – which is a gout medication. This will cause serious reactions

I understand that the medication has potential side effects and because of this close monitoring of blood counts is required. Blood work will be done every month for the first 3 months and every three months thereafter. I have been explained the risks, and given oopportunity to ask questions. Risks of the active disease outweight the risks of the medication. I understand and agree to start the medication.

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