Mercaptopurine Side Effects

Not all side effects for mercaptopurine may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

For the Consumer

Applies to mercaptopurine: oral suspension, oral tablet

In addition to its needed effects, some unwanted effects may be caused by mercaptopurine. In the event that any of these side effects do occur, they may require medical attention.

You should check with your doctor immediately if any of these side effects occur when taking mercaptopurine:

More common
  • Abdominal or stomach pain or tenderness
  • black, tarry stools
  • blood in the urine or stools
  • clay colored stools
  • cough or hoarseness
  • dark urine
  • decreased appetite
  • fever or chills
  • headache
  • itching
  • loss of appetite
  • lower back or side pain
  • nausea and vomiting
  • painful or difficult urination
  • pinpoint red spots on the skin
  • skin rash
  • swelling of the feet or lower legs
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • yellow eyes or skin
Less common
  • Bleeding gums
  • chest pain
  • joint pain
  • pale skin
  • shortness of breath
  • sore throat
  • sores, ulcers, or white spots on the lips or in the mouth
  • swollen glands
  • troubled breathing with exertion
Incidence not known
  • Abdominal or stomach cramping or burning
  • constipation
  • diarrhea
  • heartburn
  • indigestion
  • joint pain, stiffness, or swelling
  • lower back or side pain
  • vomiting of blood or material that looks like coffee grounds

Some of the side effects that can occur with mercaptopurine may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

Less common
  • Darkening of the skin
  • headache
  • weakness
Incidence not known
  • Hair loss or thinning of the hair
  • low sperm count

For Healthcare Professionals

Applies to mercaptopurine: oral tablet

Hematologic

Hematologic effects including myelosuppression have been reported. Myelosuppression is the most frequent adverse reaction reported with the use of mercaptopurine. Anemia, leukopenia, and thrombocytopenia have also been reported frequently.

Renal

Hyperuricemia may occur as a consequence of rapid cell lysis. Adverse effects may be minimized by increasing hydration, urine alkalinization, and the prophylactic administration of a xanthine oxidase inhibitor (such as allopurinol).

Renal effects including hyperuricemia have been reported.

Gastrointestinal

Gastrointestinal effects including intestinal ulceration have been reported. Nausea, vomiting, and anorexia have been infrequently reported during initial administration. Mild diarrhea and sprue-like symptoms have been reported occasionally. Oral lesions have been reported rarely. An increased risk of pancreatitis may be associated with the investigational use of mercaptopurine in inflammatory bowel disease.

The mild diarrhea and sprue-like symptoms are not necessarily related to the mercaptopurine.

Oral lesions resemble thrush rather than antifolic ulcerations.

Hepatic

Hepatic effects including a small number of deaths which may have been attributed to hepatic necrosis have been reported.

Dermatologic

Dermatologic effects have included skin rashes, alopecia, and hyperpigmentation.

Genitourinary

Genitourinary side effects including oligospermia have been reported.

Other

Other effects including drug fever have been reported very rarely.

Before the drug fever is assumed to be caused by mercaptopurine, the clinician should exclude more common causes of pyrexia such as sepsis in patients with acute leukemia.

Oncologic

Oncologic side effects have included hepatosplenic T-cell lymphoma.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. Drugs.com does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.

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