Pregnancy - Mercaptopurine

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GYXE > Chronic colitis > Pregnancy - Mercaptopurine - 6MP 4 June 2008 03:46:23

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Pregnancy - Mercaptopurine - 6MP
Amy 4 June 2008 03:46:23
	Hi everyone, Just a quick question. Has anyone here taken Mercaptopurine or 6MP while pregnant? The web has scary information about it. I figured I would ask the CD patients directly. Thank you for your help on this! Amy
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Js 7 April 2005 01:49:15 [ permanent link ]
	"Amy" <amyrwinkler@yahoo.com> wrote in news:1112800331.351790.240950 @f14g2000cwb.googlegroups.com: Hi everyone,> Just a quick question. Has anyone here taken Mercaptopurine or 6MP> while pregnant? The web has scary information about it. I figured I> would ask the CD patients directly.> Thank you for your help on this!> When I was perscribed 6-MP I was told that even the male taking 6-MP can have an effect on a pregnancy if he has been taking the drug during the fertilization. My clinic (your experience will likely vary) had me sign a form stating that I understood this and would practice some form of birth control. The info I've seen on the internet varies, but most say that women who are pregnant or trying to get pregnant shouldn't use it. I was a little suprised when the clinic told me all this since I hadn't seen it on the internet really. As others have said, and will say again, your Dr. has the best answers for your situation. -- Jeff S
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Guest 7 April 2005 03:17:25 [ permanent link ]
	Hi Amy, There was a recent report in one of the gastro journals that said that it was safe to take while pregnant (if you want the reference, let me know and I'll look it up-- the stuff on the web tends to generally be inaccurate because its individuals experiences as opposed to research reported in peer-review journals). That said, my doctors and I discussed it and decided to wait to start imuran or 6mp until after I have children. I have CD (dx'ed 9 years ago) and my husband and I have been trying for children for 3 years (on our own and with treatments)... so my GI and I have had a lot of conversations about meds with the pg issue in mind! I've had a couple of flares and have controlled them with prednisone. Basically what we've (my GI doctors, myself and my husband) decided is that I will try to stay on just Pentasa as my maintance med, use pred for flares (which is ok even while pg) and then after kids go on imuran or 6mp as my maintance med. Hope this information is helpful. Good luck! -Leighann Amy wrote:> Hi everyone,> Just a quick question. Has anyone here taken Mercaptopurine or 6MP> while pregnant? The web has scary information about it. I figured I> would ask the CD patients directly.> Thank you for your help on this!> Amy
		Add comment


Amy 7 April 2005 05:30:23 [ permanent link ]
	Hi Leighann, Thanks for that info.! If it is not too much trouble would you mind getting that journal citation? My husband and I would love to read it. Take care! Amy lkl1...@hotmail.com wrote:> Hi Amy, There was a recent report in one of the gastro journals that> said that it was safe to take while pregnant (if you want the> reference, let me know and I'll look it up-- the stuff on the web tends> to generally be inaccurate because its individuals experiences as> opposed to research reported in peer-review journals).> That said, my doctors and I discussed it and decided to wait to start> imuran or 6mp until after I have children. I have CD (dx'ed 9 years> ago) and my husband and I have been trying for children for 3 years (on> our own and with treatments)... so my GI and I have had a lot of> conversations about meds with the pg issue in mind! I've had a couple> of flares and have controlled them with prednisone. Basically what> we've (my GI doctors, myself and my husband) decided is that I will to stay on just Pentasa as my maintance med, use pred for flares (which> is ok even while pg) and then after kids go on imuran or 6mp as my> maintance med. Hope this information is helpful. Good luck!> -Leighann> Amy wrote:> > Hi everyone,> > Just a quick question. Has anyone here taken Mercaptopurine or 6MP> > while pregnant? The web has scary information about it. I figured would ask the CD patients directly.> > Thank you for your help on this!> > Amy
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Guest 7 April 2005 20:01:54 [ permanent link ]
	Hi Amy, I can't find the article I was originally referring to (it must be in my office, but I'm working from home today so I'll have to look tomorrow). However, here are 3 references that might be of interest to you and your husband. I've copied both the reference and the abstract. I'm not sure if you can get the full text via the web without having access to a university hospital library. Let me know via email (llitcher@ic.sunysb.edu) and I can try to email them to you as adobe pdf files. Good luck, Leighann 1. Francella, A. et al., (2003). The safety of 6-mercaptopurine for childbearing patients with inflammatory bowel disease: A retrospective cohort study. Gastroenterology, 124(1), 9-17. Abstract: BACKGROUND & AIMS: 6-mercaptopurine/azathioprine is effective in IBD patients. However, data regarding toxicity associated with pregnancy are lacking, raising both patients' and physicians' concerns and sometimes resulting in elective abortion. METHODS: To evaluate potential toxicity of 6-mercaptopurine (6-MP), we reviewed the records of 485 patients who had received the drug. We contacted 462, of whom 155 had conceived at least 1 pregnancy after developing IBD. Pregnancies were analyzed as to whether the patient had taken 6-MP before, or at the time of, conception. These were compared with IBD patients who had their pregnancies before taking 6-MP. We collected data on live births, spontaneous abortions, prematurity, abortions secondary to birth defects, major and minor congenital birth defects, infections, and neoplasia. Outcomes were analyzed comparing pregnancies from men and women who had taken or were currently taking 6-MP to controls. RESULTS: There was no statistical difference in conception failures (defined as a spontaneous abortion), abortion secondary to a birth defect, major congenital malformations, neoplasia, or increased infections among male or female patients taking 6-MP compared with controls (RR = 0.85 [0.47-1.55], P = 0.59). CONCLUSIONS: 6-MP use before or at conception or during pregnancy appears to be safe. Discontinuation of the drug before and during pregnancy is not indicated. 2. Moskovitz, D.N. et al., (2004). The effects on the fetus of medications used to treat pregnant inflammatory bowel disease patients. Amercian Journal of Gastroenterology, 99(4), 656-661. Abstract: OBJECTIVES: We reviewed data to investigate the effect of 5-ASA drugs, metronidazole, ciprofloxacin, prednisone, 6-mercaptopurine, azathioprine, and cyclosporine on pregnancy outcomes in patients with inflammatory bowel disease (IBD). METHODS: One hundred and thirteen female patients with a total of 207 documented conceptions were studied. Treatment information included: smoking history (patient and spouse), dates of conception and termination, and outcome of pregnancy (spontaneous abortion, therapeutic abortion, maternal or fetal illness resulting in abortion, premature birth, healthy full-term birth, multiple births, ectopic pregnancy, congenital defects), weight of baby, type of delivery (cesarian section, vaginal), medication history during each trimester (mean dose, maximum dose, frequency). We analyzed the effect on pregnancy outcome of medication use during the first trimester or at any time during the pregnancy. RESULTS: Thirty-nine patients (34.5%) had ulcerative colitis (UC), 73 (64.5%) had crohn's disease (CD), and 1 patient (1%) had indeterminate colitis. For 100 of the 207 conceptions, the patients were on 5-ASA drugs at some time during the pregnancy, 49 on prednisone, 101 on an immunomodulator (6-MP/azathioprine), 27 on metronidazole, 18 on ciprofloxacin, and 2 on cyclosporine. In 85 (31%) of the conceptions, patients were on none of these medications. No significant differences were found among the groups in each pregnancy with respect to outcome (p values 0.091 to 0.9). In multivariate analyses controlling for age of mother, there was no evidence that 5-ASA type drugs or any type of drug influenced pregnancy outcome. CONCLUSIONS: In 113 female patients with 207 conceptions none of the drugs used to treat IBD is associated with poor pregnancy outcomes. 3. Steinlauf, A.F. & Present, D.H. (2004). Medical management of the pregnant patient with inflammatory bowel disease. Gastroenterology Clinics of North America, 33(2), 361-385. Abstract: Gastroenterologists are not infrequently faced with questions regarding pregnancy when advising or treating their patients with inflammatory bowel disease (IBD). To advise patients effectively, the following factors must be considered: (1) the inheritance patterns of IBD for accurate counseling and family planning; (2) the effects of active IBD versus medications or surgery on fertility; (3) the effects of pregnancy on the course of IBD; (4) the effects and potential risks of active IBD versus those of diagnostic tests, medical treatments, and surgical treatments on the developing fetus; (5) approach to delivery; and (6) the risks of breast-feeding while receiving treatment for IBD. Amy wrote:> Hi Leighann,> Thanks for that info.! If it is not too much trouble would you mind> getting that journal citation? My husband and I would love to read it.> Take care!> Amy>
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Becky Gerber 13 May 2005 11:45:16 [ permanent link ]
	Hi My name is Becky and I am taking 6-MP and I am 7 weeks pregnant. I have Crohn's-Colitis. I talked with a genetic counselor and two physicians in the DC area. Both cited the article with the 482 participants showed no higher risk of birth defects so that was what my husband and I based our decision to stay on the 6-MP on. Both doctors felt that going off the meds posed a higher risk to the baby due to the possibility of a flare. Now that I am pregnant and have a life growing inside me I am second guessing to stay on the medication. I too have been reading the scary stuff on the internet but I am trying to stay confident in the article that Leighann cited and that {censored}'s are basing there opinions on. Is there anyone out there who has stayed on 6-mp while they were pregnant? I feel like I need validation. Thanks -Becky
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Guest 26 May 2005 11:54:06 [ permanent link ]
	I was on mercaptopurine throughout my pregnancy. I now have a beautiful, healthy daughter. Good luck. x
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Guest 19 May 2006 01:20:46 [ permanent link ]
	I am 22 weeks pregnant and {censored} is very well known gastroenterologist. He has me on 6MP and prednisone for my colitis, and reassures my as my ob-gyn does that this is fine. He did instruct me not to breastfeed b/c of the 6mp(mercaptopurine) since the tests are not conclusive yet.
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Guest 3 August 2006 19:57:31 [ permanent link ]
	I am nine weeks pregnant on 100mg of 6-mp. I am in the process of seeing all of {censored} (high-risk, etc.). I will let you know how things are going when I know better and hope you'll do the same.
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Erica 4 June 2008 03:46:23 [ permanent link ]
	How did it all go? I'm only on 50mg of 6MP. I tapered from 75 about a year ago and even on this "sub-therapeutic" dose, I've managed to stay in remission from Crohn's colitis. Those references are great to see!
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GYXE > Chronic colitis > Pregnancy - Mercaptopurine - 6MP 4 June 2008 03:46:23

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Pregnancy - Mercaptopurine - 6MP

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