Applies to mercaptopurine: oral suspension, oral tablet.
Serious side effects of Mercaptopurine
Along with its needed effects, mercaptopurine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking mercaptopurine:
More common
- Black, tarry stools
- bleeding gums
- clay colored stools
- cough or hoarseness
- dark urine
- decreased appetite
- fever or chills
- headache
- loss of appetite
- lower back or side pain
- nausea, vomiting
- painful or difficult urination
- pale skin
- pinpoint red spots on the skin
- rash, itchy skin
- stomach pain or tenderness
- swelling of the feet or lower legs
- trouble with breathing upon exertion
- unusual bleeding or bruising
- unusual tiredness or weakness
- yellow eyes or skin
Less common
- Chest pain
- joint pain
- sore throat
- sores, ulcers, or white spots on the lips or in the mouth
- swollen glands
Incidence not known
- Anxiety
- blurred vision
- cold sweats
- coma
- confusion
- constipation
- depression
- diarrhea
- dizziness
- fast heartbeat
- heartburn
- increased hunger
- increased sensitivity of the skin to sunlight
- indigestion
- joint pain, stiffness, or swelling
- nervousness
- nightmares
- redness or other discoloration of the skin
- seizures
- severe sunburn
- shakiness
- slurred speech
- stomach cramping or burning
- vomiting of blood or material that looks like coffee grounds
Other side effects of Mercaptopurine
Some side effects of mercaptopurine may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.
Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
- Darkening of the skin
Incidence not known
- Hair loss or thinning of the hair
- low sperm count
For Healthcare Professionals
Applies to mercaptopurine: oral suspension, oral tablet.
Hematologic
Very common (10% or more): Bone marrow suppression (e.g., anemia, leukopenia, thrombocytopenia) (more than 20%)[Ref]
Renal
Frequency not reported: Hyperuricemia[Ref]
Gastrointestinal
Common (1% to 10%): Stomatitis, diarrhea, vomiting, nausea
Uncommon (0.1% to 1%): Pancreatitis, oral ulceration
Very rare (less than 0.01%): Intestinal ulceration[Ref]
Hepatic
Common (1% to 10%): Biliary stasis, hepatotoxicity
Uncommon (0.1% to 1%): Hepatic necrosis
Frequency not reported: Hepatotoxicity[Ref]
Dermatologic
Uncommon (0.1% to 1%): Skin rash
Rare (less than 0.1%): Facial edema, alopecia
Frequency not reported: Photosensitivity reaction[Ref]
Genitourinary
Rare (less than 0.1%): Transient oligospermia[Ref]
Other
Frequency not reported: Fetotoxicity[Ref]
Oncologic
Rare (0.01% to 0.1%): Neoplasms including lymphoproliferative disorders, skin cancers (melanomas and non-melanomas), sarcomas (Kaposi's and non-Kaposi's), uterine cervical cancer in situ
Very rare (less than 0.01%): Secondary leukemia, myelodysplasia
Frequency not reported: Hepatosplenic T-cell lymphoma[Ref]
Immunologic
Uncommon (0.1% to 1%): Bacterial and viral infections, infections associated with neutropenia, drug fever
Frequency not reported: Immunosuppression, macrophage activation syndrome[Ref]
Metabolic
Common (1% to 10%): Anorexia
Frequency not reported: Hypoglycemia In patients with inflammatory bowel disease (IBD) (IBD is not an approved indication of this drug)[Ref]
Nervous system
Uncommon (0.1% to 1%): Arthralgia[Ref]
Cardiovascular
Postmarketing reports: Portal hypertension[Ref]
