Share Facebook
Crohn's Disease Forum » Treatment » Imuran/Azathioprine/6-MP » Azathioprine fail! What next?


05-10-2012, 05:47 AM   #1
Bld
Senior Member
 
Join Date: Oct 2011
Azathioprine fail! What next?

I think I am definitely going to have to come off the Azathioprine. On 150mg a day, if I split the dose I feel sick all day, if I take it all in one go at any time of day I am very sick within just a few hours. 100mg at night seems ok. I have an appointment with my GI next week but I wondered what the next step might be? Does 6MP have less side effects or is another approach more likely to be successful?
__________________
Diganosed with Crohn's in 1996. Flaring since Sept 2011.

Current meds:

6MP = 50mg/day
Pentasa 4 x 1mg/day
Ferrous Sulfate 3 x 200mg/day
Omaprazole
05-10-2012, 07:33 AM   #2
michellew
Member
 
Join Date: Nov 2011
Location: Halifax, Nova Scotia
Chances are if you are having problems with Aza, then you may have issues with 6MP, since your body converts the Aza into 6MP. I had an allergic reaction to Aza and was switched over to Methotrexate (which I find barely tolerable). Good Luck and I hope your doc finds you something that will work for you!
Michelle
__________________
Me:
45 years old
UC diagnosed Dec/07
Crohn's diagnosed Nov/11
Meds:
Methotrexate 25mg/weekly
Prevacid twice a day
Buscopan as needed
starting MLN002 soon
05-10-2012, 08:25 AM   #3
ComaGirl
New Member
 
Join Date: Apr 2012
Location: Jefferson, Texas
I am on 175mg of Aza every day. I am in good standing with my pill cutter. I take it right after I eat breakfast, my biggest meal of the day. I had issues with nausea for a while, but my body adjusted. It was thanks to this forum that I learned to take the Aza with a big meal, to make it easier on the system. Hope this helps some.
05-10-2012, 09:17 AM   #4
JohnnyRottenAppleseed
Senior Member
 
Join Date: Oct 2011
Location: Colorado
I was on Imuran 100mg a day for a year. I weigh between 200-220lbs depending on my disease status. I've dipped down to 178 when i was really bad off. I'm 6'1.

Anyways, i took myself off imuran due to slugishness and increased infections. A year later i flared and went on 6MP. It put me in remission but then i went off meds again due to constant infections and tiredness and lethargy.
05-10-2012, 02:39 PM   #5
David
Co-Founder
 
David's Avatar
 
Join Date: Feb 2006
Location: Naples, Florida
A biologic such as Remicade will probably be the next step up for you.
05-10-2012, 05:04 PM   #6
Cross-stitch gal
Moderator
 
Cross-stitch gal's Avatar
 
Join Date: Dec 2011
Location: Vancouver, Washington

My Support Groups:
A biologic such as Remicade will probably be the next step up for you.
Is that why my GI continually tries to get me on Remicade? She's got me on pred right now and is willing to try me on Aza again. But, she keeps pushing the remicade and humira on me even though she says she's not sure whether it'll even work. Seems pretty expensive for something just to try to me...
__________________
Diagnosed:
Ulcerative Colitis/IBD 1996, Iritis 2001, Ulcerative Proctitis 2013, Indeterminate Colitis 2016, Remission 2017, Hand Eczema

Current Meds:
Pentasa 1000mg 2xday, Canasa Suppositories (when needed) 1000mg 1xday

Non-Meds:
600+D Calcium 2xday, Multivitamin, 65mg Iron 1xday, Fish Oil 1000mg, Vitamin D3 5,000 I.U., Eye Drops 2xday


UP Support Group http://www.crohnsforum.com/showthread.php?t=68350
05-10-2012, 08:29 PM   #7
JohnnyRottenAppleseed
Senior Member
 
Join Date: Oct 2011
Location: Colorado
A biologic such as Remicade will probably be the next step up for you.
I would try it, but I'm already prone to infections, and the side effects are longer than the pitch on the Humira commercial.

In fact I had a prescription filled and I backed out. Then I had full remission for 6 months. It's so tiring and annoying
05-11-2012, 07:21 AM   #8
Jessasha
Senior Member
 
Jessasha's Avatar
 
Join Date: Jan 2012
Location: South Australia, Australia
I was on 100mg Aza, but it reacted with my liver so I was put on Methotrexate 25mg weekly injections, I think it's finally starting to kick in, I'm not suffering from side effects to much yet other than the odd bout off nausea. I'm hopeing to save the big guns like Remi until last..
05-11-2012, 07:29 AM   #9
Bld
Senior Member
 
Join Date: Oct 2011
Thanks everyone for your replies! I am going to try and suggest that I give the Pentasa only a go for a while because the diarrhoea has settled right down and my bowels are the best they have been in years! I am not sure what he will say to that as my Colonoscopy last month was not good but I'm going to ask the question! I'll have a good read up on the others mentioned so that I can be informed for my appointment next Tuesday.
05-11-2012, 05:51 PM   #10
Kev
Senior Member
 
Join Date: Jun 2006
Location: Halifax, NS, Canada

My Support Groups:
Have you given any thought to low dose Naltrexone (LDN)? Since AZA doesn't appear to be working.....
__________________
KEV

Dx'd July, 2006
Meds: Flagyl, Cipro, Pred, AZA.. to no effect
Low Dose Naltrexone Nov 2007 - May 2014
Remicade June 17th, 2014
05-15-2012, 10:08 AM   #11
jpxdude
New Member
 
jpxdude's Avatar
 
Join Date: May 2012
Location: London, United Kingdom
I recently came off the Aza, I think it was last Tuesday now (8th May) as it began making me really sick (Nausea and vomit, severe cramping, and suspected probs with liver). I have only just started to feel normal after coming off it. So currently on nothing right now.

I was taking 175mg, and the week before I began splitting the dose, which I felt might work, but did eventually make me feel a lot worse. Good luck on whatever you are recommended next, I really hope it works!!
__________________
Diagnosed: 2010
Previous Meds: Pentasa, Balsalazide, Prednisolone
175mg Azathioprine (started 25/04/2012) Stopped taking 08/05/2012 due to severe sickness

Currently taking: Nothing

My Blog - http://azathioprine.blogspot.co.uk
05-15-2012, 10:55 AM   #12
Bld
Senior Member
 
Join Date: Oct 2011
I saw my Consultant this afternoon and told him what had happened. He gave me the option of seeing how I go on the Pentasa or having a 2 week break from the Aza and then trying again on 50mg over a longer period and then maybe increasing slowly by 25mg. He gave me the choice but said he would 'gently encourage' me to give the Aza another try as my bloods were improving and he said the Aza can treat the disease whereas the Pentasa will just improve the symptoms rather than treating the damage.

I have agreed to start 50mg again at the beginning of June with the proviso that if I am sick again I will stop immediately. If that happens, he might try me on 6-MP but he said that it is likely that I would have similar side effects.

So it's wait and see and fingers crossed for now!
06-01-2012, 11:29 AM   #13
Bld
Senior Member
 
Join Date: Oct 2011
Well after another horrendous bout of sickness after a two week break and then 1 x AZA 50mg tablet I am now off Aza forever - yay!

My GI is prescribing 6MP and says that roughly 60% of people who can't tolerate Aza are fine with 6MP so I am hoping I am in the 60% not the 40%.

If this fails then I am looking at one of the injectable options so I'm praying that my body accepts it.
06-01-2012, 11:31 AM   #14
David
Co-Founder
 
David's Avatar
 
Join Date: Feb 2006
Location: Naples, Florida
Is your GI monitoring your 6-TGN and 6-MMP levels?

If not, you might want to ask him/her their thoughts on doing so.
06-01-2012, 11:38 AM   #15
jpxdude
New Member
 
jpxdude's Avatar
 
Join Date: May 2012
Location: London, United Kingdom
Hey Bld

Thanks for sharing your experiences, I am current still formulating a decision on what to try next. I spoke to my specialist yesterday and she said I would try 6MP but when I pressed further about it she said that I probably shouldn't bother and that I would already be eligible for the next stages of treatment which involve injections.

I'd be very interested to hear how you get on with 6MP as I may consider this next myself. My specialist did notice that everytime I had a bad experience on my last treatments that the 'Amylaise' levels in my blood always became elevated, which she attributes to some of the side effects I've had personally like severe cramping and sharp pains in my upper torso.

I wish you all the very best of luck and really hope that this works for you. Take care!
06-01-2012, 11:51 AM   #16
Bld
Senior Member
 
Join Date: Oct 2011
Is your GI monitoring your 6-TGN and 6-MMP levels?

If not, you might want to ask him/her their thoughts on doing so.
Hi David I am having blood tests every two weeks at the moment but I'm not sure if he is checking them. I'll ask next time, thanks.

JPX I am really hoping it works as the Aza was improving everything until I got sick.
06-01-2012, 03:53 PM   #17
ComaGirl
New Member
 
Join Date: Apr 2012
Location: Jefferson, Texas
Wow, I hear what you all are saying. Thanks so much for all of the information. I am actually not metabolizing the Imuran correctly and I have had two of the Prometheus tests.
We are trying an alternative therapy that is still a little new to my gastro. We are using Allopurinol to help the Imuran to metabolize correctly. We took the Imuran down from 175mg to 75mg just to make sure it wasn't too big of a dose with the Allopurinol boost.
The nausea that I experienced when I first went on the Imuran was double after adding Allopurinol. But it is slowly easing up as my body adjusts. We'll see how this works.
I also discovered recently www.crohnsonline.com It is through Abbott laboratories and they offer a FREE Crohn's patient advocacy program. You can email or call in person or both and talk to someone who is on your side as a Crohn's patient. Glad I signed up!
06-01-2012, 04:33 PM   #18
Cross-stitch gal
Moderator
 
Cross-stitch gal's Avatar
 
Join Date: Dec 2011
Location: Vancouver, Washington

My Support Groups:
ComaGirl,
I didn't realize that I had already added www.crohnsonline.com into my favorites. But, I've never actually used the site. Have you contacted/used them? If so, did they help you any? I'd be tempted to try them out...
Thanks
06-01-2012, 04:59 PM   #19
ComaGirl
New Member
 
Join Date: Apr 2012
Location: Jefferson, Texas
ComaGirl,
I didn't realize that I had already added www.crohnsonline.com into my favorites. But, I've never actually used the site. Have you contacted/used them? If so, did they help you any? I'd be tempted to try them out...
Thanks
Cross-stitch gal,

Yes! I got assigned to an advocate in my general area. We talked on the phone for an hour after she mailed me a welcome packet and with some helpful tools for making the most of appointments with the specialist and so forth.

She really listened to me and liked some of my ideas and wanted to pass them on to other patients. Likewise, she shared with me many things she has learned from other Crohn's patients that was just what I needed to hear.

I'm very glad I signed up for the program. It may not be for everyone, but it has helped me a lot. She was able to explain some physiological things to me about Crohn's that my Gastro wasn't. It's simply because she specializes in being an advocate for Crohn's patients.
06-01-2012, 05:16 PM   #20
Cross-stitch gal
Moderator
 
Cross-stitch gal's Avatar
 
Join Date: Dec 2011
Location: Vancouver, Washington

My Support Groups:
Thanks for the info! Glad to hear this has helped you. Will have to talk to my husband about this and look into it. Thanks again Lisa
06-01-2012, 06:48 PM   #21
BobbyM
 
Join Date: Mar 2012
I signed up for that advocate program and now regularly get a ton of material from Abbott trying to get me to use Humira. In my opinion it's just a way for them to get your information so they can market their drug. Left a bad taste in my mouth.
Reply

Crohn's Disease Forum » Treatment » Imuran/Azathioprine/6-MP » Azathioprine fail! What next?
Thread Tools


All times are GMT -5. The time now is 03:45 AM.
Copyright 2006-2017 Crohnsforum.com