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Crohn's Disease Forum » Treatment » Imuran/Azathioprine/6-MP » Joint pain with Azathioprine (imuran)?


 
06-27-2010, 04:34 PM   #1
JenniferH
 
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Joint pain with Azathioprine (imuran)?

I started on Azathioprine (imuran) in April after having bowel resection in March. All seemed fine for first month, then over the last few weeks I've had extreme pain in my fingers and wrists. It's so bad it's kept me awake at night and I can barely move my fingers they're so stiff. I saw gastro dr on Friday and he has DOUBLED my azathioprine and THEN he said that the pain in my joints might be caused by it! He said if it got worse after doubling it, then I am having a reaction to it and will have to stop it and try a diffferent drug. Has anyone else had this reaction to Azathioprine(imuran)?
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Crohn's Diagnosis: 1988
Current meds: Humira, Loperamide, vitamin B12
Have previously been on infliximab (Remicade), Azathioprine (imuran), mercaptopurine and methatrexate, and lots and lots of steroids!

Surgeries: small bowel resection 1990, 2010
06-27-2010, 04:42 PM   #2
Astra
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Hiya Jennifer

how weird to double the dosage of a drug that one of the side effects is joint and muscle pain?!? baffling!
hope you feel better soon
xxx
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Dx Crohn's in TI 2005 symptoms for 15 years prior

BEEN ON -Azathioprine, 6MP, Prednisolone, Pentasa, Budesonide, Metronidazole, Humira, Methotrexate,

NOW ON -Amitriptyline 25mg
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06-27-2010, 04:58 PM   #3
MapleLeafGirl
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I've noticed slight pain in my fingers and wrists particularly in the morning when I wake up, but nothing too overly bad. I'm not sure if it is the imuran or not. Hope you feel better! If it gets worse with the increased dosage make sure you call right away.
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Kelly

Diagnosed: August 2006
Current Meds: Imuran (125 mg), Budesonide (9 mg)
06-27-2010, 05:07 PM   #4
JenniferH
 
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Thanks girls. I've decided to give it til wed and if my joints are still aching or are worse, I'm def going to ring my Doctor. I hate how just as you seem to get one part of this disease under control, something else comes up!!
06-27-2010, 07:07 PM   #5
gmm
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i lasted about a month on azathioprine, put up with the hammer blows to the knees and thighs thinking theyll calm down, then pancreatitis set in and was taken into hosp for a week and a few days, put on mercaptopurine which has the element that aza has that caused the pancreatitis removed , after one 25 mg tablet it left me feeling like i was hit by a bus lol, couldnt even walk properly for a week, so if the gut pains really bother you go see a doc or the hosp a& e ,this stuff will hit you quick lol
06-30-2010, 07:37 PM   #6
kenny
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It is more often prescribed as an arthritis medication for moderately severe cases. It should help with joint pains if they are arthritic in nature. Imuran has freed me from relying on Cox2 inhibitors to function.

But as gmm says, you have to keep up with the blood tests. A percentage of people don't possess enough of the enzyme that breaks AZA down and it can cause issues if not monitored
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07-02-2010, 03:27 AM   #7
JenniferH
 
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Well, I've tried to carry on with aza but am def going to call dr today as my joints are still very sore. I also haven't been feeling great. I've been extremely tired, have headache and feel a bit like i have flu, just generally unwell. It stinks!! I just want to feel good again! Hopefully they'll just change the med and I'll feel good again!
07-03-2010, 08:23 PM   #8
kenny
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I felt that way for a week or two. It even hurt to look a the computer screen for a while. But It really did just go away for me. Hope you make it past the yucky feelings soon.
03-16-2011, 09:20 PM   #9
spingirl
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I have had pain but not like you are describing. I have joint pain in my ankles and weird pains but the other day I was blowing up a balloon with a hand pump and had a sharp muscle cramp under my armpit and down my arm. I thought I was having a heart attack. It went away. Then a few days later...I was pulling up my pants (they were a little tighter than usual from the prednesone I've been on) and I got the same armpit cramp in my other arm. Not as bad but it hurt. Went away and now I just feel achy in both of my arms. My legs ache a little bit too. None of this is anything unbearable. Well, the cramps in the armpits were very painful but that was fleeting. I am just wondering if this is the Aza or from coming off of the prednesone maybe? Not sure but yes, I feel achy allllll over.
03-17-2011, 09:55 AM   #10
vishal
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I started on Aza just over 4 weeks ago now. Started having minor pains in my fingers and elbow last week.
04-29-2011, 07:38 AM   #11
Joleen23
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Im in a lot of pain today (feel like i've been hit by a bus) Been on Aza for a little while now , hope it's going to stop. Im only on 5mg of pred at the moment. Also losing quite a bit of hair :-(
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Meds :

Methotrexate 20mg per week
Omeprazole 40mg per day
Ferrous sulphate 3 x tablet per day
Folic Acid 1 per day (5 days a week)
Ranitidine
(trammadol & Paraccetamol for painrelief

Diagnosed Nov 2010 - Crohns Colitis
(bowel problems since 16yrs) 29 Yrs old now
So far tried Asacol,Aza,6mp,Remicade
04-30-2011, 12:35 PM   #12
spingirl
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Well, I spoke too soon...now that i hvae been on Aza for a while myself...I, too, feel like I have been hit by a bus in the morning. All over joint/muscle/achy feeling. After my shower and I loosen up a bit I feel a little better but going downstairs I have knee pain. When I take a shower a lot more hair is coming out than usual. However, I did just start a cholesterol medication and that causes hair loss so I have a double whammy. I really hope it slows down...I mean...will I eventually be bald? I always wondered why so many older women have such thinned out hair...I really think its all the cholesterol medications. I am really bummed. Luckily I have really thick hair so its not anything anyone can notice yet...but I am really getting nervous. If I knew it would get better once our bodies adjusted to it...I would feel better about going through this part...my fingers and wrists hurt at times too...some days I notice it more than others. Dont' get me wrong - nothing is so bad I would stop just yet and it hasn't really interfered with my life...but its not a pleasant drug...seems to be working for my chrons though. Its better. Not all better but better and that is better than I was...which was terrible. Good luck. Please keep me posted. I am sure this thread will be helpful for all of us! As is most of this entire website!
06-06-2011, 01:25 PM   #13
Carlo
 
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Dear Jenny,
I have only just joined the Crohns forum, I have suffered from Crohns for about 28 years and have never been on Meds except for last year. IMURAN or Azathioprine 125mg, I have similar pains in both my hands and have been to GP who send me to RHEUMA person, who said(no X-ray as yet) wait six months and we will see. Both hands are very stiff in the morning, its quite unpleasant. After six months the only answer I got was, it could be the drug, but I could also have a Steroid Injection which might help. I am in a funny situation, because before I only had one bowel resection sixteen years ago and then a strict diet which seemed to work for a long time. Have you had any answer from your doctor about the pain in your hands? Let me know if you do, because as far as I am concerned all people do, is refer you on. Good Luck.
06-06-2011, 05:25 PM   #14
spingirl
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Every time I go to my GI and mention the pain in my joints he just says I could try Remicaide. I don't think I want to go to something more intense...I will have to read about what the side effects are of that drug...but the pain I have been having is getting worse. Especially in the morning or if I sit for a while and then get up. I am not sure if exercise is better or not. I wish I could have 3 or 4 people on here tell me that it happened to them and then it went away once bodies adjust...that would make me feel like there is hope. I'm so bummed out because otherwise - it really seems to be working on my symptoms.
07-04-2011, 06:02 PM   #15
digital
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What time of day do you take Imuran? I had similar symptoms if I took it during the day, however if I take it at night, I don't experience any pain.
07-05-2011, 06:35 PM   #16
Kev
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Well, when my body went toxic on it, I had crippling pain all over my body... literally from shoulders down to the soles of my feet. Hurt so bad I could barely move, and within days of that, a rash that started on my back (where the pain originated in the beginning) and worked its way down till I was covered. Dr's took me off aza, and within 2 days the pain stopped... but the rash lasted for months. My first thought would be to go to the ER and have them do blood tests to see if you are going toxic. It isn't fun if that is the case, and there can be long term repercussions if it does happen!
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Dx'd July, 2006
Meds: Flagyl, Cipro, Pred, AZA.. to no effect
Low Dose Naltrexone Nov 2007 - May 2014
Remicade June 17th, 2014
07-08-2011, 03:15 AM   #17
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I can't tolerate aza - causes too much bone marrow suppression, which does indeed feel like having the flu. I'm finally off the steroids (budesonide) after going onto mercaptopurine, tetracycline and cholestagel. I have had terrific elbow joint pain for the last 2-3 months and bad lower back pain if I'm sat down for more than 15 minutes. I always used to suffer from the wandering joint pains before, but it was never as bad as this. Seeing my consultant in 2 weeks, so hoping for some advice and answers.

I've done Remicade before, so it's not an option, but there is always Humira, or low dose Naltrexone therapy.

If you get any answers, please share them, as it may help more of us.

Colin.
09-01-2011, 08:08 PM   #18
spingirl
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Lately I have been having pain in my hands and fingers - in the morning its a lot worse. My arms ache too. My ankles and when I get up in the morning I walk like Fred Sanford. I get very upset every morning but then I sort of loosen up and its better. Not 100% but better. I walk down stairs a little painfully but nothing like in the morning. My doctor wants me to see a rhumentologist. It doesn't make sense. I know its the Aza...he said he wants to rule other things out but its just not a coincidence that it just all of a sudden happened this year that I am taking this...unless Aza can cause arthritis. I thought it was supposed to help it. So why the pain. I don't understand what is happening to my body. I wish I did. I feel like I should be taking supplements of some sort to help me with this medication but I have no idea where to start. How do I find out more about what this lowering of white blood cells is doing? How come it is causing inflamation in my gums when it is supposed to suppress the inflamation in my colon. I just don't get it. I feel like I should know a lot more than I do. Or is ignorance bliss?
09-14-2011, 09:56 PM   #19
meaculpa
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hi guys
thought i'd jump in here even though it's a old post

i've been on mercaptopurine (75mg) for 4.5 months.
the past month i started to develop terrible joint and muscle pain, fatigue/exhaustion, nausea. i thought alot of these symptoms were probably crohns or prednisone related (shows what i know!). went to see a new GI yesterday who has done a heap of research into imuran/6mp etc and he pretty much knew i was going to be in a bad way before he saw me from my blood tests.

anyway to get to the point....
these drugs produce 2 metabolites in our bodies 6MMP & 6TGN.
6MMP = good results
6TGN = side effects if the levels/ratios are to high

i had good levels of 6MMP (YAY) but really high levels of 6TGN. (OH NO thats why i feel like death!)

GREAT NEWS and the point.... this can be fixed by decreasing the mercaptopurine and combining it with another drug alloperinol (a drug they use to treat gout... doesn't look to scary compared to everything else i'm on)
this will completely eliminate the 6tgn from my blood causing the side effects (its my undserstanding this is what causes the liver toxicity too).

so i haven't taken the mercaptopurine for 36hrs (GI said to have a break for a few days) and the joint/muscle pain, fatigue is HEAPS better!
heres a link to some of the research this guys done (theres alot of other research out there too)

bugger can't post the link because i'm too new (will try again in a later post)

i hope it works.... do others have these metabolites tested regularly? how many people are combing amuran/mercaptopurine with alloperinol?
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Mercaptopurine
Prednisone
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10-01-2011, 12:46 PM   #20
carrollco
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I've been on Mercaptopurine since last March. In July I developed cripping pain all over my body. My blood levels were good so the doc thought Crohn's arthritis. The pain waxed and wained, but never ever went away. This last Monday I had blood drawn that showed meylosupression and high liver enzymes. When the doc calls on a Tuesday night at 8pm you know you're in trouble.

Here's hoping the pain goes away. I have more tests scheduled for mid-October and he'll make sure there's no permanent damage. Dang, I'm wondering if I had just ignored his advice in July if this wouldn't have happened. Just be careful with this stuff folks. I'd moved from blood tests from one month to three months because my levels were good.

Oh, well. Such is life with Crohn's.
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Louann
First diagnosed 12/4/10
Humira 4/7/11 and lovin' it


Previous Meds:

Methotrexate--had kidney/liver damage
Lialda--allergic to aspirin--but didn't know until my Crohn's got much worse.
Prednisone--only when I have to!
09-17-2012, 09:21 AM   #21
colin324
 
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Consultant is looking at putting me on methotrexate and stopping the mercapto. Still having joint pains, Rheumo said it was most likely medication induced. I just want off it now, but am worried about Methotrexate. I regularly take pain relief and have prescription sprays I use to make the joint pain bearable. Last thing I need is for it to affect my work.

Anyone else been on Methotrexate ?
09-17-2012, 10:22 AM   #22
spingirl
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SO - I'm glad this post has resurfaced. I hope that if you can't post the link maybe you can type in what I should put in my browser and can then do some research. Although the more I look the more I get nervous.

I have some blood tests done but not sure what they are for. I have to say - joint pain has been MUCH better since I stopped taking my cholesterol medicine. I was on a Statin. Tried several. Honestly felt like a truck ran me over. What I am left with now I can deal with so I am not so sure it was the AZA after all. I have to start new cholesterol medicine though before I have a stroke. That is all I need right?

I will say,after now being on AZA for close to a year I do feel my symptoms of Crohn's better. Have to see GI doc for colonoscopy so I guess they will tell me for sure but my poop is now a little wider looking from pencil thin to maybe a ball point pen size I am thinking that is good since I had a stricture so maybe some of the inflamation has helped widen that and now I won't have to have my colon out. At least not yet. However, my regular GI doc said I should anyhow because of the cancer risk. My 2nd opinon guy is who suggested AZA. First guy said it was all poison and to just have colon out. I am thinking he is just nervous doing my colonoscopies with the strictures. I might have to switch. I don't know. I don't see why I can't be monitored every year and catch it if it does become cancerous but maybe that is naive since perhaps it can hide. I don't know what to do. I don't want my colon out. I do ok now with the AZA but I do end up with a lot of infections. I am noticing my saliva is back. My tongue isn't as white with thick whatever it is...I think that is all stomach related. The saliva thing is odd. I mean...I didn't realize it before but now I guess I was just severly dehydrated. Still very tired but I also work full time and I'm the mother of 2 with a 91 year old mother living with me who is ailing so...I don't know...hard to say. I was told to see a rhumatologist...is that common for Crohn's patients? Just curious. So many questions. I need to get back on this forum more actively again. Send as much info as you can on AZA. I just can't find much when I google for some reason. LOVE you guys. As much as I wish you were all healthy...it is nice to know I'm not alone with this! People just don't get it.
10-22-2013, 04:35 PM   #23
Piper1
 
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OMGosh my joints hurt so bad. I can hardly walk up and down my steps. I am on Imuran ONLY and for about 3 weeks, this just started a few days ago. I feel like i'm going to soon be a cripple.
10-22-2013, 07:11 PM   #24
spingirl
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Have you called your doctor? There is a blood test they can do to check to see if any tissue damage. I find my joint pain is better when I do not take my cholesterol pill (statin) but who the heck wants to have a stroke!
10-22-2013, 07:29 PM   #25
Piper1
 
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I did call my doctor, they've taken me off as of this afternoon, and he's going to call me with what's next. None of the regular drugs help anymore (pentasa, asacol, colozal etc.) This drug actually made the Crohn's better, but man I feel like I can't keep up at work, i can't open a water bottle, I can't even walk down the street without feeling like my ankle or hip will give out. Both my sister and my son are on Remicade. Not sure what's next, but I don't want to get sick again that's for sure, it is so hard to work and worry about having an accident and running to the bathroom every 30 min.
10-22-2013, 09:44 PM   #26
spingirl
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Asacol never worked for me...it went right through me so fast I would see the shell casings in my stool. I thought it was pieces of my colon until I read the package insert. Scary. is remicade working for your sister and son? I am sad to hear you mention your son has it too...I have a son who is so worried he will get it. He is 16 now. No signs of it but he has my personality and I worry about him getting it. Stress really makes me run to bathroom. It's so hard at work. I know. I have to go down stairs snd right past my bosses office. When he is out I rarely go. So I know it's stress making it worse. I hope you find some relief soon.
10-25-2013, 07:36 AM   #27
n00b
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I was on Aza for 3 weeks and could not get out of bed as my knees and legs were aching soo bad.

It had felt like somebody had been hitting my knees with a hammer..repeatedly

Went to see my GI and he stopped the Aza immediatley sayingiw as clear I could not tollarate it - even though my bloods were fine.

As soon as I stopped, within 2 days the pain had gone.

It was a shame as it helps the crohns pain and my CRP decreased.
The pain was so bad thou I woudl rather the crohns than that again.
09-19-2014, 11:46 AM   #28
pmcdaidie
 
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Just started Imuran (100mg) two weeks ago and have quite bad knee pain after sitting for any period of time. I'm on 30mg pred and reducing but never have problems with this so it must be the Imuran. got blood tests and white blood cell count hasn't dropped which I think is good. Hoping that it's only temporary side effect. Seeing consultant next week.
09-22-2014, 07:11 AM   #29
spingirl
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Aza worked like magic with me but it took a while...I was pretty bad though having BM's 15-20 times a day so it wasn't until a few months that it started to taper and now...I can go 3-5 times or not at all which is a miracle and I don't have the urgency I did before. I can "hold it" better. UNFORTUNATELY, all of a sudden I started getting upper abdominal pain. I was pretty bad in the mornings. I stopped the Aza and it went away as abruptly as it started. Then I started taking it again...and right away the pain came back so I am convinced it is the Aza. Dr. didn't think so (almost like he thought I was crazy - but I did read it was one of the side effects)...and tests were ok. Just so strange. I am not taking it now and I seem to be ok...sort of...as ok as I can be with Crohn's. I am waiting for the flare up again...with strictures...surgery is in my plan but I am not ready just yet. I may give Aza another try but...I want to wait a little longer. Damn...it was such a good one! My question to you, pmcdaidie - do you take any statins? I wouldn't advise doing what I did and stopping w/o your doctor's ok but I will be interested to hear how quickly (if so) your knee feels better. Its just a shame this wonderful drug comes w/price to pay...
09-23-2014, 06:46 AM   #30
pmcdaidie
 
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Hi spingirl, I don't take statins. Over the weekend my knee pain more or less went away. It seemed to be worst during the afternoon and I was thinking of taking the Imuran at night, but then by the Sunday I was more or less ok. Even ran 5k yesterday so definitely feeling better. Hope you can get back on the Imuran.
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