Crohn's Disease Forum » Treatment » Imuran/Azathioprine/6-MP » Don't feel sick enough for Aza

10-01-2013, 04:40 AM   #1
Vezmarelda's Avatar
Join Date: Sep 2013
Location: Newcastle, United Kingdom
Don't feel sick enough for Aza

Hi guys, I am due to take my first 125mg dose of Aza today, while tapering off Pred (down to 5mg now) for Crohn's of the TI.
But I don't know if I am really poorly enough to take the Aza, I feel rather good.
I only seem to get 'issues' about once a fortnight now, and I know that's down to the steroids doing their job ... so I might just be fooling myself.
However, I guess I was hoping to be steroid/meds free for a while to see if I was fixed.
What was it like pain/sickness wise for you guys when you started Aza?
I just don't want to take this if I don't really have to, but then I don't really want to wait until I am med free for something to go wrong again.
10-01-2013, 08:29 AM   #2
carla_marie's Avatar
Join Date: Aug 2013
Location: Saskatoon, Saskatchewan
I'm surprised they are starting you on such a high dose of aza! My body reacted when I jumped from 50mg for 2 weeks to 150mg (it took a couple of days to react). So now I'm moving up slowly, increasing by 25 mg each week.

I think that the prednisone is giving you a false sense of security. It is meant to get you into remission but aza is meant to keep you there. You might just go right back to where you started if you don't get the aza into your system. I'm sure there are also people who manage just fine without, but I don't think its a majority.
10-01-2013, 08:32 AM   #3
carla_marie's Avatar
Join Date: Aug 2013
Location: Saskatoon, Saskatchewan
Also, I was told it takes about 3 months for the aza to get to therapeutic levels in your body, so you might notice some differences between meds. I started my prednisone and aza at the same time so that there would hopefully be no change in how I felt when I came off the prednisone taper. (so far so good!)
10-02-2013, 08:12 AM   #4
Vezmarelda's Avatar
Join Date: Sep 2013
Location: Newcastle, United Kingdom
Thanks for the reply carla_marie. I think I pred is probably fooling me a bit to be fair.
And as for the Aza, I just got a prescription sent in the post with a load of blood bags, to be used over the next two weeks, and appointment with the consultant for three weeks time. There's been no discussions on the dosage.
But it appears to be so far so good with the Aza, apart from more of the odd pounding heart feeling but that's been happening for at least a week now.
And my big fat moon face is shrinking too hurrahh!
10-03-2013, 05:07 PM   #5
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Join Date: Aug 2012
Location: Chicago, Illinois

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Carla Marie and Vezmarelda, Aza/Imuran/6-mp are dosages are usually weight-based as well as often based on the results of a TPMT blood test taken before you start treatment. Some folks are able to get the TPMT test to determine how well your body may accept or reject the medication, some folks are unable to or unaware of this option beforehand. Regardless, once you start the Aza, routine bloodwork should help to gauge whether the medication is being given to you in safe and therapeutic levels. If not, dosage can either be readjusted or the medication stopped altogether.

Vezmarelda, Pred can definitely fool you into being well, it is a short-term solution because it is a quick fixer-upper. But it doesn't keep majority of people well for the long run. Once they come off of it which is why doctors put you on maintenance medications such as Azathioprine. These are the long-term solutions to not only make you feel well but to try and KEEP you in remission. How long are you supposed to remain on prednisone? Most people actually start these immuno-suppressors before they begin the taper off of prednisone.

It takes about 3 months for the medication to fully kick in which is why docs tend to keep you on the prednisone for the first few weeks or months of taking Aza.

Good luck with you on your new treatment plan. I hope it all works out and you continue to feel well!
Crohn's-Colitis May 2012
Current Meds:
6-MP (100mg) / Asacol (4800mg)
Past Meds:
Prednisone/ Entocort / Flagyl
Current Supplements:
B12 Shot (1cc/mo) / Multivitamin / Vitamin D (1000iu) / Calcium (1200mg) / Omega 3 Fish Oil (4800mg)
Additional Info:
Anemia/Borderline Anemia - whole life
Generalized Anxiety Disorder - 2009 (Cognitive Behavioral Therapy, mindfulness meditation)

Last edited by CrohnsChicago; 10-03-2013 at 05:24 PM.
10-05-2013, 02:15 PM   #6
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Location: New Brunswick

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I'd take it even if I felt rather good. I went on it a few months after they got things under control with prednisone and bowel rest (that was 22 years ago - been on it ever since). Hopefully the aza will keep things under control for you.

It's been a good maintenance medication for me

Diagnosed since 1990
Current Medications: None currently. Was on Imuran (150mg/day) and 5-ASA (3000 mg/day) as maintenance meds prior to surgery
Surgeries: Left hemicolectomy 2014.
11-24-2013, 07:57 AM   #7
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I've been really lucky and my stomach settled down by itself even before I was started on Budesonide (3mg, 3 times a day). Even though I felt ok, my blood tests were showing that there was still inflammation (test result was 133 - not sure what that relates to but was told it was high!) so the doctor suggested that I try Aza (125mg) to reduce the inflammation and to make sure I don't get any scarring. It's definitely worth trying medication even if you feel ok as there could still be things going on!

I was told to stop taking it however after getting bad pains just under the middle of my ribs and across the right side so just have to wait and see what the blood test results come back with!
11-24-2013, 09:44 AM   #8
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Join Date: Oct 2011

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I agree with everyone here. Pred is notorious for making you feel pretty damn good stomach wise. Ahah. It's supposed to make you feel fine, because if it didn't then you probably aren't in remission.

It's just after a while it can come back. I was given the option to go straight to Aza from pred the first time round and I managed a year before getting another flare up, but now I have had 2 this year.

Everyone reacts differently, and that is my experience. It sometimes makes me wonder how I would have gone sans medication; but I feel as though it could have been MUCH worse had I not been on Aza.

I'd say all in all it is worth a try.

Diagnosed mid 2009
Past Tx: Prednisolone, Enteral Nutrition
Current: Azathioprine, Omeprazole, EN supplements, Small bowel resection to remove 2 strictures.

"How we survive is what makes us who we are!" - Rise Against


Crohn's Disease Forum » Treatment » Imuran/Azathioprine/6-MP » Don't feel sick enough for Aza
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