Folic Acid with Imuran??

I take Imuran, the sister drug to 6mp and I took a Biotin and Folic Acid supplement. The brand I bought was Rite Aid's "Hair, Skin and Nails" formulation. It's a pretty good multi-vitamin with a lot of nutrients in it for good hair growth. Worked pretty well for me.

As far as I know, most brands of vitamin makes have something similar...

Margie63 when you want to respond to a post you click "post reply" NOT "post new topic" as that creates a new post not respond to the post. Hope that helps.

Thanks for the tip on how to post. New to this.

as rls said, folic acid is a necessary vitamin, so it seems to make sense to have your doc check out your serum folate level...if it is not low, then there's no reason to supplement.  

On the other hand, if the blood test reveals your serum folate is low, then the benefits of supplementation will probably outweigh any potential interaction with 6 mp. I'm not aware of any scientific basis for your doc's position - am pretty sure no clinical trials have been done, documenting any interaction between 6 mp and folic acid supplements.

Also, the web site www.drugdigest.com does not list any interactions between 6mp and folic acid supplements, but it DOES list interactions between methotrexate and folic acid supplements. 6mp, UNLIKE methotrexate, is not an "anti-folate," so it makes sense that no interactions have been found between 6mp and folic acid supplements.

  

While 6mp can indeed suppress blood cells, this is NOT its primary mechanism of action (tends to be a by-product of how 6mp works) and no, there's no evidence folic acid supplements interfere with how 6 mp works.  

Actually, a severe drop in WBC would indicate your Imuran was being very effective, because low WBC is typical of Imuran. If the folic acid had intefered with Imuran's action (and there's no reason to suppose it did, since this is not a documented interaction), then you would have been LESS likely to have low WBC.

Imuran and 6mp can both lead to bone marrow suppression, which would indeed lower your WBC (because bone marrow suppression interferes with the body's ability to make white blood cells). It's good your hematologist was keeping a close eye on things: dangerously high bone marrow suppression usually stops with withdrawal from the med - but if not identified soon enough, can be fatal. 

There are some small studies of people on azathioprine (AZA) following kidney transplant and of children who are receiving chemotherapy for leukemia that have looked at the interaction of folic acid and azathioprine. There is an interaction between the two which reduces the effectiveness of azathioprine on suppression of the bone marrow. In these very rare situations there is some question about whether folic acid supplementation is contraindicated.

There is nothing that I could find that examined the question of interaction between folic acid and AZA when it is prescribed for the treatment of IBD.

There have in fact been a number of studies that have examined the effectiveness of AZA among patients who, incidentally, were also on B vitamin or Folic Acid supplementations. The fact that these patients were on supplementation was not included in the analysis of the effectiveness of AZA.

Since AZA was found to be effective in these studies it suggests to me that folic acid supplementation is unlikely to reduce the effectiveness of AZA in the treatment of Crohn's.

HOWEVER,

I am not a doctor and would not presume to say that the GP is wrong. There may be circumstances that the doctor is aware of that led her to make that recommendation.

As I said in my earlier post, normally questions like this one are resolved by the prescribing physician, in this case the gastroenterologist.

So I would go back to that doctor for an answer.

Patricia

This might be something to consider making sure her GP and GI are on the same page about.

rlsnights - I see absolutely nothing wrong with your comments in this thread. In fact, it is peppered with "consult with your doctor" type caveats.

We have a disease with no known cause, no known cure, and treatment plans that have to vary from person to person. I find the educational information that many provide here to be helpful in informing me of things that I did not know that I would research further and/or consult with my doctor.