What drugs other than 6MP/Aza and Remicade?

Dear all

Thank you for reading.  I wonder if you can help me.

I have had a nasty flare after being in remission for two years.  I am currently on budesonide as a "quick fix" for two months, just starting the wean off stage as well as a months course of anti b's.  These have been brilliant in that I can now eat, the pains are less and I feel I am definitely getting back on track.

However the problem is long term maintenance meds.  I had tried Azathioprine and 6MP 6 years ago, both giving too nasty side effects to cope with.  With this flare I was asked to try 6MP again, two weeks in and again I am suffering, even though the dose is as low as possible - 25mg ever other day.  My head feels like its being compressed all the time, constant sore throat and general feeling of "yuk".

I have been on remicade previously for perianal fistula, with the result of being completely healed and touch wood has remained so.  My consultant mentioned if I couldn't tolerate 6MP again then perhaps Remicade could be in the picture, but I agree with her it's perhaps too much of a big gun to be on for the small area of active crohn's that I have.  5cm around the anastomosis in my small bowel.  Plus I am not sure that my Primary Care Trust (I'm from the UK) would fund this again as it was a battle to get them to agree last time.

So back to question, are there any other medications that I can mention to my consultant as possibilities.  I am trying to persevere with the 6MP but today feel so low and tearful with it that I don't think I can continue.

Big hugs to all of you.

Take care.

Debbie

Thank you kazbern, that's really appreciated. This disease is bad enough let alone adding the medication quandries into the mix but I feel better having other options to discuss at my next appointment.

Best wishes.

Ask about Humira. Same class of drug as Remicade, only you inject it yourself at home instead of going in for an infusion. You could also consider Methotrexate, another immunesuppresant, but it's kinda toxic. Definitely would try to get onto Humira first, every single time.

I would also ask your consultant what he knows about treatments beyond the biologics. There are a few, but a couple are 'out there', so to speak. I'm thinking of stuff like anti-MAP antibiotics, Adacolumn, LDN (Low Dose Naltrexone), helminth therapy, etc. I don't know how your consultant's knowledge rates; my consultant told me about Adacolumn, for example, plus mentioned a couple of drugs whose names I had never heard of (and which I can't remember, sorry. I think one may have been thalidomide?)

I'm not saying any of that is where you will end up, but I think it is good to know about the options just in case one day all the standard Crohn's drugs do fail you. Hopefully you'll get onto the Humira and it will work, though. Good luck!

I have had a great deal of success with Remmicade. I went through 6mp, and other biotics before I found the one that worked well. I tend to think behind a great medication should be a good GI who can keep monitoring your disease and by extension your dosage. I hope this helps.