When do you have to worry about picking up infections on immunosupressants?

When you said immunosuppressants my mind immediately jumped to Imuran which I am on. I haven't ever worried about being more susceptable to infection whilst on Imuran. We monitor my blood periodically. We are at a dose to tamp down the over active immune system in the gut, not the entire immune system. I have COPD and have had LESS colds and NO flus (knock, Knock, KNOCK) since being on Imuran.

I didn't and don't like pred for reasons other than what it might do or not do to my immune system. Glaucoma, osteoporosis .... and its common side effects on mood, personality, hair, moon face, etc.

And - I forgot - I volunteered at our local hospital in Messenger Service meaning I traveled thru all the floors and departments each volunteer day the first 4 years I was on Imuran.

I never worry about it. Been on Pred, Entocort, 6MP, and azathioprine and didn't catch colds any more often than usual. Most people will report the same. Simply put, immunesuppressants tone down a malfunctioning / overactive immune system a notch; they certainly don't knock it out completely. If they did do that, a lá AIDS, then you certainly would be right to fear opportunistic infections of all kinds.

Actually, I've noticed that my colds aren't as severe as they used to be. I have a theory that the wonky immune system which causes my Crohn's disease might also go into overdrive on colds and make them less severe than they would otherwise be. Of course, this is just a theory... <_<

EDIT: If you want a long-term immunesuppressant, yes, go for Imuran (azathioprine) or 6MP. Steroids are not safe to be on long-term for all sorts of reasons. But Imuran and 6MP are reasonably safe and well-tolerated over a long-term period. (If you are among the minority who can't tolerate them you will find it out early on - that's what the regular blood tests for the first 3 months are for.)

Post Edited (NiceCupOfTea) : 7/1/2010 4:32:24 PM (GMT-6)

Well, that was a poor choice of words by your doctor to say "chemo" which usually conjurs up scarey, unpleasant impressions.

Be aware tho that Imuran can take quite a while to go into full effect. Generally you are started on Imuran and Entocort EC w/a tapering of the Entocort as the Imuran begins to provide some effect. If I remember correctly they figure the usual or average time for Imuran to take effect is 6 months. Whereas pred provides almost immediate effect. Imuran is more a maintenance med than an immediate treatment med is one way of describing it.

He might have been talking about Methotrexate, which is technically a chemo drug. But, when it's used for Crohn's, it's much, much smaller doses! So, as CrohnieToo says, it's a terrible choice of terms for your doctor to use.

I'm currently on both Cimzia and methotrexate (25 mg IM weekly) and don't seem to get sick (colds) anymore than anyone else I know. I am cautious at the store I wipe the cart handles, but other than that, I don't really worry about it.

Yea, I thought it was funny that he termed the drug "chemo".

That's good news tez! Glad it is working for you.