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Normal starting dose for 6mp?

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Posted 7/15/2009 3:01 AM (GMT 0)
What is the usual 'starting' does for 6mp/Imuran? I haven't started mine yet, but my GI doc prescribed me 125mg/day. That just seems like alot to start out on and I'm getting pretty worried I'll be very tired and nauseas. I'm usually only get around 7 hours of sleep so I don't know if I can deal with being even more tired than I already am.

Thanks!
Nikki
Posted 7/15/2009 3:05 AM (GMT 0)
that sounds like a lot. My doctor started me on 50mg. I am a big guy too. I am on 100 mg now. Don't feel scared to ask or question. I would seriously question that.
Posted 7/15/2009 3:09 AM (GMT 0)
Hmm I think I will ask. I'm pretty small and he said that was the normal for my weight.

Does a dose like 50 mg usually help as a maintenance dose? He's putting me on this to see if it will work as a maintenance drug, as he says it works for most of his patients.
Posted 7/15/2009 10:01 AM (GMT 0)
I think the maintenance dose is whatever amount your body can tolerate that provides therapeutic value. In my experience, most people start at 50mg and work their way up to find the appropriate dose.
Posted 7/15/2009 11:11 AM (GMT 0)
When I was on Azathioprine I started off at 50 mg because they wanted to monitor the initial blood results, and then soon increased it to 175mg.

From what I remember, a rule of thumb the doctor mentioned was that a maximum daily dose in mg was about 2.5x the number of your weight in kg.

So, at 72kg, I was put on 175mg.

(I then reduced the dose after a year, and got off it as it didn't seem to be working for me)
Posted 7/15/2009 11:45 AM (GMT 0)
I weigh about 50 kg, so I suppose that's why he put me on 2 1/2 pills (125mg) a day. I'll have to call today and ask about it.
I'm finally feeling better and reducing the mesalamine enemas and seem to be doing fine with it. I hate the thought of feeling tried and crappy from medication when I feel just fine right now.

Thanks all!
Posted 7/15/2009 12:29 PM (GMT 0)
I'm confused, so your doc is putting you on 125mgs and then reducing it to 50mgs to maintain a remission dose?

I started out at 25mgs and then went to 50mgs, stayed on the 50mgs for a while and then he upped my dose to 100mgs on Mon and Thursday while staying at 50mgs rest of those days.

But most definately ask him about this high dosage. That seems a bit much - 50kg is how much in lbs? lol I'm metrically challenged (sorry!).
Posted 7/15/2009 12:33 PM (GMT 0)
My doctor is putting me on 125mg as a maintenance dose. He isn't reducing the dose. I just asked if 125mg was too much to start out at - if I should be starting lower and then work my way up to 125mg (if I even need to go that high). I'm actually getting over a small flare right now, which I caught early so it never got bad. I'm feeling pretty good right now so hesitant to try 6mp, especially at a higher dose, if it might end up just making me feel worse when I'm feeling pretty good right now.

50kg is about 118 lbs. I'm metrically challenged too, so no worries! I had to use a metric converter to figure out my weight in kg :)


Nikki
Posted 7/15/2009 1:50 PM (GMT 0)
I am glad my doctor did not prescribe 6MP according to my weight - as I am obese - however, I assume he would prescribe more according to what I SHOULD weigh.
I started at 50 mg. then increased to 75 mg. for 10 days, had a prometheus test that showed that was not therapeutic. I could not tolerate 75 mg. even as I get flu-like symptoms, feel worse than UC. So, doctor took me off it - no use going higher he said.
ElaineNY
Posted 7/17/2009 3:15 AM (GMT 0)
That sounds like a high starting dose. I was started at 75mg and was reduced to 25mg for maintenance. The higher dose made my anemia worse. I'm about 125-130 lbs. Good luck, hope the 6mp works for you.


Universal Colitis since 2003
Asacol 12 6 tablets per day
Mercaptopurine 1 ½ 1/2 tablets per day
hydrocortisone enema as needed (try not to use unless really, really needed)
Probiotic (lots!)
Fish Oil
Folic Acid (a must on 6-mp)
Iron (Solgar gentle iron - gentle on your tummy)
Multi Vitamin
Biotin
Lots of toasted french bread (especially when its actin up!)
Quiet time everyday to d-stress
Posted 7/18/2009 1:41 AM (GMT 0)
Seem high to me. There is a blood test you can take after you've been on 6MP for a couple months that gives an indication of how right that dose is for you. Only Promethius Labs does it, so it was hard to get Optimum Choice to cover it. I am 155lb and am on 100mg which is probably as high as I can do. That blood test says so, and regular blood test show my WBC has dropped from 8 to 2.5 (with 4 being the regular "low normal"). Supposedly 2.5 is okay though.

Ben
Posted 7/18/2009 1:48 AM (GMT 0)

Yes, the Prometheus test (after I had been on 6 MP for 3 months and 10 days at 75MG.) showed that 75mg. was not therapeutic and it made me very sick at 75mg. so obviously no use taking it.  I was hoping it would kick in but never did.  By the way, I received Medicare EOB today and that test costs $695.  Glad my insurance paid!

ElaineNY

Posted 7/18/2009 1:59 AM (GMT 0)
From my knowledge, 6mp (mercaptopurine) and Imuran (azathioprine) are dosed differently.  about half as much 6mp as Imuran, so you will want to take that into account.  Which did your dr. actually presecribe for you?  If it is Imuran or azathiorpine (the generic), I think that sounds like about the right dose.  Good luck, I hope it works for you! 
Posted 7/18/2009 2:06 PM (GMT 0)
I want to say that when I started 6mp I started at 75mg. I was actually 118lbs too when I started it. If you have any concerns about the dosing, call your GI. That's what they are there for :)
Posted 7/18/2009 5:06 PM (GMT 0)
     No wonder I feel like a walking zombie.  My GI increased my 6MP last month to 100 mgm.  I now weigh 125 lbs.  I am tapering the prednisone, down to 35 mgm this week.  Still see a bit of blood and rectum feels like an army marched through it on its way to battle.  Cort enemas nightly and Canasa in the morning, not to forget the nine capsules of Colazal daily.  Is this overkill or what?  Had two normal looking bowel movements today with still some mucus.

     My main concern is this terrible fatigue.  My last white count (drawn two weeks ago) was down to 3.1 and red count down to 3.76.  Bilirubin a tad high at 2.0.  Doc ordered liver panel this past week.  That's all I need now...liver problems rolleyes .  Monocytes were low at 78, normal is considered 200-950...hmmm.  Wonder how significant that is.

Posted 7/18/2009 5:11 PM (GMT 0)

I have no idea what the blood tests mean - my doctor just tells me mine are normal.  Too bad I could not continue the 6 MP at 75 mg. as I think it was beginning to work.  However, just can't tolerate the side effects.  I know people can but not me!  Good luck to you!

ElaineNY

Posted 7/18/2009 7:33 PM (GMT 0)
I've also been put on a starting dose of 125mg of azathioprin, i thought it seemed high too after seeing what most people here are on. I have to admit though i still haven't started it as i'm a bit worried about doing so, especially with swine flu being as close as it is right now.
Posted 7/20/2009 9:51 PM (GMT 0)
I talked to my GI and he still wants me to start taking the 125mg and see what happens. He claims that most patients have no symptoms starting at the 'full' dose, as he calls it. So i don't know if everybody posting on here is a small percentage of people taking this drug or if he just has alot of lucky patients. But I'm definitely still worried about taking it. He did say that if I feel nauseas or tired from it I can call and they can 'see what they can do'. Not really sure what that means but it doesn't fill me with confidence.
Apparently he uses this drug to maintain remission in the majority of his patients so he feels its one of the best treatments out there to prevent future flare-ups.

I hear ya on the swine flu thing - I thought about that too. I even had the PPV vaccine last week (pnemonia vaccine) which the GI recommended. He also said to get a flu shot every year when you take this medication. I've never had a flu shot before, but if I start taking this medication then I sure hope they get something in that shot to help with the swine flu! One thing - at least we'd always be at the top of the list if there is a shortage of the shot again :)
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