HealingWell
Search Close Search
☰

6mp dose

Support Forums
>
Ulcerative Colitis
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 6/8/2012 5:52 AM (GMT 0)
I am now down to 10mg of Prednisone.  about 2 cort enemas per week.  I have been on 50mg of 6mp for almost 5 weeks.  My sxs are definately better than they were.  Smaller amts of blood and M, 2 to 4 bms a day, less pain, not waking in the night, less urgency.  I am not in remission yet but things are a bit bettter.  Saw my GI today and he wants to increase my dose of 6mp to 75mg.  He is happy with my progress but wants to be sure I am "covered" as I come off the Prednisone.  I think I weighed 122 lbs (up from the 115 I've been for months) today.  So is this a good dose.  I have been tolerating the current dose ok but  am nervous to rock the boat by increasing.  I also don't want to take a sub therapudic dose either.  Just wondering what your thoughts are on the increase. 

Also did most of you not see a full remission till 3 or 4 months.  I know sometimes it takes a while to work.

Thanks

 

Posted 6/8/2012 12:06 PM (GMT 0)
I originally started at 25mgs, to be sure I could tolerate it. Than I increased to 50mgs. And later increased to 75mgs for 2 days a week with 50mgs for the other 5 days. I couldn't go any higher because my liver couldn't handle it but if you can, than 75mgs is a good dose. I've read that some people can take up to 100mgs.

I saw an improvement at the 7 week mark but I didn't get the full effect for about 3 months. After that I slowly backslid because my body decided it didn't want to metabolize it correctly - I couldn't get into the proper therapeutic range.
Posted 6/8/2012 12:55 PM (GMT 0)
     My GI doctor placed me on 50 mgm of 6MP back in 2002, along with the prednisone.  It didn't really keep me in a long term remission. I believe it helped for maybe a year but then I started to flare yearly, then twice a year and finally had surgery in 2010.  My doctor increased the 6MP to 100 mgm during the summer of 09 but wow did I ever get sick shocked !  My liver and pancreatic enzyme levels were off the charts and I felt HORRIBLE!  He took me off the drug for a few weeks and tests returned to normal.  I started back at 50 mgm, but it had no effect.  I also tried Remicade and then Humira...nada.

     Just make sure you get regular blood tests to check those liver and pancreatic enzyme levels.

Posted 6/8/2012 12:58 PM (GMT 0)
Thanks Red 34. That is too bad that it didn't end up working for you. I pray this is the key to a long remission for me. My GI seems hopeful. I like the idea of doing 75mg on some days. I hope I can tolerate it. What are you doing now for therapy? Are you on any drugs? Did you have surgery? What happened after 6mp failed?
Posted 6/8/2012 12:59 PM (GMT 0)
Also is there anyone on the board that takes 50mg and has had that be effective? If so what is your weight?
Posted 6/8/2012 1:18 PM (GMT 0)
After 6mp failed me, my doc tried Allopurinol (with the 6mp). Allopurinol helps increase the effectiveness while lowering the toxicity of 6mp. Unfortunately, I found out that I am allergic to Allopurinol. So the doc kept me at 50mgs and started me on Remicade. I am now in remission. So I take Colazal, 6mp and Remicade to keep me where I am at the moment. I asked him once if I could stop the Colazal but he didn't think it was wise - not rock the boat sort of thing.

Btw, weight is used for the initial dosing but after that the 6mp is tweaked for efficiency. My doc used the Prometheus metabolites test to see how I was doing on it and my dose tweaked according to the results.
Posted 6/8/2012 2:28 PM (GMT 0)

I am on 150mg.  I started at 50mgs and worked up slowly to 150.  I also alternate taking 100mg one day and 150mg the next.  We are trying to see if I can go down to 100mg long term.  I am on Imuran so I don't know if there is a difference with dosage between that and 6mp.  After I had been on it for 18 months I also started skipping Sundays.  I do that just to give my kidneys and liver a break.  That did not come from doctor's advice - I just decided to do it and it has been fine for me. 

Oh, I weigh about 150 pounds.

Posted 6/8/2012 4:32 PM (GMT 0)
i was started at 50 mg and felt great on that. i had to get off it though because my enzymes were really high. i dropped to 25 mg first, still high, so i decided it was best to be off of it. i was 90 lbs when i started and maybe 110 when i got off of it.
Posted 6/9/2012 1:19 AM (GMT 0)
You could definitely be on 75mg at your weight but you may not need to be. The only way to know for sure is to have the 6mmp/tgp blood test done. That shows where you are on the chart of theraputic benefit vs. toxicity. The thing is, it doesn't seem like it's all that consistent. I was on 50mg and in the very low range on theraputic - high toxicity. Then I was on 75mg, same result. Then I was on allopurinol and the numbers shifted dramatically. Then my WBC dropped and I went off 6mp. Then I went back on without allopurinol at 50mg and my 6mmp/tgp showed ok levels and not much toxicity. Then my WBC dropped and I went to 25mg and everything looked perfect. It really doesn't make sense that now I am in the theraputic range on 25mg but in the past I always had toxicity and low theraputic benefit. I don't know what to make of it but I am happy I've been feeling ok.

It sounds like you're seeing a lot of improvement. I am so happy to hear it!!
Posted 6/9/2012 1:26 AM (GMT 0)
Seasons,

Glad to hear that you are feeling better! Great news and so happy that things are going in the right direction for you :))) How are you planning on tapering off the pred? (dose/how many days)

Hang in there!
Posted 6/9/2012 8:41 AM (GMT 0)
I started at 25mg, then went to 25mg one day and 50mg the next, now I'm on 50mg one day and 75mg the next and that seems to be fine, have been on that dose for ages now
I know that they make changes slowly and always keep up with your blood tests I have mine done every 3 months now but it was much more frequent to start with,I'm sure between you and your GI you will find your suitible dose.
Posted 6/12/2012 1:22 PM (GMT 0)
Oh the questions....I've just started to come out of remission, a not too bad flare (4th one in my life since Dx 2007 UC). I've not been on any meds for the remission, just the FODMAP diet and I smoked for 4 months to obtain and stay in remission. I had 10 fecal transplants, and then when I quit the smoking (only did it to achieve remission), I started to come out about 4 weeks after. So now, while I'm not in dire straits with this flare (not sure if fecal transplant minimised, or cigarettes or diet)....so saw new Gastro who wants me to do 6mp. Dosing 25mg up to 75mg. My fears are 1) Side effects ....specifically nausea and vomit, and then of course the severe ones of toxicity and increase in cancer susceptibility.

Being that I will never touch pred again, and refuse normal meds. Wondering what you have thought of your 6MP experiences? Or are all of you taking multiple meds ? Right now I'm trying nicotine gum, upping my liquid turmeric, sticking to FODMAP diet, and thinking I should add glutamine/omega 3s/ and anything natural/herbal to my diet.

I'll do anything to avoid hard drugs, but if 6mp has little side effects as the drs CLAIM...i'd be hip to try it. But my past, I got every side effect from steroids (and didn't achieve remission), I nearly died from the horrific pain of 5ASA....and have never tried Imuran or 6MP or Azathio or anything like that as I just want to avoid long term drug dependency (financially and medically). I also really don't want to have to smoke again for remission......

ANy ideas/comments?

THANKS everyone


-------------

2007 Proctitis
2010 UC 35cm
8mg of nicotine gum dailly
Posted 6/12/2012 1:29 PM (GMT 0)
I was diagnosed in 1999 and have only had a few flares too. I managed to avoid the big drugs for years. I too had horrific reactions that landed me in the ER with all the mesalmines. Can't take any of them. I did everything natural and dietary under the sun to get this flare under control and to no avail. I am way way better but still not a total remission yet. I fianlly caved to trying 6mp even though I hate the thought of what side effects can happen. I also worried like you about the nausea. So far it's been 5 weeks on 6mp. 50 mg and upped to 75mg 2 days ago. Overall I feel fine. No major nausea or anything. When I first started it I got pink eye and a sore throat. Not sure if it had anything to do with the drug and I'm fine now. I don't feel anythng very different. So I'm glad I seem to be tolerating it so far. Good luck!
Posted 6/12/2012 1:31 PM (GMT 0)
Manhattan Mama

How are you??

I plan on doing 10mg for 2 weeks then 7.5 for 2 weeks then I'll call my GI. He wants me to go slowly so that is good. I upped the 6mp to 75mg because he wants to be sure I'm "covered" as I taper the Pred.

Are you open to an email?
Posted 6/12/2012 8:28 PM (GMT 0)
Hi Seasons,

Sorry I've been out of touch lately but I am feeling better and spending more time with the kids and less time thinking about my UC :)))

I had my 2nd Remicade infusion on the 4th and I feel great! 1 BM a day, no urgency, no blood, no mucous. I am eating whatever I want and having a cocktail once in a while---yippee! The only side effects from the Remi I have had are a couple of bruises and some hair loss. The hair loss could also be from the pred. Otherwise I feel great! I tapered down to 4mg of Pred today and plan to be completely off in 10 days. I will have to lose 25 pounds but other than that things are looking up.

It is scary to think that 6 months ago my life was consumed with painful, bloody D 25+ a day. Now I am getting my life back and it feels great. Hope this message reaches you and gives you some positive energy to feel better.
Posted 6/12/2012 8:29 PM (GMT 0)
I am on week five of 6mp. My GI started me at 150mg right away and that's what I've stayed on. I'll have my second blood test later today.

Feeling better on this med - less urgency, less frequency. Issues are not gone, just better. Hopefully I'll continue to improve.

I did have to add in Prilosec recently, not sure if its the 6mp that pushed me over the edge or potassium horse pills that I have to take. Along with the heartburn I have lots of nausea now.
Posted 6/12/2012 8:58 PM (GMT 0)
Mikaa - I am on Imuran alone, no other meds and it is keeping me in remission so far. Nothing else worked for me. I have not had any side-effects and am glad to be symptom free.
Posted 7/9/2012 10:55 AM (GMT 0)
Thatfield- Did you start on Imuran 150? What was your prescription, how much did you take, how long til you upped it, and ZERO side effects? How long until you saw the blood decrease?


Seaons21- So you are on both Prednisone and 6mp? Let me know if you stay in remission once the prednisone is gone (that is one EVIL drug).........

All the best for your continued remissions......


I'm still weighing up the options....my GI wants me to start on 25mg, then 50, then 75. I've not called back yet to say yes. STill praying something changes from all the herbs (glutamine/quercetin/turmeric/rutin/bromelain). The patches stopped the cramping, diarrhea, but the mucus and blood continued. Sadly I got desperate and started smoking again (I hate every second of it) and the plan is to give it two weeks and if I get into remission again, then I can have a bit of time to figure out the long term strategy as smoking is a temporary solution and I figured 3-5 weeks of smoking versus the same on Prednisone was the lesser of the evils. Just my personal experience for short term use as prenisone makes me suicidal.

Keep the comments coming on 6mp, I need all the info before I say yes.
Posted 7/10/2012 3:00 PM (GMT 0)
Makiaa - no my GI slowly moved me up to 150.  I started at 50 for 2 weeks then 75 for 2 weeks then 150.  I had blood tests weekly during that progression.  Yes, zero side effects.  Imuran is the only medication that has put me in remission and the only med that has caused no side effects what so ever for me.

If I am remembering correctly the blood decreased after about 6 weeks.  I was in full remission after about 12-14 weeks.  I know that seems like a long time but since I had never been in a true full remission for 4 years 12-14 weeks did not seem like a long time to me.

I have actually moved to 100mg over the last couple of weeks and am doing fine at the lower doseage.  I also usually skip one day a week to give my kidneys and liver a "break".  I have been doing that for months now and it has been fine.  My doctor did not advise me to skip a day but I just decided to give it a try and it has worked thus far.  I did not do that until I had been in remission for over a year though.

I can TOTALLY understand the desperation and the reason you would smoke but please remember that the risks of smoking far outweigh the risks of Imuran.  I have seen too many people suffer with congestive heart failure, strokes, and cancer due to smoking.  I am in no way judging you - I was desperate too when my flair just would not end I just worry about the long term effects of smoking on people's bodies. 

Hope this helps.

Posted 7/10/2012 3:11 PM (GMT 0)
Seasons, I weigh about the same as you do. I take 75mg along with Lialda and that keeps me in remission. I had to stop the 6MP for a week due to elevated liver enzymes and had a flare maybe a month later and needed to go on prednisone to get it back under control. I did go back on the 75mg and my liver has been fine since (monthly blood checks). When my WBCs were quite low (after a viral infection) the dr wanted me to stop it again and I begged her to let me just reduce to 50mg with agreement that I would get weekly checks and my WBCs were fine (she said most likely due to infection not meds). Here's the thing: just reducing to 50mg for a week (maybe 2?) caused a mini flare that I was able to get back under control with prudent use of Rowasa at the first sign of trouble.

Long story short, I am about your weight and need 75mg (along with max Lialda dose) to stay in remission. Any variation from that causes me to flare. Your mileage may vary :)

Good luck with it! 6MP has worked better than anything for me (other than prednisone which is obviously not a long term option). Sadly I am currently off of it as of yesterday as I may be taking a bad reaction to it :(
Posted 10/25/2012 8:46 PM (GMT 0)
@seasons21

I was on 100mg of imuran(azathioprine) for 2 months but developed pancreatitis so had to quit.
I believe that the imuran was working to keep me in remission.

Now on 50mg/day of 6MP for last 3 weeks and tolerating it well.

May drop to 50mg every two days as it makes me mildly suicidal and feel generaly lousy.

Didn't tell the doc, just a personal decision.

Sunflower seeds seem to be helping as well.
✚ New Topic ✚ Reply