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Azathioprine

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Ulcerative Colitis
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Posted 2/12/2014 10:20 AM (GMT 0)
Does anyone have any experience/advice with this?

I'm in the middle of a flare up (which I have just been put on steroids for), but they also want to see me in a few weeks as they are thinking of introducing azathioprine.

I've looked this drug up and it sounds so scary and not something I would like to be on!

If you are on it for a long period of time and then come off it, does your immune system ever recover, or are you stuck with being fearful of catching infections for the rest of your life?

confused
Posted 2/12/2014 11:57 AM (GMT 0)
Many of us here are on an immunosuppressive drug (aza, 6mp, imuran). At the dosages they are used for uc, there is very limited risk, and high benefit. Those meds are used in other conditions in much, much higher dosages. Yes, your immune system recovers if you stop using immunosuppressive drugs. I've been on said drugs for over a year and haven't had a single infection.

Ulcerative colitis is an auto immune system disorder. Your immune system attacks the lining of your large intestine which causes inflammation, urgency, diarrhea, and bleeding. The first line of defense is anti-inflammatory medications (meslamine, asacol,pentsa,etc). If those are not enough to keep a uc patient's symptoms in-check, then immunosuppressive drugs are also added to your prescription. The immunosuppressive drugs do not stop your immune system, rather it takes it down a few notches. If your immune system is say, only 85% effective then less inflammation is caused in your intestine, and the anti-inflammatory meds can better do their job.
Posted 2/12/2014 12:23 PM (GMT 0)
I'm on Azathioprine (Imuran) and I'm doing well. Sure I have to cover up in the sun and I have to fight nausea once in a while. But it's all worth it when you can have a normal poop :-)

I was on Aza a few years back and my GI had me lay it off when I started to flare. I know now that I should have stayed on it however and combine it with some pred maybe. Anyways, my immune system recovered while I was off it again.

Don't be afraid. Be happy when it works and you gain remission.
Posted 2/12/2014 12:46 PM (GMT 0)
I've been in Imuran since the middle of December and have no complaints. Had my first normal BM since August, woo hoo!
Posted 2/12/2014 2:28 PM (GMT 0)
Are you on any other meds? Your post makes it sound like you were not on anything, went into a flare, was put on steroids, and now they are talking about the AZA. There should have been many other meds to try first before going to the AZA, both oral meds and rectal 5ASA meds. Steroids by themselves are not a cure so if all you did was take them, get better, go off them, then I can see why you started flaring again. What about probiotics, supplements, and diet changes? Many of these actually do work and you can avoid those more dangerous meds. Unfortunately, something different works in everyone. You really should have been on both oral and rectal 5ASA's.
Posted 2/12/2014 3:53 PM (GMT 0)
I was diagnosed in October, was put on asacol and prednisolone. As I was doing well, they lowered my dose of steroids quicker (dropping one tablet every week, rather than every two weeks) but upped my asacol.

After coming off the steroids, I had another flare about 2 weeks later. I wasn't absorbing the asacol, so that got changed to granules. I stuck to a low residue diet without dairy when I was first diagnosed. In the second flare, I took out wheat and this really helped - the flare stopped and I was back to normal for a few weeks.

I was doing well until the end of last week when I flared again. They gave me a steroid foam enema to use with my granules, but this didn't seem to help much so they have put me back on oral steroids instead.

I take a probiotic every morning, have just got myself some multivitamins as I'm not really eating properly so thought they would help. I have looked into the paleo diet and thinking of cutting grains out as well.
Posted 2/12/2014 3:56 PM (GMT 0)
i was on 6mp before aza and have been on aza since july. so far, it's like taking a sugar pill since it does nothing for my symptoms.
Posted 2/12/2014 3:58 PM (GMT 0)
Thanks for the comments on azathioprine, didn't realise they used different doses for different conditions. I guess it's not ideal, but if it helps to get into remission, then maybe it's worth it to feel better again! Really helps to hear things from people who are actually using it!
Posted 2/12/2014 4:07 PM (GMT 0)
I really recommend this presentation of the Chron's and Colitis Foundation website: http://programs.rmei.com/CCFA139VL/start.html

It helped calm me down and make my decision. Imuran seems really scary, but the presentation does a great job of going over your risks of taking vs. not taking. I chose to start it, been on it about 3 weeks now, so far nothing noticeable except a little nausea but that could also be from weaning off the prednisone.

Good Luck, hope this helps!
Posted 2/12/2014 5:15 PM (GMT 0)
I've been on Imuran since September last year, not concerned with being on it. I like feeling better and this med is not causing me any side-effects like the Prednisone is.
Posted 2/13/2014 12:46 PM (GMT 0)
Hi! I have been on azathioprine for 14 years now and haven't really had any problems. All my bloods have come back fine every time the only thing I noticed is a little hair loss nothing major..

I'm taking 150 mg a day at present but I have been on higher dose in the past..

Everyone responds differently to all medications and probiotics. What works for one may not work for another.
Good luck! I hope it works for you :)
Posted 2/16/2014 3:29 PM (GMT 0)
Thanks for the replies!

I am visiting my specialist nurse in a few weeks to discuss it then, so will make sure I write down any questions I have about it and make sure I feel comfortable about going on it.

One thing I was wondering though, I am still experimenting with food. If I eat something that doesn't agree with me while I'm on the medication, will I know? Or can you basically get away with eating anything whilst on it?
Posted 2/16/2014 4:36 PM (GMT 0)
In my experience, it will be a lot less confusing as you get better. I tended to just be sick, no matter what I ate, when I had pancolitis. Now I can see clear reactions to the things that bother me.
Posted 2/16/2014 4:44 PM (GMT 0)
I've been on imuran for over 8 years. It improved my UC significantly with no side effects whatsoever. Get your blood work done religiously at first, as you go on, you forgot that you're even on imuran.
According to my GI doc, if you're going to have issues with this drug, the blood work will show it right away. Imuran has been around for ages and has a better safety profile than most drugs out there.
best of luck, hope you see results!
Posted 2/16/2014 4:47 PM (GMT 0)
Food, for me, really depends on whether you're in remission, not so much what medication you're taking. I've been on 6mp for a few years and throughout most of this time, I've been able to eat whatever I wanted. I am a healthy eater but I can have all the stuff people mention avoiding without repercussion and still have normal BMs, once a day, like before UC.... Now I have hit a little blip where I've been flaring up while on 6mp and I've been eating very light foods because the more I eat when I have symptoms, the worse I feel. I have never had food impact whether I am in remission as far as I can tell. I have only had dietary changes make a difference while I was flaring, and in that case, the only beneficial change is eating less. Anything and everything I eat while flaring causes countless painful, gassy, explosive BMs.
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