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Alluporinol with Azathioprine

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Posted 9/29/2014 3:22 PM (GMT 0)
Well I got my blood results back and it seems that even though my dose of imuran was increased six weeks ago that I am still not within therapeutic range. They can't increase my dose as I am at risk of my liver getting toxic. So they are talking about pairing the drug with something called alluporinol which he is hopeful will work. He says I am within the 15 per cent of the population that metobolises the drug differently.

Is anyone else taking allopurinol with aza and how have you found it?
Posted 9/29/2014 7:19 PM (GMT 0)
Anyone??
Posted 9/29/2014 7:37 PM (GMT 0)
Type in Allopurinol in the search engine above. You will get different experiences from that combo.

I was on the Allo and 6mp combo for a short while because my 6mp levels were never therapeutic either without risking liver toxicity. I was placed on that combo but shortly delevoped an allergic reaction to Allo that sent me to the hospital for 3 days. Which is sad because it was starting to work.
Posted 10/1/2014 1:24 PM (GMT 0)
Anyone else had experience with this combo? I am worried about my WBC going dangerously low as the allupurinol boosts the effect of imuran. Even though it never has been whilst I've been on imuran.
Posted 10/1/2014 7:38 PM (GMT 0)
You reallly need to just keep going for the blood tests and see how you feel and what the tests say as metabolism of thiopurines is very much linked to personal genetics. I presume you will be on very regular blood count screening on this regime so you will find out if WBC drops.
Posted 10/1/2014 9:42 PM (GMT 0)
Did your GI suggest Cellcept instead ?
Posted 10/2/2014 4:28 AM (GMT 0)
No Dreadsteal what's that?
Posted 10/2/2014 2:44 PM (GMT 0)
Happychick

My 13 yr old has been on this combo for over a year with great results. She is on 6-mp - same as Imuran but already broken down and Allopurinol. I was able to substantially decrease the 6-mp after adding Allopurinol and she got into therapeutic range very quickly.
She was never in therapeutic range without Allopurinol.

I would try and just check your lab work- we now only check every 3 months unless a result is concerning and they we may check again.

Hope it works for you!
Posted 10/2/2014 3:27 PM (GMT 0)

Happychick said...
No Dreadsteal what's that?

Mycophenolate mofetil

It's an alternative to Imuran/6mp for those who can't tolerate them.

http://www.ncbi.nlm.nih.gov/pubmed/11280551
Posted 10/2/2014 6:38 PM (GMT 0)
IBDISTHEPITS - did your daughter experience any side effects on the combo and how long did it take for the allopurinol to kick in? Did it put her in to a complete remission?

I am currently flaring and it's not that bad but just very irritating and it's been going on for six months now. Is she still on the combo? My 6TGN measures at 225 which is a bit low but my 6MP level is 8139 which is apparently high and I'm at risk of hepatoxicity even though liver levels appear normal at present.

I think I will be going on the allupurinol next week after my appointment.
Posted 10/2/2014 6:40 PM (GMT 0)
And yes he wants me the reduce the imuran by quite a lot. I am currently on 125mg a day and will reduce to 50mg so it's quite a drop.
Posted 10/2/2014 7:47 PM (GMT 0)

Happychick said...
IBDISTHEPITS - did your daughter experience any side effects on the combo and how long did it take for the allopurinol to kick in? Did it put her in to a complete remission?

I am currently flaring and it's not that bad but just very irritating and it's been going on for six months now. Is she still on the combo? My 6TGN measures at 225 which is a bit low but my 6MP level is 8139 which is apparently high and I'm at risk of hepatoxicity even though liver levels appear normal at present.

I think I will be going on the allupurinol next week after my appointment.

Would be great if you could keep us (I.e me) posted since allopurinal/aza is my next course of action when I have my GI appt in a few weeks time. Like you, my flare isn't too bad, just very up and down which is frustrating. I thought I could finally get rid of it by upping the rectal meds but still can't get back into remissionšŸ˜ 
Posted 10/3/2014 2:45 AM (GMT 0)
No side effects and I think we checked therapeutic levels within 2 weeks and they were great!

Her 6-TGN levels were 175-190 and her toxicity level was as high as 15,000!!!

You may need something else to help with the current flare-
I think we were on Flagyl while initiating the combo and yes pet her in a good spot- always a slippery slope though.

I would highly recommend trying as it seems to be helpful with no side effects.
Posted 10/3/2014 7:49 AM (GMT 0)
That's great to know thank you!

I was a little reluctant to take yet another medication but I think allupurinol does not seem as strong a medication as imuran and 6MP so it's probably better to significantly reduce the immunosuppressant and add the allopurinol.

I will definitely be trying it! I hope it works quickly! I am ok with my flare at present as it's mild. No bleeding or mucus and only 1-2 BM per day. But I get some abdominal pain and still have tummy noises and looser BM.
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