Is this normal when taking Azathioprine/Imuran

I seem to be feeling fine during the day, obviously morning being a little rocky but I only have about 3 bowel movements till I take my azathioprine in the evening during my dinner. I get bloated, gasy and eventually need to go toilet again (only once more but I'd like to keep it at 3 rather than 4 a day).

Is this normal? I've been on it for 15 weeks and 4 days. I don't even feel that it's helping. I started taking suppositories last week and that's made so much more of a difference than any other meds I take (Pentasa 4g, pred, omneprazole and allopurinol)

iPoop said...
What's your dosage of aza/Imuran? 3-4 bms a day isn't terrible but it does indicate you have some mild uc inflammation remaining. I would ask to have your dose increased (if not already at max). What other uc meds are you taking? Daily rowasa enemas may help clear up sny remaining inflammation. Good luck,

I'm on 25mg of Aza (night time) and my other meds are:

Pentasa (2g morning/2g night)
Allopurinol (100mg morning)
Pred (15g - tapering down - morning)
Omeprazole (20mg - morning)

Wouldn't increasing it make it worse?

Agree, 25mg Aza is nothing, unless you weigh about 10kg! I am on 150mg of Aza and I weigh 65kg. Also, I found that it's hard to know whether Aza is doing anything if you are also on Pred. I thought my Aza was working until I tapered the Pred, but quickly realised that it was in fact the Pred that had been doing all the work.

I'm definitely sure my improvement isn't due to the pred as I'm doing only a 2 week course of pred (1 week of 30, tomorrow I'll taper it to 10 then 5 on Sunday) and my bowel movements have been consistently 3 in the morning and rises to 4 or 5 because of aza.

Each time I take my azathioprine my stomach swells up and I have a bowel movement in 20mins and there's no actual solid stool, it's liquid. I don't know whether to increase my dosage to 75 tomorrow and Sunday or stop taking it for the weekend and call my doctor on Monday.

I've dropped down to 51kg because of my flare up, maybe that's why I'm on 25mg? My last appointment was 5th Jan and next is 16th March, so it seems like there's some lack of monitoring. Perhaps I should ask to change my gastroenterologist?

Since you are also taking allopurinol, you probably shouldn't increase the aza unless you dr tells you to. I believe the 2 drugs work together and I think the aza is pretty low when used in combination. Have you had a Prometheus test done to see if you are in the therapeutic range? I was only on aza for 2 months before my liver enzymes were elevated and I had to stop taking it. The 1st month I felt fine on it at 100mg. The 2nd month I was increased to 150mg and had horrible indigestion, heartburn, gas and felt bloated all the time. I kept hoping it would go away but it didn't. I did get some relief by using Zantac. All that went away when I stopped the aza and I haven't needed Zantac since. Are you having regular blood work done to check your blood counts and liver enzymes?

CCinPA said...
Since you are also taking allopurinol, you probably shouldn't increase the aza unless you dr tells you to. I believe the 2 drugs work together and I think the aza is pretty low when used in combination. Have you had a Prometheus test done to see if you are in the therapeutic range? I was only on aza for 2 months before my liver enzymes were elevated and I had to stop taking it. The 1st month I felt fine on it at 100mg. The 2nd month I was increased to 150mg and had horrible indigestion, heartburn, gas and felt bloated all the time. I kept hoping it would go away but it didn't. I did get some relief by using Zantac. All that went away when I stopped the aza and I haven't needed Zantac since. Are you having regular blood work done to check your blood counts and liver enzymes?

Yeah I didn't want to increase my dosage anyway. No I've had blood work done once a month since October, but I don't think my doctor has asked to see them next month or month after. I'll be sure to bring that up on Monday when I call.