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Can 6mp be used if azathioprine caused problems with liver enzymes?

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Ulcerative Colitis
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Posted 2/2/2015 4:21 PM (GMT 0)
I know they are very similar drugs, but wondered if 6 mp would be destined to cause the same problems as I had with aza (elevated liver enzymes AST, ALP, ALT)

I am still hopeful that I can get this last bit of inflammation tamed with other means (Acacol HD, Nopal water, and just started a week of Uceris), but I want to get a Plan B formulated just in case.

Been in this flare since June and the only lingering symptom is a bit of blood every 3-4 days and since starting drinking the nopal 2 weeks ago things have dramatically improved and the blood is a lot less than when I started drinking it. I am getting impatient so I added Uceris this week since I still had a week left from when I was on it in Dec. (Still had blood when I was on Uceris before -- it was less than in June when this all started, but more than what I have since starting the Nopal).

I need to get this flare kicked to the curb! Hoping I don't have to go up the med ladder and would prefer to avoid biologics if it's a possibility that 6 mp would work for me.

Has anyone had problems with aza but did ok on 6mp?
Posted 2/2/2015 5:20 PM (GMT 0)
I have not had the exact experience you mentioned. But sorry, I would not touch 6MP with a 10-foot pole. http://livertox.nih.gov/Mercaptopurine.htm
Posted 2/2/2015 5:43 PM (GMT 0)
I used allopurinol with 6mp and it helped. You can use it with imuran too if your GI will monitor you.
Posted 2/2/2015 5:56 PM (GMT 0)
k-del, why wouldn't you use it? If it's because of the warnings listed in the link you provided, there are many meds that can do the same thing. If I can't take 6mp the next step up will be a biologic and they can have even scarier issues when you read about them

If the time comes, I will ask about the allopurinol, NSSG. When you were on 6mp alone did you have liver problems that were eliminated by lowering the dose and adding allopurinol?

I keep thinking that I saw someone here who had mentioned that they had liver problems with aza, but were able to take 6mp without any issues.
Posted 2/2/2015 6:14 PM (GMT 0)
I did. I also got into a long remission without allopurinol on the lowered dose and my liver was fine. The remission lasted a few years, it was great. Eventually I flared up and I was never a great responder to 6mp so we decided it was time to try something else.
Posted 2/2/2015 6:23 PM (GMT 0)
Good to know that 6mp could possibly work even though aza caused problems for me.
Posted 2/2/2015 6:59 PM (GMT 0)
i did bad on 6mp but well on imuran so its the opposite for me.
Posted 2/3/2015 3:14 AM (GMT 0)
I got pancreatitis on AZA, but was able to tolerate high doses (150mg/day) of 6-MP.
Posted 2/3/2015 2:04 PM (GMT 0)
You all are giving me hope that I can avoid a biologic. I'm not crazy about the possibility of going on any immunosupressant, but the biologic ones really scare me. With aza, as soon as I had a problem I stopped taking it and felt better within a few days. If problems come up with a biologic they are already in your system for at least a couple weeks.

Still hopeful I can avoid any stronger meds, but good to know what the possibilities are.
Posted 2/3/2015 3:14 PM (GMT 0)
CC, I was on 6mp and it did cause me to have elevated liver enzymes. It also gave me extreme nausea & loss of appetite.
Because of these issues I had to discontinue.
6MP is a very good drug...unfortunately not for me. Everybody responds differently. I know many people who are on it & are doing extremely well.
I don't know if your reaction to aza would preclude you from taking 6MP.
Good luck in your next step...
Posted 2/3/2015 5:34 PM (GMT 0)
What did you do after you had to stop the 6MP, twingirl? Also, how long were you on it before you had problems?

Hope you are doing well now!
Posted 2/3/2015 6:35 PM (GMT 0)
CC, I am on Entyvio & I am receiving infusion # 4, Actually I was supposed to get it today & the infusion center said it hasn't come in yet. A little bummed as I was really hoping to get it today.
Anyway...my Dr ordered me to take the 6MP along with the entyvio.
I started the 6mp shortly after my first few infusions. He started me at 25 mg for one month & then bumped it up to 50mg. It was shortly thereafter the nausea came & my enzymes were on an upward trend.
I am doing considerably better which I attribute to Entyvio. I am not in remission yet but I am optimistic & staying the course with the prescribed treatment plan.

The adverse symptoms of 6MP do reverse pretty quickly when you discontinue it.

I am wishing you all the best.
Posted 2/3/2015 8:52 PM (GMT 0)
Wishing you all the best too! Hope your next infusion is the one that really kicks in!
Posted 2/7/2015 2:02 AM (GMT 0)
Cc did you start 6mp?
Posted 2/7/2015 2:14 AM (GMT 0)
No. I am still holding out hope I can get in remission without it. I did switch to colazal this week to see if that can do better than the asacol. I'm still drinking nopal too. I am going to give it a few more weeks to see if I can continue to improve. I feel so close to remission ... hope I get there soon!

Hope we ALL get there soon!
Posted 2/7/2015 2:22 AM (GMT 0)
Me too! Just got back from dr and he thinks it's time. I am pretty nervous. But he gave me a bunch of samples for uceris and I will take that and other meds and see what I can do to get remission. Feeling very sad these days! It overwhelming!
Posted 2/7/2015 2:32 AM (GMT 0)
I know exactly what you mean. Hang in there!

I see that you are on Apriso. I did better on Asacol than on Apriso. I tried Apriso 2 different times and flared after a couple months each time and went back on Asacol and did better. Did you ever try anything else?
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