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Ulcerative Colitis
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Posted 5/21/2015 4:47 PM (GMT 0)
Hi, I'm new to this forum having only been diagnosed a year ago following a major flare when my first child was 5 weeks old. I achieved remission following a hospital stay including iv steroids & then a long course of prednisolone and steroid enemas, 1200mg of asacol 4 times a day and commencing mercaptopurine, it took a good 5 months to achieve the remission so obviously I'm terrified of it flaring again, but my question is, whether anybody has safely stopped mercaptopurine? We are hopefully going to try for another baby & I'd rather not be taking them. My last colonoscopy showed there was no signs of the uc.
Thanks in advance!
Posted 5/21/2015 5:23 PM (GMT 0)
Too risky to take anyone but a top pro's advice here. I don't know what the warnings are on 6mp. I do know that your health is the key to a healthy baby, and flares get harder and harder to treat. Going off the med that got you in remission is frightening. There is a top doc at Mayo who specializes in IBD and pregnancy. She has published a lot too. Shoot, forgot long name- they call her "Suzy", perhaps Google her papers thru Mayo GI dept.for insights on safe preg. recommendations.
Posted 5/21/2015 5:26 PM (GMT 0)
Just remembered, Dr Sunanda Kane- Rochester based. She also speaks at the CCFA meetings and DDW. Saw her a few times ,and when it comes time for my daughter to want kids, I'll hunt her down!
Posted 5/21/2015 5:45 PM (GMT 0)
Thanks for your reply! It's also the side effects of the mercaptopurine in general that concern me long term! It's all so new to me, I'm not sure if people do taper down their meds after a set period of time in remission?
Posted 5/21/2015 6:54 PM (GMT 0)
Other than tapering Pred., the common wisdom is - stay with what brought you to remission. Reducing doses is like playing roulette. That said, pregnancy is a different situation. I know a few who stayed on their biologics and did fine. Post birth, you would not give a baby any live vaccines for a time, as some drugs cross the barrier and their immune systems cannot handle. Remicade is newly considered "safe", Entyvio is untested and I cannot say for Immuran or 6mp. Pretty sure the 5asa's are commonly used. Keep reading on this site, use the search bar at the top, we have lots of moms!
Posted 5/21/2015 7:04 PM (GMT 0)
Often the philosophy is stay on the medications that got you unti remission, in order to sustain remission, why risk tapering. I understand on pregnancy risk and 6mp. It's a personal choice. Biologics are safer for pregnancy (remicade, humira, etc.).

Here's a couple links on ibd medications and pregnancy, I think 6mp is a class D medication:

From conception to delivery: Managing the pregnant inflammatory bowel disease patient
www.wjgnet.com/1007-9327/pdf/v20/i13/3495.pdf

The Second European Evidenced-Based Consensus on Reproduction and Pregnancy in Inflammatory Bowel Disease
ecco-jcc.oxfordjournals.org/content/eccojc/9/2/107.full.pdf
Posted 5/21/2015 8:38 PM (GMT 0)
I would discuss with your GI if the maintenance plan might use only one drug. for the mesalamine, you can generally take fewer pills in remission. but 6mp is by body weight and it may not make sense to take less.

also to consider is that the hormones of pregnancy can bring about flares.
Posted 5/21/2015 8:43 PM (GMT 0)
Thanks to you all, for taking the time to reply! maybe I still haven't come to terms with the fact I'll have to deal with this stupid condition forever, I know I shouldn't complain as so many people would love to be in my position right now but it sucks to have to be worried about every little thing!
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