update:my 6mp dosage

Hi,

I've been on 6MP for about a year. I had to drop down from 100mg to 75mg when my blood work showed I was getting close to neutropenia. My wbc quickly increased; unfortunately, 75mg wasn't enough to keep me in remission and I started to have mild symptoms after a few weeks on the lower dose.
Also, my ALT numbers (indicating liver issues) have been slowly increasing since I started 6MP. My GI decided to put me on a combo of 25mg 6MP and 100mg allopurinol, which slows the metabolism of 6MP so the dose can be reduced, avoiding damage to the liver. I've been on it for a month, and am doing quite well (my only symptom is a little mucous) - I'll know more after my upcoming bloodwork.

Good luck. When we finally find a med that works, it's so stressful to have to keep making changes!

i've been dealing with chronic neutropenia for a while. my scope shows clinical remission so my doc is really hesistant for me to alter my medications. i get bloodwork done around shot times (of simponi) and i do need to wait to take it sometimes. i am on the lowest possible dose of imuran so i am not sure if that has any effect on my neutropenia at all.

my doctor said i have "allergic UC" or "eosiniphilic UC." my eosiniphils have been elevated since my diagnosis and these correspond with an allergic reaction in the body. he has me take allergy meds because that calms down the eosiniphils and raise the neutrophils. i also eat a lot of antihistamine foods. i take DAO, drink green tea and holy basil tea, eat lots of vit C, and probiotics.

6mp gave me a low wbc too. I was able to lower my dose and stay in remission for quite a while. If you have your levels checked, you can see where you are in regard to therapeutic benefit and see whether you have room to move down without leaving the "zone". You really don't have a choice, you can't let your wbc go too low, then you will be at risk for infections. It really depends how low it is. my GI was always OK with mine as long as it was over 3.

Allopurinol doesn't reduce the wbc. It boosts the effectiveness of 6mp which causes the wbc to get lower while on the two medications in combination. If you were sub-therapeutic without allo, with it, you could be on the top range of the chart. the higher you are on that chart, the higher the likelihood of developing neutropenia.

If you have low wbc and you're in the therapeutic range, you definitely don't need allopurinol. Allo is for people who have toxicity and can't get into the therapeutic range. It increases the likelihood of neutropenia.