Side effects of Azathioprine - please share

Some do have side effects and new users will no doubt reply. But lots don't. They always read scarier than in reality. Only comment is aza is not a drug to respond to major flares ... It is a maintenance drug.

Azathioprine, Imuran, and 6mp all have statistically rare but serious side effects (4 in 10,000 or 0.04 percent of patients who take them). To put the risk into perspective, 1 in 5 die due to heart complications, and 1 in 133 die in car crashes. The Crohn's and Colitis Foundation of America is the source for these statistics:
Webcast: programs.rmei.com/CCFA139VL/presentation/player.html
Transcript: www.ccfa.org/assets/pdfs/risk-and-benefits-transcript.pdf

I was worried as well when first reading the warnings on them. I've now been on 6mp for 1.5 years and I have not had a single side effect from it (I'm not sick anymore than before, etc). But my uc has improved greatly.

Untreated uc inflammation is far more dangerous than aza, or any of the other uc medications.

I haven't recently start it but in 2005. I get nausea once in a while but it's manageable.

Like you, I was terrified of taking Azathioprine, convinced I'd get pancreatitis or have my white blood cell count drop massively in the first week. I refused to step up to azathioprine for 2 years, and waited until I was hospitalised and the decision was effectively taken out of my hands.

I don't have a lot of the TPMT enzyme so I couldn't tolerate a therapeutic dose of Azathioprine and was switched to 6MP. I mainly suffered from nausea and fatigue with 6MP and azathioprine. The nausea tends to die down after a month or so, but one unwelcome side effect for me was mood suppression. 6MP makes me feel low / slightly depressed. I came off the 6MP for a month (after a year of taking it) and felt "back to normal" in terms of my mood, but unfortunately I got a viral infection at the same time and flared up. I'm now back on a low dose of 6MP along with Humira but I want to stop the 6MP because of the mood suppression.

I'd advise you to give Azathioprine a try, get regular blood tests done, and trust your instincts. If you have an IBD nurse you can phone or text them if you have any worries while you're starting it.

I've been on azathioprine for 7 years now. Other than mild nausea in the first two weeks and headaches in the first 6 weeks I've had no side effects whatsoever from it. I do have to have blood tests every three months, which is a necessary hassle. Can't even say I've gotten sick more often. Really no complaints about it at all.

Thanks to all for replying. I know I need to bite the bullet and take the tablets. I'm so fed up with feeling unwell and like many of you have stated- no side effects can be worse than how I am feeling now.

Hello. Thanks for asking. No I haven't yet. Budesonide unfortunately made me feel even worse than I was already feeling so started 40mg of predisolone this morning. 😢 I need to get this flare under control before i start the Azathioprine. I'm still really worried about taking it as due to go on holiday on 03 august and really don't want to have side effects whilst away. I know I need to take it though to get flare under control. Why do we have it so tough!! I'm also depressed at the moment which isn't helping. Off to see therapist on Friday to talk things through.

Hi! I'd start taking your aza right away! Although tough call with the vacation soon. As long as you can still make your weekly (or roughly) bloodwork, i'd start asap since it takes so long to work.

I started aza (200 mg/day) at the beginning of March, so 4.5 months ago now! I've been off prednisone for two months and so far no flare! After tapering off pred things started to get a little worse again, but then the aza evidently started kicking in!

The only side effect I had was some minor stomach discomfort during the first two months. After two months almost exactly it miraculously dissappeared! And it was so minor I wouldn't really call it nausea. And it was especially mild when I split my dose, half with breakfast and half with dinner. I found it best to take it with a good meal. So just know that if you get nausea and it goes for more than a couple weeks (as it seems for most people) it will go away! I can now even take my whole dose together at once with no food and not have a problem!

Also, my doctor left it up to me if I wanted to start at a low dose (50 mg/day) while waiting for the genetic test results, or go right to the 200 mg right away and "see how it goes". I went straight for the 200mg right away. If they do bloodwork once a week, they'll catch any possible issues wih the blood counts and liver enzymes. I just didn't want to delay at all and risk any return to the frequent "accidents" and going 30 times a day!

The bad side effects are so rare its worth taking in my opinion, although I was scared too. I have had one sore throat since, which I caught from a coworker. It might have lasted maybe a day longer than usual, but wasn't too bad. And I think I only caught it because I was super stressed with work and not getting enough sleep, and was rundown. That, and she accidentally coughed right in my face... gross.

Good luck!