Allopurinol addition to Imuran

I did. I had a situation where i was never able to get into the therapeutic range due to toxicity to my liver. The allopurinol allowed my results to shoot up and toxicity to drop down. Eventually I ended up with neutropenia from the 6mp being too therapeutic. I did get into remission from it. It seemed a little dangerous in my case because my WBC dropped so low. I am surprised I didn't get a terrible infection. Later, I did end up with a terrible infection from UC drugs, and it landed me in the ICU, but I wasn't on 6mp at that time.

I think allo can be helpful in that case I mentioned, people who have toxicity and can't get into the therapeutic range. You do need very frequent monitoring. i was getting blood tests almost weekly and seeing a hematologist.

I am not a doctor so it's hard for me to give advice. I can say that in my case, it worked and I got remission out of allo+6mp so I am thankful for the year or two that I was in remission from the combo. On the other hand, it really depends if her situation is as I described. If she's in the therapeutic range already, I don't think it's a good option or even an option that should be offered. It seems like it's a good solution if you're in that particular situation I was in.

For me, I was a complete non-responder to Remicade. I could have ended up having surgery years ago if I didn't have that combo work for me for 1-2 years. Would that have been a bad thing? Probably not. I am actually doing better now, than I even did on the meds and I don't take a single drug. I also had really great insurance at that time, my surgery would have probably been covered 100%... I also spent all those extra years trying all these meds with no result, sick, in pain, spending money on doctor trips, worried about what I could and couldn't eat (even though none of that mattered in reality). I also had side effects from the meds, and I was on and off courses of steroids. My weight was consistently up 10 to 20 pounds from normal. I hated looking in the mirror...

if you have a great GI who can track her and keep watching the bloodwork, it's probably worthwhile. You may even want to start a relationship with a hematologist in case she has problems. My WBC plummeted, they thought I had lymphoma. I was about 1 week away from a bone marrow biopsy. Not fun stuff. Going to doctors that often sucks. I've gone for two check ups since my takedown 6 months ago. it's very liberating. I don't have another for another few months, then nothing more & no drugs.

Id try it, if no luck, of course try biologics. If nothing works, don't waste too much time...

My husband was on 6MP (similar to Imuran). It was impacting his liver so they cut back the 6MP and added allopurinol to try to get him to a therapeutic level with 6MP. It didn't help at all with symptoms. He tried all the biologics (Remicade, Humira and Entyvio). Doc's advice was to stay on the 6MP - it is supposed to prevent antibodies to the biologics from forming. Remicade worked for a little, but didn't achieve full remission and did develop antibodies. The other biologics did not work.

No side effects from the 6MP-allopurinol. He is off of both now.

You need to get bi-weekly CBC blood tests when on Allopurinol + Imuran. Do not forget to do this! I was in the hospital for a week this month because the combination effectively shut down my bone marrow and made me neutropenic + anemic. I was getting fevers of 104 the whole time.