Azathioprine becoming less effective

Hello everyone,

I’m 25 years old (male) and today is just one of those days where I can’t hold back the tears. I wish I had some close friends who truly understood how terrible this disease can be and how life inhibiting. My azathioprine has been working for me for about 1.5 years or so and lately it doesn’t seem to be able to holding me. I don’t know what I am doing differently and my biggest fear is having to move to the next level meds. I am afraid of them, humira, remicade etc. I have been given Proctofoam enema to try and it only seems to exacerbate my symptoms and make me worse and my doctor is insistent that it should help. But it is not. I honestly just want a quick prednisone dose to bring my flare down because I know it works for me but my doctor seems reluctant about that. I don’t know why. Can I not take prednisone while on azathioprine? I really just wanted to post to vent. I know all you understand. I know there are others who have worse symptoms than me and I can’t imagine and can’t compare. This disease is just draining, tiring, depressing, etc. It has taken my life away.

Dx with Ulcerative Proctitis Oct 2015
150mg Azathioprine
Canasa as needed
Many many supplements

Thanks for answering. This forum is so comforting to have people who understand. I am at my max dose of azathioprine and my levels are good according to the blood work. I’m just nervous about stopping azathioprine and other meds not working and then going back to Aza and that not working then. Prednisone is nasty but it does work fast for me and it doesn’t bother me short term. The bios definitely scare me. Especially long term. I know aza isn’t good either but I’m comfortable with it especially with the blood tests every 3 months. Canasa helps me more right now in getting somewhat normal BMs and less mucus. I just have too much going on in my life right now and all this is making it so much harder. I think one of the hardest parts of this disease is people just not getting it. Not that they should, but especially in social situations people just don’t understand. It’s hard.

Thank you for your response again. I am sorry for what you are going through as well.

UC is a 100 percent invisible illness and we're often misunderstood as a consequence thereof by spouses, family, our closest friends, etc. " But you look healthy..." is the real kick people throw at us. I've had coworkers say to me during the middle of a flare "Wow you look great, did you loose weight?" That's when my sarcasm kicks in: "I lost 20 pounds in a month through this great new program called IBD and I wasn't even hungry! All I had to do was be doubled-over in pain and have frequent diarrhea. You should try it!"

"Can I not take prednisone while on azathioprine?" Yes, you can take pred while aza.

What scares you so much about biologics? I ask as the safety-profile is very similar to azathioprine. Few experience side effects. The same rare side effects included for both. I've been on remicade for 3 years, experienced zero side effects but did achieve a remission!

Sometimes our UC just progresses in extent and severity, and we need stronger medications. .

could you take a melamine with it? I do and have been in remission since early 2014. I take 6 asacol hd a day and 2 50 mg azathioprines. seems to be the magic combo for me, and I was in an extreme flare that hospitalized me for 9 days and last 3-4 months

Hi.

I have been on Aza and pred at the same time and biologics to that matter with no issues with no side effects.
Honestly don't fear biologics. Remicade worked wonders for me where steroids initially failed. Strangely steroids worked for my second flare but not my first. During an infusion, nurses will be monitoring you closely for reactions.
I'd personally choose a biologic over pred because of the bone thinning, mood changing, cataract causing properties of pred. I feel biologics are a cleaner drug despite less I known about their long term side effects.