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azathoprine vs 6 MP

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Ulcerative Colitis
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Posted 1/6/2008 1:29 AM (GMT 0)
Hello Everyone!

I have had 2 prolonged courses of steroids this year and am still symptomatic with my proctitis (blood, mucous, urgency, gas and bloating)

I started 50mg of azathioprine for 2 weeks and was OK, but when increased to 150mg had severe nausea - perservered for nearly 2 weeks and then stopped.

Have now just started 6 MP (2 days at 50mg and so far no nausea) but was wondering if I should have perservered longer with the azathioprine andd which drug is preferential?

I also have been reading about the possible effects of stopping smoking and as I stopped 3 years ago and my symptoms have got worse since then.

Any suggestions?

Posted 1/6/2008 1:28 PM (GMT 0)
I had a Prometheus test to determine which one I would do better on. So my GI thought I would do better on 6mp then Aza. Aza breaks down into 6mp in the liver so maybe your body just couldn't handle the breakdown. When you increased your Aza from 50 to 150mgs, was that instantly? No gradual increase? When I started on 6mp, my GI had me start at 25mgs - to be sure my liver was fine with it, then increased to 50mgs after 2 weeks and now I'm on 100mgs 2 days of the week and 50mgs for the rest of days (was on 75mgs for those 2 days but it wasn't working right - still flared). I'm not sure if a gradual increase is better or not, but with each increase I had some minor symptoms such as when I first started.

As for the smoking, there is a recent thread that I think you should take a look at. Many have found that by stopping it has increased their flares. I know that was the case for me too. I quit for 2 years only to be one flare after another. I started back up (yeah I know, bad me) and my flares settled a bit.
Posted 1/6/2008 1:52 PM (GMT 0)
Thanks for the reply. I'm presuming that you're in the US? Perhaps they do thing slightly differently here in the UK or maybe it's just my GP. I was starter on 50mg of azathioprine for 1 week and then straight up to 150mg and I didn't stay on it long enough to get to target dose 200mg. The first day after the increase I felt really nauseous and then the second day vomited all day and each successive day for the remaining 2 and half weeks felt nauseous (about 2 hours after taking the dose in the morning). I also wasn't given advice as to what time of day to take it so took it AM after breakfast - perhaps switching to night time might have been better to avoid nausea? I'm now on 6 MP and taking 50mg each morning and so far so good - the plan is to increase to 150mg in a week again - should I switch it to night time to you think?

I'm really reluctant to take these drugs but obviously can't go on with these symptoms and hate the few side effects that I've had from the most recent course of steroids so feel I have no choice. I'm tempted to start smoking again as I still quite miss it and if it helps.....but worrried that it may not help and then I'm hooked again. I'm willing to rik the side effects of smoking in order to avoid side effects of other meds, stupid though that may be, I think it suits me and my lifestyle more. I read the other threads on smoking last night thanks.
Posted 1/6/2008 3:22 PM (GMT 0)
When I first started on 6mp, I was having horrible side effects too. My GI told me to take it in the morning. But under the advice of veteran 6mp/Aza users here, I started taking it at night before bed and noticed a world of difference. I was basically sleeping thru the side effects. Now that I've been on it for over a year, I don't have any side effects anymore - unless I have to do an increase, but even then the side effects are much more milder then when I first started.
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