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Imuran and Remicade

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Ulcerative Colitis
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Posted 2/21/2008 10:30 PM (GMT 0)
Hi all!

Did anyone start remicade and stay on imuran? At what point did you stop the imuran? Aren't there risks to being on both at the same time?

My Gi wants me to stay at 150mg imuran and begin remicade soon. Should I be concerned?
Posted 2/21/2008 10:53 PM (GMT 0)
I stayed on imuran until some recent studies showed that the slightly increased incidence of certain types of cancer with Remi appears to be primarily for people who are on both Remi and Imuran. At that point, my GI gave me the option. Since I didn't feel the Imuran was doing much for me anyway, I chose to discontinue it. This was about a year and a half after I started the Remicade.
Posted 2/22/2008 12:52 AM (GMT 0)

I'm on both.  I actually started the Remicade first because I needed to get out of a severe flare - FAST!  Then I started the Imuran.  It's pretty common practice to be on both from what I understand because the azathioprine helps to reduce the risk of building up antibodies to the mouse proteins in the Remicade - thus rendering the Remicade useless.  I've been on the Remicade for 2+ years and the azathioprine slightly less than that.   I've been doing great!  My doc is hoping to wean me off the Remicade completely (not before Humira is approved in case Remicade won't work 2nd time around) and leave me on the Azathioprine.  He likes it better this way because he feels there is more long term data on the aza than on the Remicade.

Good luck!  Hope it works as well for you as it does for me!  :)

Posted 2/22/2008 5:31 AM (GMT 0)
My GI pulled me off the azathioprine COLD TURKEY last year because of the reports. You can go on methotrexate to reduce the build up of antibodies to Remicade.
If you were already on Imuran and started Remicade doesn't that mean the Imuran wasn't helping anyway? Methotrexate you just take one time per week.
James
Posted 2/22/2008 9:53 AM (GMT 0)
but my understanding is that methotrexate - in and of itself - has some potentially concerning side effects (I don't know how it interacts with remi) and my GI says it doesn't work as well in UC as in Crohns.

my guess, Kelly, is that it doesn't matter what you do in the short term. meaning, if you stay on both for 6 months, for example, then wean off Imuran, likely your body won't have any major effects of being on both at once. I suspect the concern of increased cancer risk is from prolonged use of the two in tandem. just my first thought.
Posted 2/22/2008 2:48 PM (GMT 0)
Thanks for the input...

gardnerjames, my gi won't put me on methotrexate becuase my husband and i want to get pregnant in the next year or so. It's a big no no for pregnancy.

They said my Gi will be at my first infusion so i can ask him anything i come up with. I'm wondering if there is a way to test for whatever cancer risk there is. Wouldn't it make sense to check after six months or so? Now I am just getting excited to start remicade. I just want to feel better. The fear is gone!!! On to the impatience!
Posted 2/22/2008 4:08 PM (GMT 0)
I'm sure if there was a test they would give it to all of us before starting remicade. The other option is to not taking anything with your remicade. My GI also mentioned that to me. I, obviously, am not planning to get pregnant so he wanted me to be on the methotrexate "just in case". I guess what I would do is ask your GI what the risk of building antibodies is if you don't take anything in conjunction with it.
James
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