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Remicade and Azathioprine

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Ulcerative Colitis
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Posted 12/13/2009 5:24 PM (GMT 0)
Does anyone know if you have to be on Azathioprine for Remicade to work?  I recently stopped Azathioprine and my first two Remicade infusions have been unsuccessful.  I just wonder if it because I am not taking both drugs at the same time.  Thanks.
Posted 12/13/2009 5:31 PM (GMT 0)
Hi Kimadennis; it's actually recommended that you are not on Azathioprine and Remicade at the same time because the chance of lymphoma is increased when taking the two together. When I started Remi, I was also on both but my doc felt the evidence relevant enough to take me off of it. Have you noticed any difference since your infusions? Some folks find it takes about three infusions before they start seeing any results. I say give one more a try and maybe add some rectal meds to get you over the hump. Take care.
Posted 12/13/2009 6:01 PM (GMT 0)
Oh thanks, that is great to know.  I wonder about my doctor sometimes as he is not very informative.  He insists that I space the Remicade 8 weeks apart but my symptoms are pretty bad with alot of bleeding.  I am am taking 40 mg of prednisone too.  I feel slightly better after each infusion and I have had two so far.  Do you know how many weeks apart the infusions must be?  I am also wondering if I should increase the prednisone to 60mg.  Thank you!
Posted 12/13/2009 7:01 PM (GMT 0)
well, the juries still out on the Imuran & Remicade situation- while it does slightly increase the risk of the lymphomas, the Imuran will help your body not make antibodies to the Remicade. When I went on Imuran, it was with full intention of being on it a few months, then starting Remicade. My GI feels that using the 2 together will help the Remicade to work better, in the long run. But yes, it does raise the risk of lymphoma. However, the risk is still miniscule. Whether both drugs are used, or just the tnf blockers. I guess it's all a matter of what you feel comfortable with.
Posted 12/13/2009 8:43 PM (GMT 0)
Yes, very true Eva Lou. I thought about my post to you kimadennis (while in the shower, where I do my best thinking!) and forgot to mention that I was leery of being taken off the Azth because of having symptoms again, but that hasn't been the case. I've been fine since being taken off about 2 years ago. As always, team with your doctor and make a list of questions for him/her. Remember it's your body, but you need to have a GI that teams with you and that you feel comfortable with. I actually went through two GI's before I found my incredible doctor. So, if you feel like you are not being heard, think of switching to another -- even interviewing them! Remember, you are in charge of you!
Posted 12/14/2009 10:50 PM (GMT 0)
Hi,  for what it's worth,  my son has been on Remicade now for over a year.  It took about 4 or 5 treatment before he noticed a significant change,,, and, he stopped taking everything else, including his Asacol, 6MP, no prednisone, and doesn't even take extra vitamins or Probiotic (although I tell him he should)  He feels good, all the little sores he used to get on his arms dissappeared.  He eats huge bowls of cereal, like Fiber 1 and Wheaties,,etc,,,that have lots of vitamins,,plus Activa but hates taking pills.  So far he is doing good.  He does notice that if he eats to much ice cream, (that he LOVES)  or

spagetti, or too many french fries,,he gets looser stools.  He lives with us, and I watch him like a hawk :-)  Hey, I'm his mom..!!    He didn't even get the H1N1 vaccine,, and is feeling good, not even a cold so far..knock on wood.  Before he got colitis,, (about 8 years ago)  he never got sick,,no flu, no colds,,,nothing.. I used to think the guy was super man,,as the rest of us would get these things.  AND  he even smokes!!  Go figure.

His doctor actually told him that for some reason, Nicotine helps colitis, no now he has no incentive to guit, although I tell him he should.  Oh well...this is one guys story.

Good luck with your Remicade treatments.  

Posted 12/15/2009 12:09 AM (GMT 0)
Our doc agrees with Eva Lou-she thinks the 6mp ( in our case) may help reduce the chance that antibodies against the Remi will build up. The Lymphoma cases are statistically small, but occur in adolescent males predominately. It is a risk, but in our case, we are about out of drugs, so we have stuck with the combo of drugs. It is working so far.
Don't be afraid to discuss increasing the dosage AND increasing the frequency of the Remi. Ours took 5 treatments to achieve full affect and that was at the 10mgs per kilo dose!
Posted 12/15/2009 11:53 AM (GMT 0)
     My doctor preferred me being off the 6MP when I started Remicade.  He is in agreement with Carol's doctor.
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