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6mp questions

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Ulcerative Colitis
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Posted 3/9/2010 2:22 PM (GMT 0)
Can someone give me the low down on this med?  There is a possibility I'll need to start taking it and I don't know much about it.  My UC has been manageable for the last 10 years with just Asacol and Rowasa, with the few occassional rounds of prednisone, but this last flare up had my GI thinking about putting me on 6mp.  I'm gonna start researching it and have a doctor's appt later this month, but thought I would come here too and see what you all have to say about it.

How long does it take to "start working"?

What side effects did you have?

What do you like about this drug?

What don't you like about this drug?

I'm coming off prednisone (at 15 mg this week) and have started noticing some UC symptoms.  This is NOT the norm for me when weaning off prednisone.  I take it, go off it, and stay in remission for months.  I have another appointment in a couple weeks and I want to be prepared with questions when I go in just in case he brings up the 6mp again.

Thanks in advance.

 

Posted 3/9/2010 2:33 PM (GMT 0)
     I have lots of experience along this line Trixy.

 

     My doctor started me on 6MP about eight years ago while I was still on prednisone.  It took approx. 3 months to "kick in" while still on the prednisone.  I enjoyed a two year remission but then started to flare yearly.  My usual dose of 6MP was 50 mgm. 

     In May of 2008 I suffered a major flare.  When admitted to the hospital my pancreatic enzyme levels were 4x the normal limit.  Doctor took me off the 6MP immediately.  I was in the hospital 10 days.  At the end of my stay, my pancreatic enzyme levels returned to normal.  In June of 08 the doctor placed me back on the 6MP with careful monitoring of both liver and pancreatic enzyme levels.  I want to add that he always had me go for monthly CBC's as 6MP will lower your white count. 

     Remission from Nov of 08 to May of 09.  Flared again...doctor increased the 6MP to 100 mgm.  This made me feel terrible....fatigue, nausea and white count plummeted to 1.6.  Bilirubin 2x normal but pancreatic enzymes ok.   Still flaring.  Doctor took me off the 6MP and started Remicade in Nov.  Thought that helped but I was still on the prednisone.  Remission for about a month.  After 3rd infusion flared again, back on prednisone.  4th infusion 3 weeks ago...no change.  Looking at surgery.

     I believe 6MP is just another band-aid.

Posted 3/9/2010 3:02 PM (GMT 0)
1. 3-9 months is probably the range of time to build up to a therapeutic dosage.
2. No side effects noticed in terms of how I feel.

Started this drug in June of 2009 at a dosage of 50mg. Dosing is generally based on weight - optimal is around 1 to 1.5 mg per kg of body weight. For me, I weight 75kg so optimal (in theory) is 75 to 112.5mg of 6MP. After two months on 50mg I upped to 75 and then to 100mg after 4 months. I had continuous blood monitoring - CBC and liver enzymes. All were normal. After 3 months at 100mg my liver enzymes came back 2x normal. Dropped to 75mg and LFTs returned to normal. Had the Prometheus test to determine 6MP metabolites at 75mg. This came back showing that 75mg was below toxic levels and slightly below what is considered therapeutic.

With regard to my Crohn's, I haven't seen much improvement in 9 months on it. My GI is still pushing it though. Apparently he's had lots of luck on it.

Good luck to you!
Posted 3/9/2010 3:41 PM (GMT 0)
i've had colitis since 1985,was in hospital for 28 days lost 45lbs ,was a very sick little boy.Bad flare in 86,both times  prednisone got me better.Only had minor flares since 86,rowasa always got rid of bleeding.Last year had a flare that wasn't as bad as in the eighties,but was worse than the minor ones.Big D all day-some blood,started pred-40mg in early summer,started 6mp in August[also taking apriso,folic acid,rowasa,ACIDOPOLOUS also],in the last 2 weeks starting to get to having almost normal stools,can't overeat or the next day might have trouble holding it in when necassary.Eating anything i want.Im a big guy who loves to eat,eat more smaller meals.I'm currently on 125 mg of 6mp[i'm 6-5,usually 230lbs-now 212lbs].So i'm not certain what exactly is getting me better,but the 6mp is got to be helping[only taking 2.5mg of pred].GOOD LUCK
Posted 3/9/2010 6:14 PM (GMT 0)
How long does it take to "start working"?
For me I started seeing a difference at 7 weeks and it continually got better. After being in remission for about 6 months, my daughter gave me a stomach bug and I started flaring again. I then found out that I can't get into the therapeutic range or I become toxic.

What side effects did you have?
Headache, nausea, fatigue and mild hair loss but by taking it night, the side effects didn't bother me as much. Once my body got used to the med, the side effects went away

What do you like about this drug?
It made me capable of getting off the steroid enemas that I was previously on for almost a year continuously.

What don't you like about this drug?
The frequent blood testing. And I still get some fatigue but it's not that bad. Oh and it makes a bit more sensitive to heat especially in the summer time.
Posted 3/10/2010 12:42 AM (GMT 0)
Hi, Trixy-- I can't answer your Qs from personal experience, but am sorry to read that you're still having trouble getting out of this flare. My gastro, who subspecializes in IBD treatment, is very worried about longterm effects of repeat steroid dosing-- (especially since recent research shows that Pred can change the T-cells in a way that prolongs inflammation instead of reducing it.) -- & so tends to put patients on 6MP in combo with 5-ASA meds, sometimes also adding Xifaxan (non-systemic antibiotic) to the regimen for a few months. In case you want to see specialist rationale for Rx meds, look up E.J. Scherl article on 5-ASA responders/non-responders on gastroendonews Website, and/or The Changing World of IBD by Scherl & Dubinsky (hardcover text). / Old Hat (30 yrs with left-sided UC; presently in remission taking brandname Colazal)
Posted 3/10/2010 1:28 PM (GMT 0)
Just a quick flyby response. Thanks for the replies! I'll be back later today when I get some more time to respond. Thanks!
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