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Allopurinol + 6mp?

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Posted 9/14/2010 9:38 PM (GMT 0)
I seen my GI today and because I can not metabolize 6mp correctly and I'm in a stubborn flare, he told me he was going to lower my 6mp mg's and add in Allopurinol. Supposedly this is supposed to help reduced any toxicity and improve the performance of 6mp. Has anyone here ever been on this combination and did it work? I am also scheduled for a lovely sig next Tuesday so he can a small look to see what we are dealing with.
Posted 9/15/2010 11:00 AM (GMT 0)
Ohhhh No one huh? I get to be the guinea pig???! LOL
Posted 9/15/2010 11:49 AM (GMT 0)
There are some small studies at pubmed.gov, key words: allopurinol 6mp

http://www.ncbi.nlm.nih.gov/pubmed/18299738

Good luck.

Posted 9/15/2010 12:20 PM (GMT 0)

I was on that comination for that same reason in 2009. If I remember right 6mp has two metabolites, one of those levels was toxic  and I was  still flaring. My GI called another GI at UNC and was told to add Allupurinol and to decrease my 6 MP to only 25 mg per day, I guess it was supposed to gear the 6mP towards producing the effective metabolite without the toxicity. I was in remission for 5 months (than my meds were stopped and the rest is history).

AC

Posted 9/15/2010 12:51 PM (GMT 0)
Hi Sherry - I did a search and found this:

https://www.healingwell.com/community/default.aspx?f=38&m=1061004

from our forum, and also someone had posted they were being put on it in the Crohn's forum, but like you, they were just starting and asking questions.

I so hope this is the key combination for you!!
Posted 9/15/2010 12:52 PM (GMT 0)
Yeah, that is my problem too. I just can't metabolize it right without going into toxicity so that is why my GI decided to add in the Allupurinol with the reduced 6mp at 25mgs. I don't want to get my hopes up on this new additional med because I have been let down before so I am just going to cross my fingers and hope that this works!

Thanks Seconder for the link. I tried doing a search myself and the studies are limited so I couldn't find that much info about it. I guess this is a fairly new approach to toxic 6mp and controlling stubborn IBD.
Posted 9/15/2010 12:54 PM (GMT 0)
Songlady, we must've been posting at the same time. Yes, I seen that post but I was hoping that someone with Uc instead of CD has tried this combo with good results :)
Posted 9/15/2010 1:01 PM (GMT 0)
Looks as if maddypoo was on that combo, from UC, but she hasn't been here in a few years (maybe she's doing so great she's out kicking her heels up....?!)
Posted 9/16/2010 9:07 PM (GMT 0)
Red, I have the same exact problem with 6mp and my doctor recommended I add Allopurinol. Have you seen any improvement? She said it can take a while to get into your system. I have to get frequent bloodwork now.
Posted 9/16/2010 10:28 PM (GMT 0)
I haven't actually started it yet. I have to have a sig done on Tuesday and then I will start it. My GI wanted the 6mp to wane a little in my system before I start on Allopurinol since I'm at a somewhat high dose of 6mp at the present time.
Posted 9/16/2010 11:08 PM (GMT 0)
Do you take 75mg 6mp? I am on 50. I saw the toxicity amount in my system when I was on 75mg and it was pretty bad. I hope this stuff helps so I can increase back to 75mg without the toxicity increasing.
Posted 9/17/2010 12:19 AM (GMT 0)
I take 100 mgs on Mon and Thurs, 50mgs rest of the week. With the Allopurinol, you can decrease the amount of 6mp because less is needed to get the desired effect. When I start Allopurinol, my GI wants me on only 25mgs of 6mp to start.
Posted 9/17/2010 1:01 AM (GMT 0)
I am staying at 50mg and starting the allopurinol 2x a day. I hope it helps. Are you close to the theraputic range now? I was not close but I was much closer at 75mg than I am at 50mg. My toxicity is at the max on 50mg. Is this how your results are?
Posted 9/17/2010 1:17 AM (GMT 0)
No, I never got into a good range. No matter how much my doc increased my 6mp, I always stayed at the very lowest end. I had one test come back toxic on the low end and for a while there I had to keep going in for more frequent blood testing. But luckily my numbers rebounded and I got out of the toxic range but my doc was afraid of raising my 6mp dosage because of that one test.
Posted 9/17/2010 1:41 AM (GMT 0)
I am not sure if I am describing the #s correctly. There was a theraputic # and then there was a toxicity #. It said the theraputic should be around 200 (from what I remember) and the toxicity should be below 5000?

My liver tests have never shown anything to be concerned about but the toxicity # worries my doctor enough to keep me at the lower dose where I am getting minimal theraputic benefits. I hope adding this allopurinol brings the toxicity down. Maybe things will balance out and we will get into the range we need to be in. I am probably only getting 15% of the maximum benefit. I tried to get details but I never remember everything and if I get too any details I become hypochondriac and obsess.
Posted 9/17/2010 12:14 PM (GMT 0)
I'm not sure on the numbers. But yes, there are two sets of numbers. Like you said, one shows the therapeutic range and one shows toxicity.

My GI showed me a graph from my last set of tests and on one graph had the therapeutic range and the other toxicity range. When he raised my 6mp, the therapeutic range never budged from the low end of the chart but the toxicity range went up. But my doc did say that I was in around the 5-10% range of effectiveness and I was in the small category of Uc'ers that showed no or very little benefit from the 6mp.

So let's keep our fingers crossed and that this Allopurinol helps us!!! :)
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