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Azathioprine Advice?

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Ulcerative Colitis
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Posted 1/6/2013 10:47 PM (GMT 0)
Hello! I am a new poster on this board though I have been a reader of all of your posts for a few months.

I have had UC since 1998 and am currently 34 years old. In general, I feel as though I have been very lucky. After getting my initial flare under control, I was essentially in remission until after the birth of my first child in 2006. Since that time, I typically have had 1 flare a year. A course of prednisone tended to do the trick.

However, it seems that my luck has run out. I have been dealing with back-to-back flares over the last year. I have been on WAY too many courses of prednisone (5 taper courses each starting at 40mg). I was very nervous about trying Azathioprine, but would very much like to be done with prednisone. So, I started Azathioprine yesterday. I am currently on 15 mg of prednisone and 4 Apriso twice a day. Right now, things with my UC seem to be under control (as in no blood, etc). I have some lower back pain (which is usually the first sign that I am about to flare) but other than things are ok. I decided to start the Azathioprine now, before needing to go back on a higher dose of prednisone.

So...give me your best Azathioprine advice. The side effects are scary, but I do understand they are rare. Right now I am only taking 50mg/day and will increase to 50mg/2x/day in a couple of weeks. The only thing I have noticed both yesterday and today is a feeling somewhat like heartburn. I am not certain that this is the Azathioprine.

Thanks in advance for your thoughts!
Posted 1/6/2013 11:05 PM (GMT 0)
Azathioprine worked really well for me for many years. I took 100mg for over 7 years.

It took about 3 months to initially start working. I used prednisone as a bridge before it kicked in.

I had no side effects except for some fatigue (which I never know if is the meds or the disease in general).
Posted 1/6/2013 11:20 PM (GMT 0)
Did you take Apriso even when you were in remission?
Posted 1/6/2013 11:54 PM (GMT 0)
Thanks, Pink.

Gary--Apriso is new to me. I was previously on Asacol but after starting with a new GI in August he pointed out that Apriso often works better when you are flaring (releases at a different pH level that Asacol). I wish I could say that I was good at taking my Asacol when I was in remission, but I was typically not. A mistake I will not make again!
Posted 1/7/2013 1:16 AM (GMT 0)
I was on 6mp which is similar to Aza for 6 years. It never worked right for me but it did keep me out of severe flares (I would still flare though which why I'm on Remicade now). But in the beginning, I had fatigue, headaches, mild nausea and mild hair loss. Once my body got used to it, the side effects went away.
Posted 1/7/2013 3:56 AM (GMT 0)
I've just started this drug as well and I'm nervous too. Three doctors that I spoke with in the last couple of days are saying to me it is the prednisone that we need to be more concerned of. Yay, eh.

Anyways, I don't have any advice, just thought I'd say I'm with you.

I'm on 40 mg of oral prednisone along with the imuran, I also had 4 days of solumedrol which is IV prednisone, I'm taking Mesasal and a Salofalk suppository to round it up nicel

I only had 5BMs today. Last week I was at more than 22, so the prednisone is doing it's job for me.

Good luck
Posted 1/7/2013 4:56 AM (GMT 0)
I've been on pred for ~6 weeks now, can't get below 15mg without my joint pain returning, although my stomach/stool is fine (could be Lialda) so I think I'm starting on Imuran Tuesday. I was going to start a month ago but things didn't quite work out.

First time I tried tapering I got down to 20mg before pain came back, this time I spent a week at 20mg pred with no pain but 48 hours after going down to 15mg my right wrist started hurting. I'm just a bit worried that I'm going to go on Imuran without truly needing to do it. I do know I need to get off the pred as soon as I can.

Anyone go on Imuran and get results faster than the 3 months they say?
Posted 1/7/2013 3:43 PM (GMT 0)
I took 6MP and also took Azathioprine. At 75 mg, 6MP made me sick (nausesa), complete loss of appetite, and had stomach cramps. I stopped it and all symptoms went away. I tried Azathioprine for another illness. At 100 mg it gave me drug induced hepatitis (ALT/AST enzymes went way up). Make sure you get your liver functions / enzymes tested on a regular basis and know what to look for for side effects. I think you should be getting some type of initial metabolite test to ensure you can metabolize it and then regular liver tests.
Posted 1/7/2013 3:56 PM (GMT 0)
I started Imuran a month ago and I think it's working. I have been tapering the pred (down to 15 mg today~) I think the pred is so much scarier than the Imuran. The aza is probably your best bet. Good luck
Posted 1/7/2013 3:56 PM (GMT 0)
I started Imuran a month ago and I think it's working. I have been tapering the pred (down to 15 mg today~) I think the pred is so much scarier than the Imuran. The aza is probably your best bet. Good luck
Posted 1/7/2013 7:40 PM (GMT 0)
Pink1- what made you stop azathioprine if it was working for you?

For those who has/had azathioprine working at a certain dosage (ex. 100mg), could you tell the drug worked even ever slightly at a lower dosage (ex. 75mg)? I went from 75mg to 100mg in December. I was at 75mg for many many months, and even now I can't tell if the drug is helping or not. No noticeable side effects though, which is a good thing, I guess.
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