HealingWell
Search Close Search
☰

Remicade or 6MP

Support Forums
>
Ulcerative Colitis
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 3/12/2015 6:50 PM (GMT 0)
Hey Guys,

So now that the pred is wearing off (on 10mg now), symptoms are slowly coming back. Doc said if VSL doesn't help and upping my delzicol dosage doesn't help next step is going either 6MP/imuran or remicade so I want to ask. Which 1 is better in your opinion and why?

My doc said he prefers remicade because apparently the side effects of 6MP (especially Lymphoma) are too high of a risk for his preferred method. He was saying remicades side effects and serious side effects are much lower. Which is higher cost?

Any opinion helps.

Thanks,
M
Posted 3/12/2015 6:59 PM (GMT 0)
Without question I would go on both. Imuran is dirt cheap, Remicade ranges between 30,000-50,000/year without insurance. Remicade is more effective but it is a 3 hour infusion, while Imuran is just a pill. However, they work synergistically and Imuran helps prevent developing antibodies to Remicade.
Posted 3/12/2015 7:03 PM (GMT 0)
you could try Imuran 1st, because I think he overstated the cancer risk, and it is cheap.

also it sounds like you have room to explore and are not in crisis-flare.

Also, when doing remicade studies are showing it will often lose effectiveness in 1-3 years if you are not also taking Imuran, ASA, or Methotrexilate or something to suppress forming antibodies to the Remicade molecules.
Posted 3/12/2015 9:40 PM (GMT 0)
If I was FORCED to choose between 6mp or Remi (I would never take either, but if I was forced to) I would choose monotherapy Remicade. 6mp is dirt cheap for many reasons b/c of it's known toxicity, and Remi is not b/c it has less side effects.

When taking both at the same time, you gain better therapy, but at the cost of risking even greater side effects.

Pregnancy risk: Category B (No evidence of risk in humans) vs Pregnancy risk: Category D (Positive evidence of risk)
Posted 3/12/2015 9:48 PM (GMT 0)

fightUC said...
If I was FORCED to choose between 6mp or Remi (I would never take either, but if I was forced to) I would choose monotherapy Remicade. 6mp is dirt cheap for many reasons b/c of it's known toxicity, and Remi is not b/c it has less side effects.

When taking both at the same time, you gain better therapy, but at the cost of risking even greater side effects.

Pregnancy risk: Category B (No evidence of risk in humans) vs Pregnancy risk: Category D (Positive evidence of risk)

1) Unfortunately, not everyone has the luxury of avoiding anything above 5-ASAs

2) The reason 6mp is cheap and Remi is expensive has nothing to do with side effects. Its a matter of patents and the cost of developing, mass producing and administering each drug.

3) The risk of cancer in both cases is about 0.004 - 0.006%, while the risk in the average adult population is 0.002%. Not really anything to worry about. The risk of colon cancer in patients with long term inflammation can be as high as 40-50%. Thats much worse.

4) Both drugs are safe for pregnancy (if thats even an issue).
Posted 3/12/2015 9:52 PM (GMT 0)
I would start with 6mp and see how it goes first.
Posted 3/12/2015 10:14 PM (GMT 0)
How much do your symptoms interfere with work and leisure? 6mp takes several months to work but I do not have personal experience with it. Remicade worked for me immediately. A definite life changer so I am biased. There is financial assistance for remicade.
Posted 3/12/2015 10:36 PM (GMT 0)
Well, if cost is your your primary concern then go with the 6mp as it is a generic and therefore much cheaper. My insurance policy has a $10.00 a month copay on generic prescriptions. Immunosuppressive medications, like 6mp, are often tried before biologics, like remicade.

6mp and remicade have basically the same risk factors, both extremely rare (lymphona, increased risk of infections like bronchitis, uti, etc) as others have stated. Immunosuppressive medications do have one difference, a skin cancer risk. You are advised to be more vigilant in using sun block, etc.

Remicade is billed at $6,600.00 for an 8 week dosage, my insurance disallows half that charge, so it becomes $3,300.00. My insurance pays all but $120.00, for which I am responsible. I use the remistart patient assistance program to reduce that to $50.00 out of pocket.

Remicade worked the best for me, of the two.
Posted 3/13/2015 12:52 AM (GMT 0)
Currently it's not interfering too much. I have to go maybe 3-4 times a day. It was once when I was at about 30-20 mg of prednisone so it's worse than it was. Also more mucus is coming back and more "wet" gas.

So if I'm hearing correct, if worse comes to worse and I have to pick, go for 6MP first and if that doesn't work remicade where I'll need 6Mp anyway?

Thanks,
M
Posted 3/13/2015 1:34 AM (GMT 0)
Yeah, that's the standard gastroenterologist protocol. Good luck,
Posted 3/13/2015 2:06 AM (GMT 0)
this thread has an article I posted that studied antibody formation

www.healingwell.com/community/default.aspx?f=38&m=3247882
Posted 3/17/2015 6:06 AM (GMT 0)
How much (mg) of Pred did you take and for how long? My son was on 40mg. Doctor said wasn't working and we were days away from Remicade. We had done the tests and insurance was on board. Then the Doc upped the Pred to 60mg and things started getting better fast.
✚ New Topic ✚ Reply