Shingles and 6MP

Hi all,

It's been awhile since I have posted. I did a search on Shingles, but couldn't quite find what I was looking for.

I have been on 6MP for the last seven years and it has mostly kept me in remission. I orginally started with just a 50 mg dose, but now am up to 100 -125 mg every other night.

Three or four years ago I had my first case of shingels, very mild and I recovered from it quickly. Two months ago, I came down with them again. This time it was more severe. The rash wasn't too bad, but the nerve pain was terrible. It took me three weeks to recover. I have an appointment with my doctor tomorrow, because I think they are coming back. No rash is present, but the same sensation around my lower back is there. It is a very unique feeling and I wouldn't be surprised if I didn't see the rash in a few days.

My concern is that over the last year I have had to increase my 6MP dosage quite a bit (think I was at 75 mg nightly at this point). A little over the year ago, I started flaring due to stressful work situations and have been trying to keep the flare at bay. As I've increased my 6MP dosage I have been able to control my UC, but I'm concerned it is making me more susceptible to other things like shingles. Does anyone have thoughts about this?

My liver and blood tests have all come back fine on the higher 6MP, but I have to say in the past three months as we've increased the dosage yet again, that I don't feel awesome. My body always seems to ache just a little bit when I wake up. I'm always slightly lethargic no matter my diet, sleep, health, etc...Maybe my body just needs more time to adapt to the higher dose?

My doctor has talked to me about other medications, Remicade, Humira, even a trial for Methotrexdate. At what point does one decide to try something else? Or should I stay on the 6MP because it's working decently at this point. My doctor said if I keep re-flaring through the higher medication then it probably is time to try something else.

Any thoughts would be appreciated.

6mp lowers your immune system, therefore it is easier for you to get an episode of shingles.
as for the other medications (humira, remicade....) they are not as scary as they are made out to be, the side effects that are assosiated with them are scary but they are also quite rare
but have you tried both rectal and oral mesalamine medications?

I think you should stay on the 6MP for now and get the shingles vaccine as soon as they allow you to so you don't get it yet again. It can come out during periods of stress. They should have already given you the vaccine. You don't want to change from something that's basically working because you don't know if the others will work or not. Too much of a gamble. Stress releases histamines so you may want to try a daily generic Allegra during times of stress. Might help, might not.

Sorry to hear that you've been hit by shingles. I think that one is supposed to get such vaccines BEFORE starting immunosuppressants-- be sure to confirm with your IBD doctor if you consider getting any. / Old Hat (34 yrs with left-sided UC; presently in remission taking brandname Colazal)