I've been on 6MP (a sister medication to azathioprine) for 3 years and have yet to experience a side effect from it, side effects are rare. Nausea can occur only upon starting the med (for a few weeks) in roughly 20 percent of people starting it. Taking aza just before bed with a sack can help reduce the odds of experiencing it. Those who experience it say it goes away in a few weeks.
Yes, your doctor would prescribe azathioprine (the second class of UC meds) if he/she believes the first class of medications (your pentasa) isn't strong enough to control your UC symptoms. If you can successfully get off of pred and sustain without aza then that's great, sometimes we can do this and other times we cannot. You can certainly try this, if you feel strongly about
it are feeling well and want to be sure aza is absolutely necessary. However don't lie to your doctor, tell him/her so as good doctors will listen and try to work with you. But I'd frame it as try this first and then go on azathioprine if it's necessary. Just know it takes 3 months for azathioprine to work, delaying treatment can mean a longer recovery if you do actually need it and delay.
Yes, we're all a bit anxious when prescribed a new medication especially when we start reading about
side effects listed for them. What really helped me was comparing the risks to the benefits. The odds of azathioprine helping with your UC symptoms are about
70 percent. The odds of adverse side effects are less than 1 percent.
It seems the prospect of immunomodulators (like aza) or biologics seem to scare folks the most. However, your pentasa can cause liver-failure, heart inflammation, and abnormal blood results (all very, very rarely in a less than 1 percent frequency). It's the same with the azathioprine, some scary things can happen but tgey are very rare (often less than a fraction of 1 percent of patients experience them).
I always find it helps to know what a drug does and why. Azathioprine is part of the second line treatment for U.C. which reduce the white blood cell count within the body. White blood cells cause inflammation within the body, the less you have the better your UC gets. When we flare our WBC are always on the high end of blood tests. We need to level of WBC to ward of infections, so they monitor our blood through tests, initially frequently and then backed out to tri-monthly for the duration that you are on that medication.
If you want to take a deep dive into risks versus benefits then i suggest the following from the Crohn's and Colitis Foundation of America. It gelped me greatly when deciding on going on an immunomodulator.
Webcast:
programs.rmei.com/CCFA139VL/presentation/player.htmlTranscript
: http://www.ccfa.org/assets/pdfs/risk-and-benefits-transcript
.pdf