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Ulcerative Colitis
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Posted 11/5/2017 6:46 PM (GMT 0)
I have always said/thought that it doesn't seem right to take medications that have side effects worse than the underlying problem they are meant to treat (think of drug commercials and all the fast talking at the end) but I'm now at the point where the next step is azathioprine. Given my seeming ability to enjoy most side effects of all the drugs I've been taking I think I'm a bit gun shy. I've had the prescription for almost a week but still haven't started it. I've been on prednisone on and off for over a year, this last go round has been since March and I really need to get off it but had bad relapse the last time I tried. I guess I am just whinging and need to buck up and get on the azathioprine, right?
Posted 11/5/2017 7:32 PM (GMT 0)
Prednisone is the most dangerous medication available for UC when taken long term. Pred will cause one or more of the following irreversable changes to your body when taken long term. Pred is bone wasting and can cause osteoporosis when used long term. I have osteopenia from my cumulative 2.5 years on pred. Pred causes glaucoma. Pred causes type ii diabetes. Use it briefly as a rescue med and then rely on other maintenance medications that are safer (including azathioprine).

Everyone is a little nervous when trying a new class of medications, myself included. For me that worry was for naught. I've been on 6MP (a sister medication to azathioprine) for over 4 years and have yet to experience a single side effect from it. Few experience side effects from azathioprine.

Looking at the actual risks versus benefits helped me a lot when pondering going on 6mp. The odds of aza improving your uc symptoms are about 70 percent. The worst of the symptoms (black box warning) occur in less than 1 percent of UC patients (more precisely 0.04 percent versus 0.02 percent of the population). The benefits far outweigh the risks. So, you're talking very, very long odds. Nothing at all to loose sleep over.

I recommend reading/watching the following from the Crohn's and Colitis Foundation of America (also the source for these statistics):
Webcast: programs.rmei.com/CCFA139VL/presentation/player.html
Transcript: http://www.ccfa.org/assets/pdfs/risk-and-benefits-transcript.pdf
Posted 11/8/2017 2:29 PM (GMT 0)
Well, I finally started taking them Monday morning. No side effects at all, at least so far. Now to wean off the pred!!
Posted 11/8/2017 4:17 PM (GMT 0)
If I remember correctly it takes like 4-8 weeks for azathioprine to actually get to any kind of level in your body. So side effects can still happen more than just 2 days later, just a warning. If you change the level of your meds from let's say 50 to 100mg it takes that same time for the 100mg to take effect. I may be wrong on overall length period but it is a few weeks for sure.
Posted 11/8/2017 4:27 PM (GMT 0)
I was more worried about nausea and vomiting as the pharmacist warned of this for the first week or so. I have stuff I need to get done, can't afford to be out of commission!

I think the total time to take effect is potentially something like 3 - 4 months, but due to the bloodwork I did I am at full dose already (100mg x 2/day). I go back to the GI in 6 weeks, will probably have more bloodwork done then.
Posted 11/8/2017 4:46 PM (GMT 0)
Azathioprine will take about 3 months to reach maximum therapeutic (healing) effect within your body. So, I wouldn't rush off of the pred. Even though, I know, we all hate pred and want to be off of it yesterday.

As Bul101 explained, it will take 6-8 weeks for the first pill to have an affect. We start aza at a low dose, and then later increase that dose. The increase in dose takes 6-8 weeks to be noticeable. So, that gives you about 3 months from start point to the point where we feel the affect of the higher dose.
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