Can someone inform me on 6mp

I want to know about 6mp as I’m going to bring it up to my doctor. For anybody who has followed my posts, I basically have my doctor saying I’m in remission when I’m clearly flaring just because a stool test said I was “completely normal”. But I remember someone telling me this is a good drug to be on and it can help a lot , as the remicade & meslamine enema duo is really doing nothing for me. This is my last strand before I switch doctors.

6MP is a generic medication, and therefore should be affordable at your pharmacy. I've been on 6MP since 2012 without any side effects. It take 1.5 of the 50mg tablets a day (a total of 75mgs). 6MP is a weight-based medication. I weigh 155 pounds or 70 kilograms. The medication is dosed at 1.0mgs (low end) to 1.5mgs (high end) per kilogram of body weight. So, my range of dosing would be 70mgs (low end) to 105mgs (high end) a day. Often they start you intentionally at a very low dosage, watch your blood tests and then increase the dosage as you get good results back from CBC, HFT, and Thiopurine Metabolites tests (described more later).

How the medication works. When we flare, our immune system creates lots of White Blood Cells (WBCs), blood tests show us as high and above normal. WBCs are our immune system's attack-dog, directly causing inflammation within the body (specifically within the large intestine for UC). The less WBCs you have, the less inflammation you have, and the better your UC symptoms are. However, it is important that your WBC count does not get too low, so you get routine blood monitoring as a precaution. Immunomodulators work by slowing the rate in which your body can create WBCs. 6MP does nothing at all about the WBCs that are already within your circulatory system. When those existing WBCs are cleared as part of your body's normal processes, there are less WBCs available to fill their place and that's when the medication truly starts working and you begin feeling better.

Immunosurpressants take 2-3 months to build up to therapeutic levels within the body (for the above mentioned reason). Immunosupressants initially require blood to be monitored weekly (for the above mentioned reason). After good results are collected monitoring is often reduced to biweekly, monthly, and finally trimonthly. I've been on tri-monthly monitoring for years.

Before starting 6MP you can ask for a TPMT blood test
Helps to see if your genetics might result in immunomodulators NOT being effective for you.
www.questdiagnostics.com/testcenter/BUOrderInfo.action?tc=18831&labCode=SJC
/www.labcorp.com/test-menu/35601/thiopurine-methyltransferase-tpmt-enzyme-activity-erythrocytes

Standard, ongoing blood tests for monitoring of 6mp/Imuran/azathioprine

• CBC with Differential. This test is a Complete Bloodcell Count (CBC). These drugs intentionally lower your white blood cell count, and this test monitors to make sure it doesn't get too low.
  
• Hepatic function panel (LFT). This test looks for elevated liver enzymes a warning sign for adverse reactions to these drugs.

Your lab should enter your tests as a "standing order" within their system. When you arrive tell them you have one, and paperwork won't be necessary with every visit, as you're already in the system. Test intervals are often weekly, then biweekly, then monthly, and then remain at trimonthly while you're on these drugs. After multiple good results, your doctor will likely decrease their frequency.

Thiopurine Metabolites Diagnostic test
A diagnostic test for immunomodulators that determines if you have the proper concentration of that medication in your system for optimum therapeutic (healing) effect, and it is helpful in establishing proper dosing for individuals.