I was on 6-MP from 2008-2011 (after remission was induced by a long course of Prednisone), then I went off the drug because I was doing well. Now in 2018 I've had a painful flareup (luckily no blockage or surgeries, but I had a colonoscopy that showed moderate inflammation throughout, particularly around the terminal ileum) and my new doctor wants me to go on Azathioprine (50 mg to start, then increase the dosage as my body tolerates it). I'm doing better now but I'm not in remission, and he's suggesting this as either a monotherapy or in conjunction with Pentasa. I've veto'd Pentasa because I tried that for a while when I was first diagnosed in 2007 and it made me feel awful. Now with Azathioprine I'm worried about a few things:
1) I tolerated 6-MP with minimal side effects (minor hair thinning at first, slightly yellowed eyes when I have Gilbert's syndrome anyway, bruises/cuts lasted longer), but Azathioprine will be new. Are there benefits for going with this over 6-MP? I understand that it can be more potent, but I was on a relatively low dosage of 6-MP (50 mg/day or less) and that seemed to do the trick, so I wonder why he wouldn't suggest trying 6-MP again. I'm nervous about jumping into this, but I need to do something to try to stop the cramping and inflammation, and it seems like Aza/6-MP is the backbone of treatment for most patients that can tolerate it.
2) I've heard that Azathioprine/6-MP may not do much unless remission has already been achieved. Have any of you achieved remission (of course it's hard to know if the drug itself induced remission) and maintenance while being solely on one of these drugs? The risks of the drugs seem rather large for this uncertainty...
3) I saw this notice in the drug facts: "Avoid contact with people who have recently received live vaccines." What does this mean specifically, as in how long do you have to avoid them? A number of my close friends either recently had a baby or are about to have a baby, so I'm really curious how long I would need to stay away from the vaccinated kids if I go on Azathioprine. Do I also need to avoid the adults who have been around the kids?
Thanks for reading and for any anecdotes/advice!
1) I tolerated 6-MP with minimal side effects (minor hair thinning at first, slightly yellowed eyes when I have Gilbert's syndrome anyway, bruises/cuts lasted longer), but Azathioprine will be new. Are there benefits for going with this over 6-MP? I understand that it can be more potent, but I was on a relatively low dosage of 6-MP (50 mg/day or less) and that seemed to do the trick, so I wonder why he wouldn't suggest trying 6-MP again. I'm nervous about jumping into this, but I need to do something to try to stop the cramping and inflammation, and it seems like Aza/6-MP is the backbone of treatment for most patients that can tolerate it.
2) I've heard that Azathioprine/6-MP may not do much unless remission has already been achieved. Have any of you achieved remission (of course it's hard to know if the drug itself induced remission) and maintenance while being solely on one of these drugs? The risks of the drugs seem rather large for this uncertainty...
3) I saw this notice in the drug facts: "Avoid contact with people who have recently received live vaccines." What does this mean specifically, as in how long do you have to avoid them? A number of my close friends either recently had a baby or are about to have a baby, so I'm really curious how long I would need to stay away from the vaccinated kids if I go on Azathioprine. Do I also need to avoid the adults who have been around the kids?
Thanks for reading and for any anecdotes/advice!