6mp Question-should I be worried?

[McM17]

Hi!

I was started on azathioprine in August 2013. About two months after I started it I began to feel nauseous. For an entire month I felt mildly nauseous until suddenly I started throwing up at least once daily. I tried taking it with food and was told to take prevacid with it. That helped for a little while, but eventually even the double dose of prevacid wasn't making a difference, and we decided after I got horrible mouth sores along with the vomiting that I couldn't tolerate aza.

I was at the doctor last Wednesday. It has been five days of 6mp and I threw up again this morning. I know that nausea is not abnormal at the beginning with these, but should I be worried? Should I call my doctor about it, or should I wait a bit longer to see if it just goes away? After the aza, I don't really want to feel that awful again!

 

[nogutsnoglory]

If you continue to throw up then yes because you may be having a visceral reaction. Nausea is a side effect that is common but vomiting is more severe. They may get you off, adjust the dose or prescribe anti nausea meds.

 

[Miss Underestimated]

I've been taking it for a couple of months now. No reaction at all. It's so individual. Doctors can test you to see what you can tolerate and what you will respond to. I guess not all of them do - there are different philosophies about it.

 

[smiley95]

No need for you to be suffering with that. At the very least, they can give you anti nausea meds. It is for sure something to figure out.

 

[McM17]

Thank you all! I'm going to call today and see about getting something to help!

 

[Patricia56]

6-MP and AZA break down into the same basic chemical compound - 6MP.

So it makes no sense to me why your doctor would have switched you like that. It's my understanding that most people who can't tolerate one version of 6-MP (Imuran, AZA, 6MP) can't tolerate the other versions either.

If you are also having abdominal pain with the nausea you may be getting pancreatitis a well known and common side effect of 6-MP.

Is your doctor ordering any labs for you?

If your doctor is not doing labs at least every 2 weeks since starting you on these meds I would suggest you find another doctor if possible.

Either that or ask him to run labs at 2 weeks, 4 weeks, 6 weeks, 8 weeks, 10 weeks and 12 weeks. Then you can drop to monthly labs for 3 months and after 6 months labs should be done every 3 months. This is the widely accepted safety monitoring plan when prescribing these drugs.

Labs should include CBC with differential, complete metabolic panel and lipase (lipase has to be ordered separately from the complete metabolic panel and helps to screen for pancreatitis)

Good luck. The alternative to 6-MP is methotrexate.

 

[McM17]

I'm getting labs every two weeks- I believe I go in next Wednesday. I'm supposed to see my doctor again in a month to check in, unless I have problems and then I go in sooner.

 

[Patricia56]

You might try taking it at night before bed to see if you can sleep through the nausea. Asking your doctor for Zofran may also be helpful. Perhaps lowering the dose would be worth a try. Splitting the dose might help too.

Did you get any benefit from taking the AZA? You were on it long enough that you might have had some improvement assuming you were at the right dose.

The thing that bothers me about what you've shared is the mouth sores that you and your doctor think were from the AZA. I would have thought that the mouth sores were from CD not the med. In that case it sounds like the AZA is not helping.

If not then I would hesitate to keep on since it sounds like you can't tolerate this med.

Definitely worth talking to your doctor about sooner rather than later.

 

[McM17]

I asked my doctor and we're trying splitting the dose in half. I've always taken it at night, and I sleep just fine, but throw up in the morning.

I noticed an improvement right away with the AZA, and have already noticed some improvement with the 6mp, so I'm hoping to be able to take it!

My doctor said that mouth sores are a rare side effect of the medicine, especially since I have no disease in my stomach or upper GI tract. As soon as I stopped taking the imuran the mouth sores went away and haven't come back.

Depending on how I do with a split dose I am either going to attempt to take the 6mp or try something else. The immunosuppressant along with remicade seems to work well for me, if I can tolerate it.

 

[NurseAdam]

6-MP and AZA break down into the same basic chemical compound - 6MP.

So it makes no sense to me why your doctor would have switched you like that. It's my understanding that most people who can't tolerate one version of 6-MP (Imuran, AZA, 6MP) can't tolerate the other versions either.

If you are also having abdominal pain with the nausea you may be getting pancreatitis a well known and common side effect of 6-MP.

Is your doctor ordering any labs for you?

If your doctor is not doing labs at least every 2 weeks since starting you on these meds I would suggest you find another doctor if possible.

Either that or ask him to run labs at 2 weeks, 4 weeks, 6 weeks, 8 weeks, 10 weeks and 12 weeks. Then you can drop to monthly labs for 3 months and after 6 months labs should be done every 3 months. This is the widely accepted safety monitoring plan when prescribing these drugs.

Labs should include CBC with differential, complete metabolic panel and lipase (lipase has to be ordered separately from the complete metabolic panel and helps to screen for pancreatitis)

Good luck. The alternative to 6-MP is methotrexate.

Hey one of the reasons its swapped if you cant tolerate Aza. Yes they both end up as the same drug 6mp. But a lot of peoples bodies cant tolerate the breaking down process of aza to 6mp this is where most side effects come from, the breaking down process also causes a few unwanted by-products which can also cause some unwanted side effects.