Allopurinol

[Splasher]

Has anyone been on this medication? I have been given this in combo with azathioprine after the aza affected my liver. I had alot of bad stomach pain when i was on the aza so am really nervous about re-taking them. My GI has said the allopurinal will tame the side effects, would appreciate anyone else's experience with these?

 

[secrets]

I take Purinathol every day. Is that the same drug. I was on IMURAN, but had devasting side-effects from it. The switch to Purinathol was miraculous.

 

[PsychoJane]

I can't speak for my own experiences, but I know that this combo is a bit unusual... so I went to read some published studies and I got my answer. They have been published at the beginning of last year but are based on research made by another team around 2005 so it is not new new.
If I may make complicate things simple, they notice that some AZA/6MP users produce more of a certain metabolite(6MMPN) than others. That metabolite is known to be hepatotoxic (affects your liver). Introducing the allopurinol apparently helps getting a better ratio between 6MMPN and 6TGN(another metabolite that helps the Crohn) and may therefore be responsible for an increase of the therapeutic effect. The studies state this " they showed a general improvement in clinical outcomes (reduction in steroid usage and improvement in disease activity scores) and a normalization of liver function tests."(Sparrow(2007) in Gardiner, Geary, Burt and al.(2011))

Did they reduce your AZA dose? Cause it specify that everywhere, AZA needs to be reduced by 25-50% of the dose they would normally give you because the Allopurinol will makes the AZA level in your blood higher than they would normally be so be careful about that. On the same idea, be really assiduous with your blood test. This combo may mess with your WBC big time so you don't want to neglect any blood tests!!

 

[Splasher]

thanks that really helped alot, a search didnt reveal alot of posts on folks taking this particular drug and i didnt know it went by another name, yes they did reduce my aza dose, and i will make sure not to neglect any blood tests, tyvm for the info and replies, much appreciated

 

[Johnnysmom]

My son was put on Allopurinol about a month ago. He started taking 6mp 50mg in October. They said he didn't have therapeutic levels in his blood so they upped it to 75mg of 6mp. Then they said that his body was metabolizing it too quickly and they prescribed the Allopurinol (50mg) with 6mp back down to 50mg. They called yesterday and said his white blood cell count was down (risk of Leukopenia) and so they changed it to 25mg of 6mp with 50mg of allopurinol. I am not exactly sure why they have chosen this combo for him. I think it is the balance between the therapeutic affect and minimizing side effects. When I say side effects I mean the lowered white blood cell count, he hasn't had any physically noticeable side effects. The Dr. said it is not common but it he has several patients who have required tweaking with Allopurinol. He has had no reaction to the Allopurinol. He has been getting his blood checked about every two weeks just so they can find the right combo. I hope this works for you. Let me know how it goes, I am learning myself and don't completely understand the process.

Tiffany

 

[DustyKat]

It is not uncommon, for doctors that know about the interaction between the two drugs, to prescribe this combination when a patient can't tolerate higher or therapeutic doses of Azathioprine.

Allopurinol blocks one of the pathways that inactivates Aza, so if you take Allopurinol with normal doses of Aza you very likely will suffer with toxicity. The advantage of this reaction is for those people that have issues with normal doses of Aza when you add Allopurinol you need to reduce the Aza down to a third or a quarter. So if your ideal Aza dose is 100mg you should drop to 25mg.

@secets: Imuran is the parent drug to 6MP (Purinethol). It is possible though to have side effects to one and not the other.

Dusty. xxx

 

[Johnnysmom]

Thanks Dusty!! You are always able to explain things in a way that I can understand them.

 

[Splasher]

thanks, i am really starting to understand the combo and how it works now also. I was on 125mg of azathioprine now i have 100mg allopurinol and 25mg azathioprine and i really am hoping this works better

 

[slimjim]

Hi, I have crohns and was taking asacol for a number if years until it really started to not work for me. I think this was because my body had started to get use to them, I had been on them for about 10 years. Around a year ago I was then given aza on its own and quite quickly probably within 4-6 weeks I started to get very short of breath and a pain in my chest. This was my liver really struggling with the aza. I was told to stop the aza immediately and back to the hospital. They then decided that aza was the best of a bad buch of drugs to take (least side effects, long term) so they added to it allopurinol. And again monitored my bloods and this time with no side effects. This combo seems to be working, but like this drug and all the other options I am very concerned about the long term effect it/they will have.
Paul

 

[Keenie]

Hi I am on 50mg Imuran and 100mg Allopurinol a day for crohns