Azathioprine

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aarond

aarond

Joined
Jan 6, 2008
Messages
51
Hiya everyone,

Rare posting crohnie here

Had my review the other day and he put me on Azathriprine and a shock course of Pred, (GRRRRR!!!!!)

What I want to ask is did anyone (who has been on Azathioprine) had sickness i.e. vomiting everyday etc?

I had to call my consultant after 2 weeks trying to tolerate it but to no avail, so Im back in there next week to see what else I can try.

Ive been on oral Budesonide, Pentasa and now azathioprine. Oh and good old pred. So im just curious what everyone thinks the next step is going to be?

All comments suggestions would be appreciated.

BTW My crohns is in my small bowel.
 
Yep nausea and vomiting are both on my list... I tried to improve things by taking the Aza at night which did help a bit and I managed til the drug impacted on my liver last Dec and I had to stop it for that reason..

My GI then put me on Mercaptopurine which is what Aza is converted to by the body so maybe your GI will do something like that? I then had to stop the Mercap because it affected my liver too in Feb even though only started it mid Jan.
He also moved my Remicade from 8wks to 6wks and am now having probs with 6wks so they are thinking of moving it to 4wks. Its all really a juggling game.

Really depends on what your GI prefers to use and what research they are led by to be honest.. Mine leans towards infliximab (Remicade) with the Aza and Mercap as back ups. Others will do it the other way round.

Hope you get some joy next week. Let us know how you get on.

Thinking of you.
 
I was put on Imuran (Aza) to try and wean myself off prednisolone. I took one imuran at 10 am and by 1.30 pm i was bent over with the pain and then the vomiting took over. I had to go to my gp and he gave me a morphine injection to try and kill the pain. I was vomiting until 2.30 am the following morning and it took me a few days to recover. My consultant is away for the next few weeks so I stopped the imuran until i can speak to him.

I was in Imuran in 1993 and I was sick with it then, but cos my crohns was so active then, i had surgery that year, my consultant thought it was the crohns that may have been causing the sickness, so we decided to give it another try. - same results.

I would speak to your consultant, maybe there is something else he could try you on. I'll be ringing mine in the next few weeks and hopefully he will try me on something else.

Geri
____________________________
Crohns since 1991 - has surgery in 1993 - anastomosis of terminal ileum.
Laproscopy 2007 - to remove adhesions
currently on prednislone 2.5 mg
losec 20 mg
galfer
 
I take Azathioprine but don't even know if it's benefiting me at the moment, too many other changes. Kinda sad I know, seeing as how it has potential sides....but I haven't had any nausea from it, had nausea from the disease itself when I was worse a couple months ago, took some gaviscon for that and it helped.
 
I tried Imuran/azathioprine... Posted a daily diary of it on here. It didn't last long as I became toxic/allergic at 100 mg. No prior side effects or issues with it. My next choices were: Methotrexate via weekly injections, remicade in a series of infusions, or possibly humira by injection. Humira had just been given the OK by our local medical community; was considered very cutting edge. As for Remicade, since I have no private insurance to cover the costs, it was just out of the question... unless the manufacturer took me on as a charity case. The metho seemed financially acceptable, BUT the potential issues/side effects sounded very daunting, to say the least... AND, the success rate seemed less than appealing. It looked like the potential benefits were comparably low compared to the risk associated with the drug. Then, thanks to this site, I heard of LDN. Did a little research AND liked the relatively MUCH higher odds of success, especially when weighed against the almost neglible risk of known side effects/issues.

I slowly convinced my GI to trial me on that, with metho as a backup if LDN failed. So far, it is working. I have improved tremendously. I'm not saying it is for everyone... and it hasn't been a miracle cure. Just a safe, practical alternative.. And I will continue taking it. Fortunately, it seems safe/effective/cheap
 
I was prescribed Aza about 3 years ago. I was on it for 3 months and experienced extreme fatigue. After 3 months I was told "oh yes, it can do that" which really got my goat! Also it began to suppress my bonemarrow and so I came off it. I didn't have any vomiting. However, I had a fantastic year after taking it, without a flare-up at all! Sadly that didn't last.

Hope you get it sorted.
 
Hiya everyone,

wow what a response, im kind of glad that im not the only one who is not tolerating the aza but i feel for each and everyone of you who have been on this and had probs. Its a pretty evil drug in my opinion.

As I said im going in next thursday to see what he wants to do, It sounds promising from you guys that there is more options before he gets too happy with the scalpel!

Thanks again guys

Aaron.
 
Godd luck with your appointment. Make sue you have regular blood tests to monitor your blood counts and liver and kidney function while on Aza....
 
Well I had my appointment today and I am now on 6-mp.

So watch this space lol for the evil side effects this time round lol.

Yes I have also been booked in for the weekly blood tests, so they are looking out for me on that one.

he also mentioned try not to handle the tablets lol, radioactive or something ? christ knows.

All the best

Aaron
 
Aaron,

You have gone down the same route I did.. the tablets are cyto toxic so dont handle them. Mine came in a bottle so I just shook them into the lid and threw them into my mouth from there.

Hope you get on ok with them.
 
Toxic Tablets !!! OMG.... I have been taking it for 3 years now and never knew that. Should I wear gloves or a radio-active suit when I have to take them now :))
 
LOL yeh you should wear one of them suits thats they wear to make the intel computer chips. Im not sure whether it is that toxic but makes you think what they do to your insides!!!
 
If you look at the Imuran box you notice they write POISON on it!!! This med is very toxic,. When I was on 150 mg I had toxicity in my liver, and had to drop to 50 mg. But I'm still worried on what the long term side effects will be :(
 
OK, I'm lost now... Which are the cyto toxic ones,, the Aza or the 6MP ones?

I know 1st hand the Aza can be toxic... but I think there's some confusion re which ones are which.. The Aza ones are the ones with the radioactive element to them, correct? Been so long since I took them I dont' recall...
 
Well i understand it as azathioprine can create toxicity in the body but are not harmful to touch.

6MP i was told that do not handle them so I think this is the radioactive one.

I feel like a air conditioning engineer / scientist now lol
 
Why are their radioactive substances in this medication? I have never heard of such a thing.

Dan
 
Guys, neither Aza (Imuran) or 6MP (Mercaptopurine) are radioactive.

Cytotoxic means it kills cells - in other words its toxic to cells

Aza SUPPRESSES a type of immune reponse cell called a T cell

6MP KILLS the same cell.

The aim of both drugs is to suppress our immune system, they both attack the same cell different ways.

The reason 6MP shouldnt be handled is because it harms good as well as bad cells. The most commonly used cytotoxic drugs are cancer drugs where the impact is body wide and the cancer cells as well as healthy cells are killed.

Therefore Cytotoxic drugs cannot differentiate between good and bad cells so handling them means it could impact on the good cells.

Any drug can create toxicity in the body from impacting on the liver or other organs or due to too high a dose for the individual and some drugs faster or moreso than others hence the regular blood tests to monitor impact and titrate things.

Does that help to clarify things?
 
Last edited:
I was on Azathioprine for 3 months and saw no good benefit from it. I didn't have the nausea but I had diarrhea and extreme fatigue from it still. I came off it 2 weeks ago and I feel loads better from an energy standpoint.
 
Hmmm, maybe it was metho... I just remember in my research of one of these drugs... imuran or metho.. (Damn, wish I had the memory I used to have, or at least I'd bookmarked the webpage).. that one contained a radioactive base element... sk25 or something... Does any of that ring a bell with anyone?
 
soupdragon, wow thanks for that, are you sure your not a pharmacist? lol

i stand corrected,

just a question on 6mp has anybody had any sore head / itchy head etc (ive got a shaved head so it isnt head lice lol)

started to get a really sore and painful head.

any ideas??

all the best aaron
 
If u r talking AZA/Imuran, then check out their websites for 'rashes' under side effects/adverse reactions. mine started in my legs and back, but I've heard a rash anywhere while taking it is worth checking out ASAP. I could be wrong
 
aaron I am not a pharmacist but I am erm ermmmmmmmm a nurse (can I hide now?) lol gastro is not my field though I work in cardiac intensive care so with heart and lung transplant and those who have had coronary bypass grafts done - that sort of thing. We use Aza for our transplant patients to prevent organ rejection along with other drugs hence I know a bit about it.

Kev, Have tried to research your thoughts on the metho and can only see it being mentioned in relation to folate being radioactively tagged to look at metho uptake in the body. metho does deplete folic acid and so it usually has to be taken as a supplement on top. Will keep looking though. Let me know if you come up with anything as am interested...

On the rash front I agree any rash needs checked out as could well be an allergic response as you are thinking Kev.
 
side effects?

hi everybody,

I recently joined the forum and have to say, it's good to know i'm not alone!

After 12 years of living without flares (almost forgetting i had Crohn's), it came back with a vengeance: obstruction, fistula, abces, antibiotics, Prednisone (40mg), parenteral feeding and surgery in about 6 weeks. they also put me on Azathioprine (125mg), for the first time, about 2 weeks ago.

I've been reading the thread on Imuran, and hearing a lot about side effects.
After 2 weeks i don't notice anything (i know it takes at least 6 weeks for it to 'kick in'), but i was wondering about the side effects. do these also take weeks to manifest, or did some of you taking the drug (similar dose to mine) immediately notice changes? Guess I'm wondering whether not noticing anything is a good sign?

Take care/thanks,
e.
 
elp888 said:
hi everybody,

I recently joined the forum and have to say, it's good to know i'm not alone!

After 12 years of living without flares (almost forgetting i had Crohn's), it came back with a vengeance: obstruction, fistula, abces, antibiotics, Prednisone (40mg), parenteral feeding and surgery in about 6 weeks. they also put me on Azathioprine (125mg), for the first time, about 2 weeks ago.

I've been reading the thread on Imuran, and hearing a lot about side effects.
After 2 weeks i don't notice anything (i know it takes at least 6 weeks for it to 'kick in'), but i was wondering about the side effects. do these also take weeks to manifest, or did some of you taking the drug (similar dose to mine) immediately notice changes? Guess I'm wondering whether not noticing anything is a good sign?

Take care/thanks,
e.
Click to expand...

Hey E. There is tons of good info on here for sure. Glad you're reading!

I noticed the fatigue almost immediately but other things like rashes and itching came on later .. almost a month down the road. I'm not a doctor but as long as you're getting your blood work done and its coming back without any sign of toxicity I know thats definitely a good sign =)
 
Well, I had liver toxicity after about 6 months from taking it. Before that I noticed nothing and my blood work was normal!!! The toxicity went after I lowered my dose from 150 mg to 50 mg
 
Infliximab

Aarond,

Has your consultant not suggested infliximab yet?

It has worked wonders for me.

I was admitted to hospital at the end of February, was in there for three weeks. On hydrocortisone injections 4 times per day and didnt respond.
My colonoscopy showed severe crohns and colitis. They thought I was definietly heading for an op but thought they would try the infliximab first.
Within three days I was so much better and had my first solid stool after three weeks. I had another infusion last wednesday and still feel fine. I am still on steroids (20mg now from 40mg) but hoping that when I finally come of them the infliximab will continue to work.

I also met another person last week who was having an infusion at the same time as myself. He has had crohns since he was nine (now 28) he has suffered severely since then and had countless operations etc. He said the infliximab has been the only treatment to work properly and he also thinks its a miracle.

I do understand it doesnt work for everyone which is a shame but just wanted to mention it as your doctor doesnt seem to have offered it to you?

claire
 
thanks...

for all the quick responses.
guess i'll just have to be patient and see what happens as many of you seem to have a different reaction to the Azathioprine. they are checking my blood every week, so if something happens/changes i'll find out soon enough.

thanks again
e.
 
I'm not sure what bearing this might have on the discussion but when I started Imuran/Aza I looked it up and there is an interesting read on Wikipedia, of course it is the internet and Wikipedia so it may not be fully accurate but Aza when administered is changed into 6MP by way of a chemical reaction in the body. Its supposedly safer then 6MP taken directly according to the documentation but it doesn't state why that is since the byproduct is still 6MP.
 
I should scan and post up the pages of of a booklet I picked up at the IBD convention, it went over what you just mentioned Drew, although I read it myself earlier tonight and don't recall it giving an answer as to why offhand, it's got a bunch of good info in it, although it's 2 years old.
 

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