Azathioprine

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First of all sorry if theres already a thread on this.

basically, ive been to see my specialist today. and hes decided to start me on Azathioprine and after what he was saying im a bit apprehensive and not quite sure what to expect when i start taking these tommorow.

i was on pentasa and im still on steroids and things arent quite working out so im hoping this will do the trick, but someone who i know who also takes this said it messed him up for the first few weeks, and im gona be having a ridiculous amount of blood tests too so was just wondering what other peoples experiences with this are? and if theres anything i should maybe watch out for
 
Azathioprine a medium to long term remission maintenance drug with a possible 12 week lead time before it starts to noticably do anything.

Things to watch for: nausea is the main one. Along with unexplained bruising and/or bleeding. It made me feel pretty unwell and tired as well as the yuck-about-to-throw-up feeling. Report anything out of the ordinary to your GP - better safe than sorry.

Once you are a few weeks in if your arms get sore or sensitive when they are taking the blood get the phlebotomist to put a bandage on your arm as it seems to help lessen the internal bruising. Leave it on for an hour or so.
 
I was on it for 7 years with no serious side effects. When I first started out it killed my appetite and made me nauseous around food for a week or more. I also lost a lot of hair while I was on it (but malnutrition from being sick from Crohn's could have played a part in that too).
 
I've been on it since March. Fatigue initially but no other side effects. The bloodwork is to make sure your liver doesn't reject it. As I increased dosage, I had issues and had to go back down to a lower dose. I still have my hair.
 
The dosage that you are on usually depends on your body weight. My GI started me on 50mg and gradually increased it. He said it's like turning on a hot water faucet...if you do it too fast you get burned, so you gradually need to turn it up. Not sure what happens if your initial dose is too high though. The higher dosage did make me very nauseous.
 
Hi Robbo, I've been taking it for about 3 months (now on 100mg a day, which is the maximum for my body weight) & I haven't experienced any nasty side effects so far. My hair was falling out before the introduction of AZA (pentasa can cause this, as can steroids.....as can the malnutrition...). I feel a bit better than I did on just the steroids and pentasa but I'm still a fair old distance from feeling good. I had fortnightly blood tests to begin with, as my dose was increased. Now I'll only need to go every couple of months. Don't be scared of trying it...it could help. Good luck!
 
I was on it for about 6 months...I had no problems..I was even on 150mg towards the end and was weighing around 115lbs at the time. Pretty high dose. I felt like crap at the time, but it had nothing to do with the med. From what I've learned here, most people know when they can't tolerate it. I hope it works for you.
 
thanks guys, taken my first tablet this morning so heres hoping all goes well!

i guess its ok to have alcohol whilst on these aswell?
 
Hey Robbo, I've been taking 75mg Aza since May and can't say i have had any bad side effects but maybe i'm just lucky. It's keeping me off the loo 15 times a day and that's the important thing!

I started off with weekly blood tests, then fortnightly and am now down to monthly - i'm quite lucky in that my doc surgery is really near my flat so i just go on my way to work to get the tests done. It's really not a hassle at all.

And i have had no problems having drinks either! All my friends when i was first diagnosed and taking all the pills were like "can you still drink on those?!" - clearly the most important question!! Nobody's told me not to and i haven't had any issues...
 
Hey Robbo, I took my first dose today also. I guess we will find out what it does together.
 
Make sure you have your bloods tests, I am still fairly new to all of this and stupidly thought that this was something the hospital took care of. There is generally a 3 week limit as to whether you can tolerate it or not, had I had a blood test at 2 weeks then maybe the subsequent problems I suffered could have been avoided.
 
I've been on Imuran since May. I started on 50mg, and increased gradually until I got up to 150mg. I have not had any side effects that I know of so far, so I feel lucky. Just make sure you get the lab work done to monitor your liver function. Also, my doc has me on a multi vitamin with folic acid to help my liver. He says that if you're not on some kind of folic acid supplement, the Imuran is more likely to cause problems. Good luck to you, I hope all goes well, and that you get to feeling better!
 
i have been on azathioprine and pentasa for ages now and they have worked really well for me havent had any side affects for several months..nearly a year....good luck....it certainly did the trick for me :)
 
ok so im about 2 weeks in, and at the moment im having severe joint pain, and since yesterday have been feeling really sick, ive barely been able to eat or drink and im just not feeling good at all. but im not sure what to do , or whether its a typical flare up or if the aza is causing problems :(
 
I'm sorry buddy! I don't have any answers for you - but I sure hope you get to feeling better soon!
 
Hi Robbo,
I really sympathize with you - I'm almost 2 weeks in as well, and have been feeling really sick, dizzy and have lost my appetite. My consultant said these were fairly common side-effects and encouraged me to keep going for a few more weeks as it should get better. Fingers crossed you'll start to feel better soon,
Karen
 
Good luck Robbo,

I got very sick on AZA, try and persevere, although I got put on Mercaptopurine which is a pro-drug(?) Consultant said it's the same thing essentially but metabolised differently and less likely to make you sick?

Get well soon

Lishyloox
 
Azathioprine is the pro-drug for mercaptopurine - you motabalise aza into 6mp and something else. Some people dont get on with the other metabolite. Aza is cheaper than 6mp so they put people on that first.
 
I've got untill the 15th to decide whether i start on AZA in conjuction with my remicade. Its interesting reading this thread.
 
well im now in hospital after falling really ill over the past few days. looks like its a flare rather than a reaction to the aza, so fed up now.
 
Oo, sorry to hear that, at least on the bright side you can count on AZA still, as it should eventually kick in. Hopefully you get short term help to tide you over till the AZA is scheduled to help.
 
well im back, the prednisolone has been upped back to 40mg :( and theyve upped the aza to 100mg i dont think im ever gonna manage to come off pred at this rate!
 
Hopefully you will eventually get there and not need the pred once the Aza kicks in it can take a few months to get the full benefit of the drug.

I was on Aza but had a reaction to it 5 weeks after starting, my inflammation marker went sky high and was really ill and had a rash, so was taken off it. But went to GI today and they have now put me on 6MP so finger cross this will work for me. They even mentioned that it is more expensive then Aza and so don't like to prescribe it unless you can't tolerate Aza... it cost the government more!

Good luck hope you start to feel better soon
 
Hey I just started mine 3 weeks ago today. I've have the puking feelings and a lot of bleeding but I think the bleeding is from flare up. I seem to have gone up and down with it thus far but am only on 100mg a day which is half for my body weight. I'm only allowed to increase 1 pill a day every 2 weeks after bloodwork. I will go up to 4 pills in 3 weeks time. The bloodwork is to make sure its not suppresing your immune system too much because it is an immuesuppresent drug. My other suggestion for you is I was told to take it right before bed because often in the hours after taking it you can feel nausea so you'll actually sleep right through that. Also try taking it with food or milk if you can tolerate it because it will also help your stomach tolerate it better.
 
robbo87 said:
well im back, the prednisolone has been upped back to 40mg :( and theyve upped the aza to 100mg i dont think im ever gonna manage to come off pred at this rate!
Sorry buddy.....I hate pred and love it too. Are you having a lot of side effects?
 
not really having to many side effects, trouble sleeping but i get that anyway, one thing is tho i have been feeling really down lately to begin with, like seriously down.... and i dont think the pred is helping that one bit, had an awfully miserable day today :(

but generally its making me feel ok atleast.
 
Sorry robbo....I had to start on antidepressants because I was feeling so down. There is a connection between serotonin not being reabsorb in the gut in IBD patients and depression....The lack of sleep and fatigue are a wicked combo....Plus Prednisone can cause depression.....Feel better;)
 
I've been on azathioprine for several years now to treat my Crohn's Disease.
to start with it was a bit trial and error with the dosage, as it was making me feel sick. but i've been on 75mg per day for a long long time now and it seems to be doing the trick.
I find its definitely better to take it with or just after food. and i find i tolerate it best if i take it before i go to bed, although its kind of convenience as well as i tend to forget to take it other times of day.

i have trouble sometimes with joint pain, and i'm pretty much always tired, but have never really had any problems with loss of hair - it happens occasionally but its not noticeable at all, just a few strands here and there.

but obviously it will affect everyone slightly differently.

-bc x.
 
I have been on Aza on and off for a few months now, never consistently because I would get a call from my doctor to stop because my White Blood count has dropped. I am on a 50mg/25mg alternating plan and all is good. I have never felt any side effects. Maybe because I take it before I go to bed, and I always go to bed on a full stomach.

Hope you get well!
 
Hey Robbo,
I know the feeling of thinking you've never going to get of pred, but it will eventually happen! Have faith!
I've been on 150 mg of aza since 1996, after taking Pentasa and Prednisone for a long time.
It takes a while to kick in (up to 12 wks), but I have hardly any symptoms anymore. Along with the aza, my diet plays a big role in keeping me healthy. You need to learn about the things that hurt you, and then avoid them like the plague!
The only side effect I have from the aza is some hair loss. It doesn't happen in one specific location, just more stands of hair then before all over come out. I have lots, so I'm not worried, plus it grows back.
good luck dude!
 
Hey there update on my AZA. I'm on 200mg a day (weight 150lbs.) and it has changed my life. For 2 weeks now I would say 90% of my BM's are solid! I only go to the bathroom about 5 times a day now with is a huge improvement. I know that drugs will affect everybody differently though but in the begining (I already posted on this thread) that it wasn't going all that well for me. My doc encouraged me to stick with it and I couldn't be happier that I did. Best of luck and I really hope you could have the same success I have right now.
 
i've been on it for almost a year... but have recently taken breaks from it (longest break was for about 3 weeks, i did get one flare up after that... went back on for a month or so and presently i'm off again)... this is just me choosing to take breaks, as i'm on remicade anyway.

i only got real results once i paired it with remicade... i did have flare ups about once a month while on imuran alone, but generally felt better... but my colonscopy showed otherwise (along with the flareups)...

i've had no serious side effects... only thing that bugs me the most is the skin side effects, (more for vanity reasons lol, i just hate my skin right now) my skin is a mess in comparison to before (i.e. bumps and blotchiness on my face, and sometimes small mild dry/rash like patches of skin around my neck)... also, i'd say i'm pretty tired but it's tolerable. i've also kept weight on and eat fine. but i'm kind of abnormal with my ability to keep on weight, even though i'm a crohnie... it takes super severe flareups before i'll lose my appetite and lose weight.
 
crazycanuck said:
Hey there update on my AZA. I'm on 200mg a day (weight 150lbs.) and it has changed my life. For 2 weeks now I would say 90% of my BM's are solid! I only go to the bathroom about 5 times a day now with is a huge improvement. I know that drugs will affect everybody differently though but in the begining (I already posted on this thread) that it wasn't going all that well for me. My doc encouraged me to stick with it and I couldn't be happier that I did. Best of luck and I really hope you could have the same success I have right now.

Overall this thread has me a bit nervous but This other Crazycanuck has me looking to the bright side.

I met with the IBD follow up team today and it looks like I will start Imuran this week. I was having too much trouble with Arthritis and have started bleeding again with increasing regularity. Surgery was back in Oct but there were some immediate problems with two fistulas popping up almost immediately. They held off any treatment until we made sure I was infection free. This will the be first medical treatment for me since surgery three months ago.

I thought this stuff would be a walk in the park but It seems like I should expect to feel like puking and not wanting to eat for a few weeks. Then If it doesn't almost kill me I'll get better. Just what I need. :yfaint:
 
Hey kenny, try not to get nervous about it before you even start...i know i know easy to say. But try to think positively - this could be the drug that'll finally get things under control!

Also, not everyone gets the side effects, i certainly did not have any nausea or feel like not wanting to eat. having said that, i started it while tapering pred so was hungry ALL the time!

Aza has worked really well for me, i guess i am in remission as, essentially, i live the same life i did before all this started up for me. Eat whatever i like, normal bathroom trips, no pain. I get quite tired but i was always an early-to-bed girl anyway...and i've just found out the tiredness could be a B12 problem, rather than anything to do with aza.

What i'm trying to say is don't knock it til you've tried it and i hope you have as good an experience as i have.

Good luck
 
Hey kenny, don't stress too much everyone is different with how they react to each drug... I couldn't tolerate imuran but have so far been fine on its sister drug 6mp. You know your body better then anyone else so if you feel somethings not up then speak with your doctor... but there are alot of this forum who have been on it for years with no issues at all you might well be one of those lucky ones. If not don't stress cause there are still heaps of other treatments out there. Make sure you get your bloods check and all should be good.
 
I'm back up to 165 lbs and prescription is 175 mg to start. I have a blood test schedule of ( weekly x4) than (biweekly x4) so thats about 12 weeks of blood tests.

I might as well have vampire bat for pet at that rate! :bat:

Well at least i figured out the bright side. If the Imuran works I be betrer than ever. If not I get out of the blood test thing ! :voodoo:
 
Blood test tomorrow for me to make sure my 200mg a day is alright for me. I weigh 150 lbs. So far experience with it has been positive and I'm still doing pretty well even though I'd say I'm starting to flare a little bit I think its because I'm still not really healed from a dilation I had done a week and a half ago now. Anyways stick with it because I didn't feel great at the begining, I had puking feelings, I passed out once (this could be related to concussion history though), and some pretty intense stomach pains. But like what you quoted from me above I thank my doctor and that little voice in my head that made me stick with it because after about a week everything settled down and I'm feeling pretty great. I think the reason I may have had a rough first week is never in my life have I taken more than 2 tylenol for pain or the extremely mild Asacol for 2 years. So I think the stronger Imuran caused an "adjustment" phase for me. Experiences to drugs are different to everyone as pointed out by Tan. I hope you have a good experience with it and thats a pretty good way of looking at it is if its the one you'll feel the best you ever have, if not you don't have blood tests so damned often. I'm extremely needlephobic so my GI is letting me do bloodtests once a month after tomorrow :p Good luck and keep us updated.
 
Gezz that seems like alot to start straight on.. I know when I starts imuran they stepped the doses up every 2wks and the same when I started on 6mp although after 5 weeks Im still on a lower dose for my weight as my GI says that its seems to be doing ok at this present time so if we can get away with a lower dose then we will try too. So until my body says its time to increase it Im only on 50mg. I think my GI might be a bit slack with the blood tests cause he only got me to do 2 in the first month then every other month after that... but in saying that if Im feeling a bit off I just have to call and organise a blood test to make sure everything is going ok thats how I found out I was reacting to the imuran. I hope it works for you and keeps you in remission. I was going all right with no pain but have noticed pain over the last few days back in my right side abdo hoping its not the start of a flare.
 
I started on 125mg a day back in August last year, and I don't seem to have had any side effects. In fact it doesn't appear to have done anything.....I can't get below 30mg of prednisolone as my symptoms just come right back.
 
its been three days now and my head never exploded yet. Kind of anticlimactic actually :eek:

My eyes are pretty bloodshot but overall I feel great. Maybe it is too early to be feeling any negative effects yet. Sorry to see you are stuck in the steroid loop Absent. From what I hear that is a nasty spot to be.
 
I'm glad you're doing ok so far! I really hope it works for you.
It is a bit rubbish. I don't have too many bad side effects, it's mostly the fat face that's annoying. Still, what with the slight hair loss from the aza and the hair growth from the pred, I'm going to have a bald head and a beard....not so good on a 24 year old female!!
 
I'm going to have a bald head and a beard....not so good on a 24 year old female!!

I think bald women are pretty sexy actually, but the beard thing is a bit of a tickler :cool2:

From what I am reading, imuran is usually prescribed for around 4 years at a time to those it seems to work well for. Maybe this will be the help I need having coped with Asthma and allergies all my life. As well as regular bouts of Arthritic joint pain and swelling for a good 10 years or more. I was 30 when that started up. I also had Erythema nodosum on my lower legs for about as long as the strange arthritic issues. It is actually a relief to finally know that all these things were tied together and get it treated.

One Pill To Rule Them All :emot-dance:
 
Tan I didn't start on 200mg/d haha. I started at 50mg/d for 2 weeks, then 100mg/d 2 weeks....now 200mg/d. I had blood tests 2 weeks on the day I increased my pills. I'll do blood tests every 2 weeks for another month or so and then everything month after that. I'm doing a 100x better on it and its changing my life a bit I think.
 

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