Higher Dose Of Azathioprine

[NoNameNoFace]

I started my course of 8 a day 5mg prednisone while taking one 50mg Azathioprine, reducing one tablet of prednisone each week. Im now down to one a week and my doctor has increased my dose of Azathioprine to 150mg a day.

Over the last few weeks my stomach cramps have certainly came back and my stools are more irregular, loose and solid. Seems the pred was working great as I felt brilliant for weeks but as I've reduced the dose I've slowly been feeling worse.

I've been getting muscle spasms, cramps and bruising easy. Most of all every other day I wake up and feel awful, cold sweats, high temperaure and generally feeling down like I have the flu. Feeling a bit nautious and fatigued. Also at night I have trouble sleeping at times, I be half awake and feel like I have the weight of the world on my shoulders worrying about silly things. I just generally feel down and depressed most days.

Is this common side affects now Im on a higher dose of Azathioprine?? Im tempted to phone my doctor on Monday or should I just be patient and give the aza time to work?

The cramps are worrying me a bit as they are very sore like they were before I started the prednisone.

Thanks for any comments, appreciated.

 

[Grumbletum]

Hey there. I would call your GP. It takes up to 3 months for Azathiprine to kick in, so it might be that you need to be on the Pred a bit longer til it does. Some of the symptoms you describe like the bruising, feeling down etc can be related to Pred and/or tapering off it. But with flu like symptoms, I'd want to mention it to the doc so they can check you are tolerating the Aza ok.
Hope that helps and let us know how you go on.

 

[NoNameNoFace]

Thanks for the reply Grumbletum.

Yea I think I deffo will give him a phone, I've felt really run down the last few days and also for the 3rd day running I've lost my appetite a bit which will be a set back as I was just arting to get the weight back on (I've lost 2 stone). I'l mention all what you said and see what he thinks. Thanks.

 

[Rebecca85]

The side effects you mention (particularly nausea and fatigue) are common when starting (or increasing the dose) of aza. Did you jump from 50 to 150 in one go?

It may help if you make sure you eat plenty when you take your tablets, I found weetabix was the best food for me to have, if I had toast with my tablets I would be feeling really sick by lunch. Also you could try splitting your dose (take half in the morning and half at night). Or take your full dose at night so you sleep through the worst of the side effects.

The bruising is slightly concerning because it does say on the aza packet to contact the doctor if you notice unexplained bruising. Have you been having weekly or fortnightly blood tests? If not I would request one just to make sure you are tolerating the aza OK.

 

[David]

You've received some great advice so far In addition to what was said, I would suggest asking to have your vitamin B12 and folate levels checked. Some of the symptoms you describe can be caused by such deficiencies and unfortunately those deficiencies are very common in people with Crohn's Disease, especially Ileocolitis and Ileitis, the forms that affect the ileum.

 

[NoNameNoFace]

Yea some great advice, didn get reading them, thanks people. I was on 50mg, then 100mg for 2 weeks and now 150mg. Im completely off the pred now. Yea I go for regular blood tests aswell and I havent heard nothing back, but the doc will be reviewing them when I go again.

Well I tried getting through to my doc a couple of times but the line was very busy, Im due to see him next week so might aswell just see it out.

Im struggling badly, I feel Im really back to sqaure one, regular stomach cramps every day and alot more loose stool an irregular toilet visits. Been a nightmare. Feel tired, weak and exhausted and my appetite is completely gone, no doubt I've lost the half stone I've put on. Im supposed to be taking high calorie milshakes and chewable calcium tablets every day but I'd never be able to stomach them, I feel nauseous every day as it is.

Is there a better way to take the aza? my doc told to take 3 50mg in the morning with breakfast? but would be alright to take the 3 spread out over the day?

 

[PaulPhoenix]

I'm not a doctor so you'd need to check with them but...

I couldn't tolerate 125mg all at once. I had stomach pain and terrible indigestion. So I split the dose and half after lunch and half after dinner. Problems went away . It did take me a full twelve weeks to get a good response on the Aza.

Good luck!

 

[David]

Just so you know, the vitamin B12 and folate are NOT included in most regular blood screens. I'd specifically ask if you've been tested as such deficiency could definitely be the cause of your current symptoms.

 

[DMS]

My son started aza 1 year ago and was told by his pediatric GI to split the dose morning and night to avoid side affects (specifically nausea).
Just wanted to mention that his aza took about 5 months to kick in - and this is normal. The good news is that he's in complete remission now.
Good luck with it.

 

[mohammed]

when i start the azathioprine i feel generalize muscle pain and my doctor told me it is a side effect of the azathaioprine.
but it take time ( 3 months ) to work , so you may discuses with your doctor to be on low dose predinsolone till the aza. start to work .

all the best

 

[NoNameNoFace]

Thanks for the advice from everyone, lifted my spirits a bit. Just need to be a bit more a patient. I will let you know next week how it goes with the doc.

Thanks.

 

[NoNameNoFace]

Well just back from the docs, my treatment of pred/azathrioprine has failed My doc has put me on budesonide, if I dont feel better in 2 weeks I've to phone him and then Im going on infliximab.

He was reviewing my colonoscopy results and told me I have quite a severe case for my age.

Was really hoping this would be the end of it, just another set back and to be honest I dont think I will be feeling any better in two weeks.

 

[David]

Let's hope you do feel better though! I'm sorry your old treatment regimen wasn't working but they'll find what works for you sooner or later. There's still plenty of treatment options for you

*hugs*

 

[Crohn'sFor Life]

Although it may take a few months for Azathioprine to help you with your IBD symptoms, side effects can appear immediately. Azathioprine did jack for my UC. And at the 150mg dose, I had horrible migraines. My blood work suggested that my liver could handle 150mg, but the rest of my body simply could not.

 

[Hellwell]

Hi, sorry to butt in here.
I have been on aza for 6 weeks and in the last 3 weeks I have been suffering from fatigue. Did someone say this was normal on aza??
Cheers

 

[NoNameNoFace]

Hi, sorry to butt in here.
I have been on aza for 6 weeks and in the last 3 weeks I have been suffering from fatigue. Did someone say this was normal on aza??
Cheers

Ive been on it for roughly 6 weeks aswell and I've felt exhausted the last few days, its got really bad recently, so probly is the aza!

Thanks David, appreciate it. Was really down yesterday that the aza/pred hasnt worked but as you say there is still plenty options, just cant wait to get better and feel alive again. Bar a couple of weeks in December the last 6 months have been a complete nightmare.

 

[Carrie171087]

Ive been on it for roughly 6 weeks aswell and I've felt exhausted the last few days, its got really bad recently, so probly is the aza!

Thanks David, appreciate it. Was really down yesterday that the aza/pred hasnt worked but as you say there is still plenty options, just cant wait to get better and feel alive again. Bar a couple of weeks in December the last 6 months have been a complete nightmare.

I've been on 200mg of aza for 8 months (also been on 2400mg of asacol since October 2011 when my Crohn's flare started) I'm no different than before. My fistulas still weep non stop.ive Had two new abscess since the beginning of September! It's a nightmere!!
I'm constantly exhausted! With working a full time job and bringing up my 3yr old boy by my self; I thought maybe it was that. But from what I read here the fatigue is normal!
And muscle cramps!! Gosh wow. I started getting them on one side of my face on my cheek and neck. Now I get it in my right hand, feel like I've constantly got writers cramp, sooooo achy and sore.
Waaaaah! Crohn's sucks, I just want a bit of normality back in my life!! :ybatty: