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How long for azathioprine?

Hi, i took 25mg of azathioprine for a week starting the 6th of April and then moved up to 50mg, which I have been on ever since - so 11 weeks now. I am still having symptoms and wondering how long I should be giving this drug? Could it be related to my dose? I have read in several people's threads that 50mg is a very low dose. I am 5 foot 5 and weigh about 110 pounds. I am 27 years old. I think my GI mentioned I may go up to 75mg if I manage to put on more weight.

I am worried because I cannot take the biologics as I had an episode of optic neuritis in 2007 and so I am at risk of multiple sclerosis, which biologics can increase your risk of developing.

Thanks
 

emmaaaargh

Moderator
Staff member
I was on 75mg initially for maybe 6 months before I noticed any difference, but my doctor upped my dose to 100mg in January and I've been feeling great. I understand your frustration about the weight thing - I'm 5'0 and about 93lbs and I've been told exactly the same thing, "put some more weight on and we can increase your dose". But in the end they increased the dose anyway. That said, maybe it just hasn't been long enough for it to work in you? Anecdotally (mostly from the forum!) I've noticed some variation in response times to azathioprine. Mine seemed really long, but I ended up sticking it out, even though there were definitely moments where I wondered when the cut-off would be.

It sucks, and I'm sorry I couldn't help you further! But I really hope that you find relief with the azathioprine, and I'll be sending you my support!
 
I was on 75mg initially for maybe 6 months before I noticed any difference, but my doctor upped my dose to 100mg in January and I've been feeling great. I understand your frustration about the weight thing - I'm 5'0 and about 93lbs and I've been told exactly the same thing, "put some more weight on and we can increase your dose". But in the end they increased the dose anyway. That said, maybe it just hasn't been long enough for it to work in you? Anecdotally (mostly from the forum!) I've noticed some variation in response times to azathioprine. Mine seemed really long, but I ended up sticking it out, even though there were definitely moments where I wondered when the cut-off would be.

It sucks, and I'm sorry I couldn't help you further! But I really hope that you find relief with the azathioprine, and I'll be sending you my support!
Sending support also.
 

Lady Organic

Moderator
Staff member
50mg of AZA/day is a small dose. im your size and I was on 100 or 125mg/day if I remember correct. Your GI probably monitor your absorption of the drug with a special blood test which is used only for AZA and 6-mp.
The fact that your inflammatory blood markers are decreasing is a good start. It can take a few months before experiencing full effect. If you can reach remission on such a small dose that would be awesome!
However, If you ever feel your symptoms are worsening, please contact your GI and he/she might be able to increase the dose. good luck.
 
I'll put it in perspective: my son was diagnosed in Germany in 2010, at 6yo, and was immediately placed on 100mg/day of azathioprine (among other things)--he was about 55lbs at the time. You can't get single 50mg tablets without special ordering them in Germany at the Apotheke...btw. I was told 50mg is about the "normal" adult dose.

We returned from Germany, September 2015. Needless to say, he's doubled his weight in that time (now 115lbs) and is STILL on 100mg/day azathioprine... He's also on 10mg/wk MTX. That's it. Odd combo, but with dietary changes, he's kicking butt--3 years now!! NO problems.

My new GI, trained in Belgium (unlike my German GI--trained in Tennessee, USA go figure) is worried about the long term impact of John's drugs. He's talking like 20 to 40 years!! HA! These drugs have been around for a LONG time. Steroids, ditto.

So, in reality, they do have their problems, but are pretty mild. Both are carcinogens, but what in our lives isn't?! In my son's case, he's been on Paleo/SCD/Weston A. Price since '13. It's been VERY successful! I'm sure the drugs played a role, I was the one who changed his diet thou. He was once a 3140 mg/L calprotectin kid, now very normal. Our current GI was talking about removing ONE drug this year, this before our most recent--awesome--tests.

I'm not worried and my son has done azathioprine since 6...now he's pushing 13. I'd love for him to be OFF the drugs, but hey--you need to do what works! What's the alternative? Surgery?? Perspective.
 
Hi, i took 25mg of azathioprine for a week starting the 6th of April and then moved up to 50mg, which I have been on ever since - so 11 weeks now. I am still having symptoms and wondering how long I should be giving this drug? Could it be related to my dose? I have read in several people's threads that 50mg is a very low dose. I am 5 foot 5 and weigh about 110 pounds. I am 27 years old. I think my GI mentioned I may go up to 75mg if I manage to put on more weight.

I am worried because I cannot take the biologics as I had an episode of optic neuritis in 2007 and so I am at risk of multiple sclerosis, which biologics can increase your risk of developing.

Thanks
BTW, I also see your location is listed as England--we had the great pleasure of visiting London and several other areas while we were overseas from '09-'15. My grandmother visited several times during the 1980s/1990s and said it was by far her favorite travel destination.

I would visit again in a heartbeat, what wonderful people and SO much to see and do (and we've been ALL over Europe)!! My neighbor in Germany was English as well, born and raised, lots of good stories. I miss the accent. Love it all, and miss it all! Wish only the BEST for you and your great nation!
 
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