If the 6MP fails, what comes next?

[GirlFriday]

Hi all, my GI put me on 6MP (Imuran, Aza etc all the same thing) a month ago, and for the last few days I have been so sick. Fever, headache, sore neck, nausea the whole fun bag of tricks. My GI called and my liver count on my last blood test is high, so it looks like there is a chance it could be poisining my liver. :ybatty: I just had another blood test, and I will find out on Monday if I have to stop them.
So far my GI has followed the 'traditional' route I guess - messazaline, then steroids, then immunosuppresents, so I am just wondering, if I do turn out to be one of the people that can't take the Aza (darn it! I was SO hoping this would be my magic bullet) then what tends to come next?

 

[imisspopcorn]

Sorry it's not working for you. I followed the same course as you. The next step is one of the immune modulating meds like Remicade or Humira. There are Remicade and Humira threads you can take a look at. I'm currently on Remicade.
Man, it can be so frustrating trying to find something that works. Don't give up!

 

[GirlFriday]

Hmm. I was hoping that would not be the answer. Thank you for the encouragement misspopcorn, I still have my fingers crossed that I can stick with the aza! I think it is wishful thinking though...

 

[beth]

Methotrexate is next in the non-biologics line. Depends on how symptomatic you are, I guess, which line, if any, you go down.

I may have just added MTX to my list of failed meds but I'm just considering it as a temporary break at the mo.

 

[GirlFriday]

Well my GI just called and on my last blood test my liver count was back to normal. So while he is still not sure what caused the spike, he got me to start back on the Azathioprine today. I am really happy that I still have a chance this will work Although, I am just a little nervous that I will be waking up at 4am again shivering and throwing up. Fingers crossed I guess.
Beth - I'm really sorry to hear the MTX didn't work for you. I hope you can find something really soon!

 

[GirlFriday]

Huh. Weird bolding there. Never mind... I promise I wasn't shouting at you Beth! Lol

 

[Crohn's 35]

HI GF, I was on 6mp and it affected my liver too, lotsa pain with it, nausea, and I stopped taking it cause I knew that is what it was, and when my Gi called I told him and he said to stop it and I already did. The pain and feeling went away within days, apparently once you stop taking it, doesnt take long for it to get out of the system. I was also on Salofalk and it was ok but didnt do a thing. My first surgery was a course of Entocort which was great, take all pills at once and no sides. I am wondering if maybe you are infected. Have you tried a round of Cipro or Flagyl? Humira maybe a good choice down the road. I hope you get some relief soon!

 

[fenway1971]

Hi GF,
I went through similar phase. But my body tolerated 50mg, just nothing higher. What dosage are you on and can you stay on low dose?

I was told next step are biologic drugs like remicade.

 

[Jennjenn]

Hi GF I had increased liver counts on some past blood tests when I used to take 6mp. I actually from time to time still have elevated bilirubin counts. My doctor said last year that it was Gilberts syndrome which fasting can make the levels increase. Some other causes that can make the levels increse are
•Dehydration
•Fasting: This produces an increase in the plasma unconjugated bilirubin level.
•Intercurrent illness, such as a viral infection
•Menstrual periods
•Stress, such as trauma and overexertion
Maybe you can mention the possibility of having Gilberts to your doctor...my doctor said Gilberts is not a serious condition to have

 

[beth]

No worries JennJenn!

 

[Jared]

remicade was the miracle drug for me, so far little to no side effects...long-term who's to know