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Imuran/Azathioprine/6-MP Support Group

CrohnsChicago

Super Moderator
A support group focused on treatment of IBD using Imuran, Azathioprine and 6-MP.

A place to gain some words of encouragement, share your tips, experiences/side effects on these meds and any information/research you may have discovered about the medication as it relates to IBD treatment.

If you have any other helpful readings please post them below and they will be considered for the main post of this group for quick access to info:

Fact Sheet: Azathioprine/6MP Drug Treatment Information
http://www.nacc.org.uk/downloads/factsheets/drugAzathioprine6MP.pdf
 
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CrohnsChicago

Super Moderator
I am on my 11th day of 75mg 6-MP after determining the combination of Prednisone and Asacol is just not enough to keep my flares under control for longer periods of time.

***UPDATE***So far the only side effect I have noticed and feel I can link to 6MP is the fatigue that hits me in waves through the day. While I know I was fatiguged from being in a flare for a while, this heavy level of fatigue didn't exist until after I started the med. It's like I get a sudden urge to just pass out my eyelids get so heavy and my body starts winding down. I also think the combo of pred is what keeps me up late or waking up SUPER early some nights unable to get back to sleep.


I'm curious to know if anyone has any information/tips on hair styling for women with curly hair. I am certain the Asacol and disease itself over the past year is what has taken a toll on my hear thinning it out significantly to where wearing it curly is not really an option anymore. I am hoping the 6-MP does not add to this as I have heard some people mention hair loss as a result of taking this medication.

I occasionally straighten it, but I am looking into the option of wigs (extensions are just WAY out of my budget). Preferably something that is durable and can be worn by a physically active person...and of course looks reasonably natural.

***2/25/14 UPDATE*** Well a year later since starting this post and The hair thinning continued on my hair my eyebrows and my eyelashes. Each time my dosage was upped the hair thinning got worse to the point I could see bald spaces around the top of my head and it looked as if I was losing hair though not much was falling out.

I talked to my doctor about it and since I am in remission and also because my TPMT tests have been a little odd (it is working for me at lower than normal dosages, but my body has an unusual response to metabolizing 6 - mp though nothing of major concern), we have decided to lower my dose of 6-mp. We are also doing a slow taper off of asacol (also known to cause hair thinning).

It has been about two months since the dose change. I can say that my hair seems to be getting slightly better with this medication adjustment. Hopefully the lowering of 6-mp and the eventual elimination of Asacol will keep me in remission. fingers crossed!
 
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I've been on 50 mg of 6MP for a little over a month now. I haven't noticed any extreme hair loss. I, too, fear the hair loss that I've heard about with this medication. Hopefully, someone comes along with some tips.
 

Catherine

Moderator
Hi, I am the mother of a 17 year old girl who has been on aza for 13 months now. No side effects, still trying to get her levels in range.

Her hair seems to have improved since being on aza.
 
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I have been on 50 mg of 6-mp for a month now. My inflammation markers are still increasing so my dose was upped today to 75 mg. Hope it works.
 
My 12 year old has been on 6mp for a year and a half now. They just doubled his dose, still trying to get the dose right.
 

hawkeye

Moderator
Staff member
I am on my 11th day of 75mg 6-MP after determining the combination of Prednisone and Asacol is just not enough to keep my flares under control for longer periods of time. So far no major side effects except for maybe an occasional mild headache/sinus discomfort.

I'm curious to know if anyone has any information/tips on hair styling for women with curly hair. I am certain the Asacol and disease itself over the past year is what has taken a toll on my hear thinning it out significantly to where wearing it curly is not really an option anymore. I am hoping the 6-MP does not add to this as I have heard some people mention hair loss as a result of taking this medication.

I occasionally straighten it, but I am looking into the option of wigs (extensions are just WAY out of my budget). Preferably something that is durable and can be worn by a physically active person...and of course looks reasonably natural.
Did you check your thyroid? If that's off it can cause thinning hair
 

CrohnsChicago

Super Moderator
Did you check your thyroid? If that's off it can cause thinning hair
I haven't had it tested in about 2 years...i think...I get so many blood tests these days it's hard to keep up off the top of my head. I know hair thinning is also common in my mom's side. In addition my dad had thyroid issues as does my grandma (my grandma is going bald a bit)

Probably should pay more attention but I definitely know over the past 12 months since my first flare it has become a lot more noticeable.

Thanks for the suggestion.

***UPDATE: I actually just pulled my blood results (I like to keep records). My last TSH test was in August 2012 and my results were 3.88 which is well within the normal range I believe so unless there's a test I'm not receiving yet I am going to say it has to be the crohn's/meds combo.
 
Location
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I suppose i should join this club too.
My 15.5 year old is starting imuran today...:(
They're starting her on 50mg for two weeks then increasing to 125mg
Shes also taking Pentasa ....and has also been put on flagyl.
 

Jennifer

Adminstrator
Location
SLO
6MP can cause hair loss unfortunately. If it helps, I didn't notice hair loss until after I had been taking it for over 10 years.

I spoke with a hair stylist friend of mine somewhat recently about the issue and she suggested having a shorter hair cut with layers to help add volume (shoulder length is ok, doesn't have to be extremely short) and if you dye your hair darker, to stop and possibly even go a shade or two lighter.

I've been dying mine black for years but with the hair loss, it starts to look like I'm balding so I'm gradually lightening up the color (grew the roots out some, got a short A line hair cut and dyed the roots a rich chocolate brown instead of touching up the black).

I'm sorry I don't have any info on wigs or anything of that nature.
 
I started imuran 6 weeks ago, and am tapering off prednisone. I feel better for the most part. I was told that hunger is a side effect to prednisone but I totally never feel hungry and force myself to eat in order to take my pills and because I know I should. Does anyone else have this problem?
 

hawkeye

Moderator
Staff member
The hunger / increased appetite has been more noticeable sometimes when I've had to take a round of prednisone for a flare than others, the same with the insomnia.
 

hawkeye

Moderator
Staff member
The hunger level has either been normal or ravenous / continually snacky, never had the lack of appetite. The next time I am on pred and have insomnia, I have vowed to take Gravol before bed.
 

CrohnsChicago

Super Moderator
Im usually crazy hungry on pred but this time I toggle between the same hungers hawkeye has.I Typically only have no appetite when something like my symptoms are bothering me Or im under stress
 
My big concern is that I haven't had an appetite for 3 months, ever since I was hospitalized and found out I have IBD. Though I am now starting to feel better with the imuran, I'm still really having a hard time with getting my appetite back, which is making it hard to stop losing weight.
 

CrohnsChicago

Super Moderator
well while on the pred make sure you are drinking plenty of water to flush out your system and reducing your sodium intake to prevent water retention which is very common and a common cause for the bloating, weight gain (as well as increased hunger). My doctor also told me increased water intake on 6-MP was good too because it helps your body flush out toxins and process the meds better.

The only other suggestion I can make is to find ways to be a bit more physically active if you are well and of course choose healthier, safer options for food as often as possible being mindful of portions. As you taper down off of pred you will start to hopefully notice some of the weight/bloating go down, but for some folks it may take a bit longer. The rest it seems will be up to you to control your diet and exercise.

Hopefully it doesn't affect you too harshly. Just continue to be mindful of your dietary habits while on pred that's about all most of us can do.
 

emmaaaargh

Moderator
Staff member
It took me almost... 6 months for my Aza to start working (well, I was only on 35mg half the time, but that's another story) but I feel like it's finally starting to work and I am so relieved!! When I first started I had to force myself to eat and I was dropping weight like nobody's business but now I have an appetite that rivals my prednisone munchies and I'm finally gaining weight again :D

Only thing is that my hair's thinned out tremendously - but to be honest, sometimes it was a little too thick to deal with before. Anyway, I just wanted to share, and say I hope everyone's doing well. :)
 

CrohnsChicago

Super Moderator
So here is my question....if you are on pred for the beginning of it all at what point did you all realize it was working for you? Was it the continued lack of symptoms that was initially Induced by the prednisone?

Or were there still some signs of things not being well after stopping pred and then eventually the 6mp/aza/imuran kicked in?
I hope my question made sense lol :p
 
Location
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Sorry to change the subject.
My 15 year old started taking imuran along with her pentasa and antibiotics a few days ago and the fatigue and nausea have already started...how long do these side effects last?
 
Sorry to hear that she is having side effects. I found that if I take 6mp right before I go to bed, it helped with the nausea and it might even help the fatigue as well.
Good luck with it.
 
Sorry to change the subject.
My 15 year old started taking imuran along with her pentasa and antibiotics a few days ago and the fatigue and nausea have already started...how long do these side effects last?
I found that the fatigue tends to stick around, I've been on imuran for about 7 weeks now. The nausea passed for the most part after a couple weeks. I still occasionally get nausea, but its not constant. I've noticed the longer I'm on the imuran and the less prednisone I'm on the more energy I seem to get, whether that's because I'm finally getting better or what I'm not sure. Hopefully that helps you.
 
My sons been on 6-MP since mid December. We started to see a real difference by the end of January, tummy pain gone and more energy returning.

However, last 2 weeks energy levels been terrible. He is needing 10/11 hours sleep a night just to get through day at school.

Saw GI Monday and generally they are pleased with him, height gone up at last. They've tested blood for various difference things to check problem with tiredness. Hoping it is just iron levels and not 6-MP, as we do think it is working.

Xxx
 
So here is my question....if you are on pred for the beginning of it all at what point did you all realize it was working for you? Was it the continued lack of symptoms that was initially Induced by the prednisone?

Or were there still some signs of things not being well after stopping pred and then eventually the 6mp/aza/imuran kicked in?
I hope my question made sense lol :p
I started to notice I was waking up less in the night to run to the bathroom and the pain started to lessen. More recently I have had more energy and just felt better all around. Still not feeling 100% but I'm also not quite up to the full dose of up imuran yet so hopefully once I get there I will be feeling more like the healthy me.
 
I have been on 50mg of 6-MP for almost two years now. It has definitely worked to lower the inflammation levels in my body.
 

Jennifer

Adminstrator
Location
SLO
So here is my question....if you are on pred for the beginning of it all at what point did you all realize it was working for you? Was it the continued lack of symptoms that was initially Induced by the prednisone?

Or were there still some signs of things not being well after stopping pred and then eventually the 6mp/aza/imuran kicked in?
I hope my question made sense lol :p
For me I knew it was working once I had tapered off Prednisone without having symptoms return.
 
I have been on Imuran for 12 years. Except for the 8 months I came off of it in 2006. I was hoping to get pregnant during that time but instead, when the Imuran got out of my system I had a major flare-up that I honestly thought was going to kill me. So I went back on the Imuran, and don't intend to come off of it again.
I don't remember ever having any side effects with this medicine. I know it takes several months to get in your system though. I just know when it gets in my system I start feeling lots better.
CrohnsChicago,
I'm not an expert on the hair loss, but it's been my experience that when I'm going into a flare and sometimes during the flare, my hair starts to fall out. I have a very thick head of hair so I don't miss it just by looking at it. But when I wash it, brush it, run my hand through it, it comes out in handfuls. I mean a lot more than what is normal. I find it all over furniture, my clothes, the carpet. I've never read this anywhere as a symptom of the disease, but I think it has more to do with certain vitamin defiencies than anything else. Because when the Crohn's is flaring up, your food is not being digested properly. So you lose vitamins and all the other good stuff you need. That's one way I know mine is about to flare up. My hair starts falling out. This has happened to me all 3 times my Crohn's has flared. I thought at first it was the medicine, but then it happened at a time I hadn't changed medicines. So I consider it a symptom of the disease because of the loss of vitamins.
Hope that was helpful!
 

CarolinAlaska

Holding It Together
Telangectasia Effluvium - hair loss associated with major life crises. Corresponds with major stressors, probably includes bad Crohn's flares. Hair usually returns 3-4 months later with the normal cycle of growth.
 
Anyone else have extreme nausea and vomiting on imuran? I didn't until I got up to my full dose and now I spend the first half my day being nauseous and puking.
 
Location
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My daughter got nausea and vomiting when she first started imuran.
Our GP gave her anti nausea tablets that helped...Finally a month later she doesn't need the nausea tablets..things have finally settled down.
 
Anyone else have extreme nausea and vomiting on imuran? I didn't until I got up to my full dose and now I spend the first half my day being nauseous and puking.
As Upsetmom said it can be one of the side effects especially when you increase the dose.

However, if it continues more than a couple of days you should mention it to your doctor. With Easter coming up, it may be worth a quick call to your doctor tomorrow just to get their view in advance of the holiday period.

Maybe try splitting your dose - half in the morning and half in the evening.
Take it with or after food.
Ginger tea or biscuits can help with nausea.
Also your doctor may be able to give you some anti-nausea drugs.

Hope you feel better soon. 😎
 

Catherine

Moderator
Good advice above, please make call today. Hard enough to contact anyone on the weekend let alone on a holiday weekend.
 

CrohnsChicago

Super Moderator
Absolutely let your doctor know. Nausea seems to be a pretty common symptom from what I hear from folks on here when their dosage is increased to the full amount as your body is readjusting to the medication. Some people wind up having to take Zofran temporarily to help with the nausea until things settle down again.

Hope you start to feel better soon!

Anyone else have extreme nausea and vomiting on imuran? I didn't until I got up to my full dose and now I spend the first half my day being nauseous and puking.
 
I called and she told me to back off by a tablet and take it at night with supper so that I will hopefully sleep through the worst of it and call back in a week. But she also suspects that I am flaring again and sent me for blood work and stool samples. If I am flaring again and while still on prednisone then she says I will have to move to remicade.
 
I'm just signing in to this support group. I've been on Imuran for (I think) about 7 years. Still having blood tests every quarter and so far (fingers crossed) I've not been aware of any side effects and my health has improved considerably. My dose was reduced about a year ago, but that was due to me losing weight (positive lifestyle changes, not a result of crohns).

I'm interested in the long term aspects of this drug. I don't really want to be on it, but it's easy to say that when you're feeling OK. My consultant advises that I stay on it for the foreseeable future.

Another aspect of it is reaction to sunlight. Basically I always cover up when I go out, I wear long sleeves, a hat, and usually some moisturiser with a high SPF factor (even in winter). I had two skin cancers removed from my face a few months ago... but I do tend to think this is more to do with my sun exposure 30-40 years ago than a side effect of the drug. I haven't discussed this with the consultant yet, but I'll be seeing him in a few weeks. The dermatologists I have seen (and I did see rather a lot) said there was no connection.

The skin cancers were basal cell carcinomas... if you're going to have any at all, they're the ones to have, but having them excised is a bit dreary (but on the positive side... no prep)
 
I've been on 100mg Aza for 2 weeks now, no side effects so far. Somehow my condition has improved, but it can't be the aza since I was told it takes three months to have any effect. So it's either a coincidence, or placebo, but regardless, I haven't had well formed stools in over a year (yes, I've been flaring for over 365 days) and this morning it was definitely formed.

Never in my life did I ever think I would be happy about a BM. :D
 
I stopped bleeding literally the day after I started Aza, coincidence? Maybe it just works faster for some people, my GP reckons he noticed its benefits much sooner than the 3 month mark
 
I'm doing well on 6mp. My dosage was lowered due to my low white blood count. My dosage alternates; one day it's 75 mp and the next day it's 50 mp. I had one "IBS" episode the end of February and one in the second week of March. I seem to be doing okay now.
 
Just a question - how many of you watch your diet?
I do.

It's been a bit of a gradual thing over the last few years, but I've been paying more attention to the things that make me unwell. I tend to have treats in moderation and eat far more healthily. I was a bit overweight, but I lost about 30lbs and kept it off for 2-3 years now. Feeling much better for it.

My rule is, I just eat whatever I want to eat... but I've changed my views on what I want to eat.
 
I've been on 100mg Aza for 2 weeks now, no side effects so far. Somehow my condition has improved, but it can't be the aza since I was told it takes three months to have any effect. So it's either a coincidence, or placebo, but regardless, I haven't had well formed stools in over a year (yes, I've been flaring for over 365 days) and this morning it was definitely formed.

Never in my life did I ever think I would be happy about a BM. :D
I definitely know that feeling, I haven't had a well formed stool in 3 years now. I was only recently diagnosed and started treatment in recent months. I think part of the feeling better so soon after starting treatment is partly psychological because you're finally getting treatment and progress is being made. At least that's what I think happened with me.
 
I've been taking 6-mp since 2005, I think. It worked miracles for me. A bit of a flareup once in a while but I would say I have been in remission since. Or was. I am starting to flare up--really horribly. Is it possible a drug can just stop working?

Also, has anyone else had problems with the generic kind? I received that years ago when the pharmacy ran out and it made me so sick--like vomitting. But my question really is about the possibility of 6pm not working anymore.
 
This is in reply to buttons post. I am glad that you had great success with 6mp but yes, it is possible for any Crohns drug to stop working. Try to call your GI doctor tomorrow about this if you can. Your doctor might increase your 6mp dosage or temporarily prescribe you a small course of Entocort or Prednisone. Hopefully, this will do the trick. If not, then your GI might want to think about prescribing one of the biologic meds - Remicade, Humira or Cimzia. In the meantime, you might want to help yourself, by getting more rest and sticking to either a bland diet or if you're flaring badly, a clear liquid diet. You might also want to take note if certain foods, supplements, or medications disagree with you or bring on flares.
 

hawkeye

Moderator
Staff member
Also, has anyone else had problems with the generic kind? I received that years ago when the pharmacy ran out and it made me so sick--like vomitting. But my question really is about the possibility of 6pm not working anymore.
I've had it provided by a couple of different manufacturers and have not noticed a difference with either effectiveness or side effects.
 
Persistent Dizziness and tingling.

Hello,
I have been taking Azo for my Crohns for around 2 months now. I was initially put on the 50 for a month but i have now been on 150 for 4 weeks.
Until now I have had no side effects from the Azo other than a bit of hair thinning and the occasional nausea(but I can't be sure that is due to the Azo as I got that before I was on it) . And blood tests show i an responding very well to it!

However over the past 4 days I have been having all day dizzy spells.
I feel very hazy most of the day and around every 10 min get hit by a brief wave a dizziness which is accompanied by tingling in my lips and tounge. It doesnt matter if i am standing or sitting down. The dizzy spells start as soon as I wake up and I still have them when I go to bed.
It has been going on for 4 days now and as it's been the Easter long weekend I have not been able to see my doctor.

I just wanted to see if this was a side effect experienced by anyone else on Azo? As its a symptom I have never experience before.

Thank you
Charlotte
 
Have you had any recent bloodwork done? Dizzyness is not usually associated with aza but I am wondering if either your red or white blood count levels are too low. Please call your doctor as soon as you can.
 
No, not very recently! I am due my next blood test next week. All the previous ones have been fine. I will see my doctor tomorrow. Azo has so many potential side effects I thought it may just be a side effect!

Thanks
 
Hi all, I just jopined this group. I have crohn's and behcets, and my teenage daughter has crohn's. My daughter and I are both now on azathioprine, after she developed pneumonia, aseptic meningitis and head hair loss from humira. I stopped taking humira so I could participate in a clinical trial of helminthic therapy in Portland, Oregon. My question for you today is whether my daughter's arm and leg hair loss is due to AZA or a delayed reaction to humira, which she has been off for about 1 month. No real benefit yet from the AZA for her, but I hear it takes a while. She is starting to feel that her life got worse when she started taking meds. Any thoughts?
 
Hi lily, Aza can cause hair loss from what iv heard but there could be a correlation between hair loss and the disease itself/ not absorbing nutrients and becoming deficient in some vitamins - which can also be attributed to hair loss, most medical literature surrounding Aza says it takes atleast 3 months to reach beneficial levels, I think it took less for
Me as I'm on the 2 month mark and am starting to feel
Much better, a few weeks ago I was very depressed and felt nauseated from upping the dose but since then my body has gotten used to the meds more and more and I assume I'll feel much better in another month. Hang in there, and plz tell your daughter things do indeed get better it just takes time, nothing's ever am overnight fix. How is the tso therapy going?
 
Hi Joshuaa. I will start tso trial in may , and probably won't start tso or control till June, but I'll keep you posted! Thanks for the wisdom and support.
 
So my GI called Wednesday morning and ordered me to stop imuran and come in yesterday morning first thing. Apparently my liver enzymes were elevated so now she has changed me to 6-mp. Of course when I tried to get my prescription filled the pharmacy didn't have any and I have to wait until today. The GI also started the paper work for extra insurance for remicade as she doesn't have high hopes for me tolerating the 6-mp. :(
 
Hello albertasweetie
Apparently a lot of people who can't tolerate Aza are OK with 6MP - there are many examples on this forum.
I will hopefully be starting 6MP soon as my liver reacted to Aza.
Good luck and I hope it works for you.
 
It's strange that people who cannot tolerate Aza (which is metabolized as 6MP in the body) will do well on 6MP itself.I'm curious to know more about the biochemistry of that. Probably an enzymatic problem related to the conversion process.

I hope you feel better, fellow canuck :)
 
My pharmacist says that the people that can't handle the aza but can handle 6-mp are reacting to the carrier agents in the aza. If you can't handle either then it's the drug itself.
 
That's interesting. Those carrier agents must really be something as a lot of people on here have been OK with 6MP but not Imuran/Aza.

Joshuaa - are you switching to 6MP?
 
I have been on Aza from 2003 to late 2008 and then from 2010 onwards til today again. Never tried MP-6 and never experienced any noticeable side-effects from Aza. I was concerned with the long-term effects of Aza, so I phased it out in 2008, but that didn't bode well with my Crohn's.

Regular blood tests haven't shown any detrimental liver effects or other problems.

I am in remission for about a year now and it's definitely the longest remission phase since before I was diagnosed in 1999 with the least problems.

Never tried remicade and don't want to due to potential side effects. From 1999 to 2003 I used Pentasa only and that didn't do anything (I had a lousy doctor the first few years of my Crohn's and was a bit too naive and stubborn to do my research myself...).
 
Glad you're doing well now bud, I think the Aza has got my crohns in remission but I'm just dealing with nausea and a general feeling of unwellness.
 
Glad you're doing well now bud, I think the Aza has got my crohns in remission but I'm just dealing with nausea and a general feeling of unwellness.
I probably say that too often, but try sport. Specifically, try long-distance running (more than 5 miles per run).

For many years I thought tiredness, nausea and periodic problems even with Aza just is the norm for Crohn's. Well, it isn't. Things can get better.
 
I currently take pentasa and 6-mp. Hopefully the 6-mp will work with little side effects and I will actually go into remission, as I am starting to run out of options.

It's weird, but totally makes sense, how much difference there is from how different people react to the same drug. I for one seem to get all the side effects of the drugs, but other people don't notice any.
 
I agree with you albertasweetie.

Like you I seem to get all the side effects. I was allergic to Pentasa and Asacol and now Aza.

Hopefully I'll find a drug that works soon. 😋
 
Hi there, I started on Imuran/Aza in May last year after failing Asacol, my current dose is 150mg. Been trying to come off Prednisone since that time, it's been a pattern of me getting off Pred for about a month (during which I've been declared in "clinical remission" by previous GIs), but then having a recurrence of symptoms once the steroids are fully out of my system. The flares haven't been as severe as before I started Aza, but it just isn't enough on its own to keep the inflammation away.

I've recently started on Humira and I've come off Prednisone as of last Wednesday, hoping that I can stay off the steroids for good now! I'm still taking 150mg of Aza, the plan is to eventually take this dosage down to a minimum maintenance dose in combination with Humira to give me some stability. Hope it works.

I've never had side effects from Aza, and get my bloods done regularly. I've had a number of unpleasant side effects from steroid use that go away when I'm off them (eg. insomnia, altered mood, moon face).
 
Many people have had good results with Humira. I hope that you will continue to do well and not have to go back on Prednisone ever again.
 
Hello, I was just diagnosed a month ago but I've probably had it for 22 years. my doc wants me to take Imuran 50mg 3 times a day. I'm scared. The cure sounds worse than the disease. Ok, so I've had rectal bleeding and intestinal pain for years, my joints and muscles hurt all the time and I can't sleep. But I don't have cancer! What a messed up choice to have to make.:eek:
 

CrohnsChicago

Super Moderator
I'm sorry to hear about your diagnosis. You have found a good community here for support. Are there any other medications your doctor has placed you on?

I also bleed along with the intestinal pains. I just started 6MP in February and was also scared but I have warmed up to the idea of being on the medication a bit more.

The medications doctors place us on can be very scary and may require some lifestyle adjustments but at the end of the day I try to remind myself that the benefits outweigh the risks and the most important thing for me right now is to get into remission sooner rather than later and avoid further complication.

And with regards to Imuran/Aza/6MP - when you read the standard labels and info online, remind yourself that these medications are typically given at much larger doses for other situations such as organ transplant patients, leukemia patients and the like. IBD patients are given significantly lower dosages of this medication and consequently, while we are not out of the danger area in the long run, our risks of complications from these meds have the potential to be reduced compared to other patients who have to take them at much higher doses.

You will also be given regular blood tests to make sure you are accepting the medication properly and that there are no liver or pancreas issues developing.

Below is some additional info on Imuran in case you were interested.
http://www.crohnsforum.com/wiki/Imuran



Hello, I was just diagnosed a month ago but I've probably had it for 22 years. my doc wants me to take Imuran 50mg 3 times a day. I'm scared. The cure sounds worse than the disease. Ok, so I've had rectal bleeding and intestinal pain for years, my joints and muscles hurt all the time and I can't sleep. But I don't have cancer! What a messed up choice to have to make.:eek:
 
Hello, I was just diagnosed a month ago but I've probably had it for 22 years. my doc wants me to take Imuran 50mg 3 times a day. I'm scared. The cure sounds worse than the disease. Ok, so I've had rectal bleeding and intestinal pain for years, my joints and muscles hurt all the time and I can't sleep. But I don't have cancer! What a messed up choice to have to make.:eek:
Sorry to hear about your diagnosis. Re imuran, yes it increases the chance of cancer, but let's compare that to people who smoke just as an example. Smoking increases the chances of cancer tens if not hundreds of times more than imuran... And still people smoke, voluntarily! Imuran has an indirect benefit by the way, because you need to do a complete blood test every 8 weeks and talk to your doctor regularly, it is more likely that cancer or many other diseases are detected very early on.
 

CarolinAlaska

Holding It Together
My daughter got her first blood tests after starting 6MP. Does anyone know what her white count is supposed to be while on this med? I know it is meant to lower her white count, right? How low is good? How low is too low?
 
My daughter got her first blood tests after starting 6MP. Does anyone know what her white count is supposed to be while on this med? I know it is meant to lower her white count, right? How low is good? How low is too low?
The normal adult and teenager range is about 4 to 11 thousand white blood cells per cubic millimeter. I had several GIs due to moving to different countries in the past years, but the consensus of all of them was that the ideal is as close to 4 (lower range boundary) as possible and falling a bit below is no problem. It start to be a problem if you are consistently in the 3 range and it is getting lower, then the dosage should be adjusted.
 
Hey guys, so my GI has given me a prescription for 6mp, just wondering though, do you guys who are on it split doses? I.e 50mg in morn and 50mg at night? That's what the chemist suggested, though the chemist said have if on an empty stomach 30 mins before food, which is contrary to what it says on the imuran box which says to take it w or soon after food... Just thought it was weird because they're basically the same drug :s
 
Hey guys, so my GI has given me a prescription for 6mp, just wondering though, do you guys who are on it split doses? I.e 50mg in morn and 50mg at night? That's what the chemist suggested, though the chemist said have if on an empty stomach 30 mins before food, which is contrary to what it says on the imuran box which says to take it w or soon after food... Just thought it was weird because they're basically the same drug :s
I can't specifically tell you about 6mp (although I think it's similar to aza), but I split my doses (2x50mg in the morning; 1x50mg in the evening). Whether with or without food actually doesn't really matter. We are talking about a long-term immunosuppressive drug here, not iron supplements or some other drug that conflicts with food.

I normally get up, have my breakfast, then after brushing my teeth and shaving I take my morning drugs (aza, iron, multivitamin+zinc+magnesium, vit D3) and in the evening I take it after brushing my teeth again (aza, iron). That way I don't forget about taking my pills...
 
Hi Josh

My doc said to split it half in the morning and half in the evening as this may help with the nausea (in his view). When I eventually get it (don't ask!) I will be taking it in the morning with breaking and in the evening with dinner.

I found that when I took the Aza in the evening after my dinner it seemed to lessen my nausea.
 
I'm not on the imuran yet, I'm stalling. At my last check up the doc found a lump in my breast so I'm having a mammogram first. I was actually grateful for at excuse to put it off. sick, I know. the side effects scare me. I notice every little scrape or tinny wound. There was a guy on the bus today that was coughing and when he didn't cover his mouth I got mad. If I let the doc put me on an immune suppressor I'm going to be afraid to leave my house! I'll be afraid of everything, especially cancer. Am I being paranoid? is it safe? I've been misdiagnosed so many times, AND given meds that you CAN"T take together! Good thing my pharmacist is on the ball or I might not even be here. I'm scared. Which is worse, crohns or imuran?
 

CarolinAlaska

Holding It Together
GM - definitely Crohn's is worse, in my opinion. I know it is scary, but if you read the side effect profile of most meds, even Tylenol, you 'll find it to be scary. At least this one will be monitored closely by your doc, as will potential risks such as colon cancer, which is at increased risk for Crohnies anyway. I'll encourage you in this: my daughter has been taking 6MP for 2 weeks without any side effects that she can feel. Her WBCs are low but not too low, and somehow she hasn't been sick yet - although she was getting sick every 2 weeks before starting the med... I am hoping it is God's extra grace for her :)
 
Joshuaa - I take my full dosage in the morning and with food. I see no harm in splitting the dosage to twice a day but I would definitely take it with food to avoid nausea.

GM - I have been on Imuran before and I didn't have side effects and felt that it helped me. However, I think it would be wise to get your lump evaluated first. I hope it turns out to be something benign, like a cyst.
 
Joshuaa - I take my full dosage in the morning and with food. I see no harm in splitting the dosage to twice a day but I would definitely take it with food to avoid nausea.

GM - I have been on Imuran before and I didn't have side effects and felt that it helped me. However, I think it would be wise to get your lump evaluated first. I hope it turns out to be something benign, like a cyst.
Thx kh, it's just weird, the imuran box says a food, but the 6mp says at least 30 mins before food or 2 hours after :s are you on 6mp or imuran?
 
Thx kh, it's just weird, the imuran box says a food, but the 6mp says at least 30 mins before food or 2 hours after :s are you on 6mp or imuran?
My pharmacist told me to take my 6- mp with food to try to avoid any of the stomach related side effects. That it wouldn't effect the drug at all.
 
Thx for that, yea it makes more sense to have it with food, dunno why it says otherwise on the pamphlet, the pharmacists also said to have it before food, I doubt it'd have much difference, should still absorb fine
 
I have just rec'd my 6MP and was told to take it at least 60 mins AFTER food and to avoid milk 2 hours either side of taking it. Also I have been told to split my dose - half in the morning and half in the evening.

Bang goes my morning cuppa then!
 
I was on azathioprine for 10 years with no side effects and a acceptable quality of life most of that time, however after a bad flare sepsis and a subsequent colostomy I was re started on the azathioprine but couldn't tolerate it at all, my doc switched me to 6mp which caused a bit of nausead for the first few weeks but then subsided, I've been on the 6mp for just over 3 months now and things seem to be improving and inflammatory markers staying low.
 
I never received any warnings or labels on my azathioprine or 6mp about food or drink. The was a warning, however, that said that pregnant women shouldn't handle the medication.
 

CrohnsChicago

Super Moderator
For my 6MP my GI told me to make sure I drink plenty of water/fluids as well and to be mindful of alcohol consumption/drink responsibly.

I can't remember if he told me about not drinking dairy around the time you take your dose or if I just read that on my own somewhere.
 
Hi everyone.

I'll be RE-starting on Imuran soon. I was on it for a number of weeks and during that time my apatite became smaller and smaller until even the thought of food mad me sick. We don't know if it was a side effect from the Imuran or just my Crohn's but almost as soon as I stopped taking it my apatite got much bigger. But besides this, my gut was definitely feeling better while I was taking it.

I was only taking 1 to 1 1/2 pills then. Now it sounds like my Doctor wants me on 2 or 2 1/2 daily.

Just looking for any advice or if any of this has happened to anyone else. Also worried if I could have any problems because I stopped taking it over half a year ago and now restarting.

BTW I have HUGE trouble getting pills down. I needed to chop them in quarters then stick it in a food I could swallow without biting chewing(also a big problem!)
 
Hey Zac, although you felt better when taking it, aza actually only takes effect after months, so the few weeks on it might actually not have had any effect at all.

Re dosage, the effective dose is 2mg to 2.5mg per kg body weight. Say you are 75kg (165lbs), that would mean you should start with 150mg (3x50mg) and then fine tune it on whether your white blood cell count is at the lower end of thr normal range on a constant basis.

Restarting it should not be a problem. But if you experienced side effects immediately before that might happen again. An alternative to imuran (aza) is 6mp, with people having different reactions on that and vice versa.

Interesting that you have trouble swalling the pills, azathrioprine pills are really quite small. Pentasa pill are, e.g. Very hard to swallow and many years back when I was on them I also broke them apart to take them... No harm in that.
 
Thanks Alex!

I may have been on it a couple months, I can't remember right now but I doubt it.

I've always had trouble getting pills down. I blame my gag reflex. I just always choke on even the smallest pills when it's the only thing going down.
 
Well it looks like I am intolerant of 6MP as well as Aza/Imuran. Had really horrible side effects over the weekend similar to the ones I had with Aza.
Onwards and upwards to try another med - probably methotrexate.
 
You really need to give it a few weeks, a couple of days isn't giving your body a chance to get used to it, perhaps a lower dose to start is the way forward.
 

CrohnsChicago

Super Moderator
Well it looks like I am intolerant of 6MP as well as Aza/Imuran. Had really horrible side effects over the weekend similar to the ones I had with Aza.
Onwards and upwards to try another med - probably methotrexate.
Sorry to hear the 6MP was not helpful :(

What were your symptoms/reactions on 6MP and compared to Aza? Were they liver related like Aza (I read what you mentioned earlier in this support group)?
It would definitely make me nervous to take anything similar. Looks like you were only on it for a few short days, did you have any lab tests done?

Hopefully you and your GI can discuss more in depth and determine the best solution for you. :hug:
 
doc just started me on metronidazole and ciprofloxacin. one says to take with milk one says to avoid dairy for 2 hours before and 6 after. but I have to take them twice a day and I have diabetes meds that I HAVE to take with food. my "cognitive" skills have SUCKED for the last 5 years, so what to do? one or both of them are making me really sick so I'm just taking one of them today and the other tomorrow to try and see which one it is. Now I'm almost looking forward to the Imuran, at least it will be the end of the antibiotics, lol
 

CrohnsChicago

Super Moderator
Please discuss any difficulties and changes you want to make to your medicine intake with your doctor. Especially if you have diabetes to avoid any possible complications.


doc just started me on metronidazole and ciprofloxacin. one says to take with milk one says to avoid dairy for 2 hours before and 6 after. but I have to take them twice a day and I have diabetes meds that I HAVE to take with food. my "cognitive" skills have SUCKED for the last 5 years, so what to do? one or both of them are making me really sick so I'm just taking one of them today and the other tomorrow to try and see which one it is. Now I'm almost looking forward to the Imuran, at least it will be the end of the antibiotics, lol
 

CarolinAlaska

Holding It Together
doc just started me on metronidazole and ciprofloxacin. one says to take with milk one says to avoid dairy for 2 hours before and 6 after. but I have to take them twice a day and I have diabetes meds that I HAVE to take with food. my "cognitive" skills have SUCKED for the last 5 years, so what to do? one or both of them are making me really sick so I'm just taking one of them today and the other tomorrow to try and see which one it is. Now I'm almost looking forward to the Imuran, at least it will be the end of the antibiotics, lol
Probably is the metronidazole. It is known to make people feel sick. Avoid all alcohol, including wipes - they mix with the metronidazole and make you sick.
 
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