Increasing Aza?

[Mehita]

Today was DS's last day on pred and he continues to hold steady. He's still on a very light dose of Aza because of an intermediate TPMT. We've done labs twice and both times they've come back normal, third set is this coming Monday. No inflammation and liver is good. Shouldn't we be increasing the Aza? He started it on May 10th.

The last set of labs, one week ago, I thought was going to include the 6MMP and 6-TG tests, but maybe I misunderstood that since we've seen no results for those two tests yet. Do they typically take a week or longer?

I'm just nervous now that he's not on pred anymore that we may be opening up the door for another flare while waiting for the Aza to kick in. Or maybe it has? I have no idea?

I'll call the GI nurse tomorrow, but was just wondering if anyone has thoughts.

 

[Novice]

Hey if when you say you thought the labs were going to inc the 6mmp test you mean they were checking to see if the levels were theraputic (I don't know what the name of the test is)
I have had this test a couple of times never taken more than a week from what I remember!

I hope it is at a theraputic level, increasing aza is not something you wabt ti rush if you dont have to!

 

[Catherine]

We are waiting on the test checking aza levels, I think its a minimum of two weeks for us.

 

[Askim]

Hi, please do not rush on Azathioprine and get regular blood tests.. This medicine gave me Pancreatitis and I have been admitted to hospital for 4 days..
Just go steady on the med and regular blood checks!!
Hope it helps..

 

[Johnnysmom]

They do take about a week to get back.

My son is on a pretty low dose of 6mp too. The GI said it has nothing to do with weight and the dose is based on how you metabolize the drug. They have been adjusting my sons dose since he has been on it, almost two years. It took me a while to get use to how slowly the do things with this drug but the trial and error is part of finding the right dose. If you switch around too quickly or too much you haven't really found out what might work. This might be the perfect dose for him.

(((((Hugs)))))

 

[DustyKat]

Sarah has had a right hemicolectomy and has been in remission for just about 7 years now. At the time of her diagnosis, when she had surgery, TPMT tests weren't available here at that time so she was commenced on 50mg of Imuran as a introductory dose to see how she responded. Seven years later and she still remains on that dose despite having been through puberty and so gaining both weight and height. The philosophy of the GI's have been that while she remains both symptomatically and clinically CD free leave well enough alone.

Good luck mum, I hope you soon have answers. :hug:

Dusty. xxx

 

[Mehita]

Just heard back from the nurse. They got his labs back this morning and she said he's in the therapeutic level already. I was surprised! He's only on an alternating dose of 25/50mg. So, I guess we're good and will just keep the status quo.

My next question... if he flares again while in the therapeutic range, then what?

 

[my little penguin]

Breathe
Don't be asking about flares
You can flare on any med .
DS had a small one in remicade
But depending on how long or how severe depends on how the Gi will treat it.
DS was on a really low dose of 6-mp as well
50 down to 25 then later 12.5 mg with allopurinol.
Good luck hope it continues .

 

[Clash]

That is great that he is in the theraputic range!!! Yay!!! We have not used Aza so not sure how that works in reference to your question.

 

[Tesscorm]

Glad he's already at therapeutic levels!!

No experience with this but, I imagine if he flares again, then as Johnnysmom said, some adjustments may need to be made to the dosage. Or, in worst case, it will be determined that it is not working for him.

The questions I would ask GI would be (keep in mind Stephen has never used aza so some of this may be basic knowledge to you??):

- how it will be determined if it is continuing to work?? Will testing of therapeutic levels be done at regular intervals or will they determine effectiveness some other way (ie MREs) and not test therapeutic levels regularly.
- Can he flare while still at therapeutic levels? ie would this mean that the Aza simply isn't working any more? Also, if he CAN flare while at therapeutic levels, what tests can be done to give an early indication of a coming flare (I suppose similar to the question above about testing for effectiveness).
- And, if he flares at current therapeutic level, would there be any benefit in trying to increase the dose or does flaring at therapeutic levels definitively mean that the med failed him?

Hope that helps...

 

[Mehita]

Breathe.

Thanks, MLP... I needed to hear that. :ghug:

I should be dancing with bananas right now.
:dance: :dance: :dance: :dance: :dance: :dance: