Need advice please.

[Okitsme]

Hi everyone,

Saw my gi yesterday and he has put my pred up to 30mg and also put me on azathioprine. Yesterday me and my partner came down with a vomiting and diarrhoea bug. So my question is will it be safe to take the azathioprine while I am ill?

Many thanks

David

 

[alex_chris]

Hi David, what is your aza dosis (mg per kg?). How long did you have Crohn's (or is it UC?).

Generally, the answer to your question is, yes, it's safe. While azathioprine is an immune system suppressive drug, at the maintenance dosage (2mg to 2.5mg per kg) that is used for Crohn's and UC patients, your white blood cell count should still remain in the normal range, although lower range.

Not however, that especially in cases of wrong doses of aza or overreactions to it, people can, in rare cases, have severe infections. But that is not common, but rather is rare.

 

[Okitsme]

Hi Alex, doc wants me to start off with 1.5mg and then go higher once I start tapering the pred. I was only recently diagnosed with crohns and have been on pred ever since. Was at 30mg, tapered down to 5mg went back up to 15mg for the past couple of weeks and now have to go back ou to 30mg.

 

[alex_chris]

Hi Alex, doc wants me to start off with 1.5mg and then go higher once I start tapering the pred. I was only recently diagnosed with crohns and have been on pred ever since. Was at 30mg, tapered down to 5mg went back up to 15mg for the past couple of weeks and now have to go back ou to 30mg.

Ok, that makes sense - I would not worry about the aza and currently being sick with some virus/bug. I hope you can get rid of the pred soon and that aza starts working. It makes sense to start with 1.5mg per kg on aza, but you should remember that the actual effective dosage is 2-2.5mg (below that, in the long run, aza has been shown to be rather ineffective - the reason is quite simple, our immune system reacts to aza by not producing as many white blood cells as under normal circumstances, which lowers the chance of a severe immune system overreaction, however, at eg. 1-1.5mg this suppression effect is negligible, while starting at 2mg it is severe enough to really help). Your doc probably also told you that aza can take up to 4 months to actually start working as a maintenance drug.

 

[Okitsme]

Thanks Alex, he did say about ten weeks before it works. Up to then I have to taper down to 15mg of pred and stay on that for a while while I am waiting for the aza to take affect. Going to be having weekly blood tests for a while to check my white blood count. Thanks for the advice though. I will ensure I start the meds tomorrow.