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Reaction to Imuran (Aza)

Hi guys,

I realise there are probably heaps of threads out there on this but wanted to ask anyway...

I just got off the phone to my GI and he now thinks Im having a bad reaction to Imuran. Am halfway thru my fifth week on it and over the last 5 days have started to go back down hill. Started with nausea only in the morning for a few hours, then slowly started to increase until the last couple of days have been all day, pain has come back really bad in my right side of my abdo and then 3 days ago I got a pimply rash on my legs, back, neck and face not bad or all over and could have been a heat rash as I live in a really hot climate, it is nearly gone now tho.

Yesterday he put me back on pred as I came off it 8 days ago and he thought maybe I didn't have the flare under control, he said cause I had been on Imuran for over 5 weeks doubted it was a reaction but sent me for blood work to be on the safe side. Then today my bloods came back with my inflammation markers high which is not normal for me as the whole time I have been suffering/sick my markers have been normal even with all my inflammation (can't be explained why). He has told me to stop all drugs even the pred as I have only taken one tablet so far in this course and too see what happens, am so scared of getting worse but know I have to do it otherwise the reaction could get worse. He did say it would only be for a few days and if I get really bad then to go back on the pred.

Sorry such a long novel but wanted to give the full story before getting to the point... finally has anyone else had a similar experience on imuran? Im now wondering what drug is next for me?

Thanks everyone!! :) :)


mum with a dogdy tum
they are loadsa of us on that med. i cant tell you my experience as i only started on it 2 weeks ago. but i do get awful cravings for salt!!!
Apart from the rash, the pain sounds like what aza (50mg) did to me at the 3+ week timescale: nausea about 5 hours after taking tablet, horrible pain in mid to lower right quadrant - under the bottom of the ribs downwards basically. They then tried me on mercaptopurine and I threw up spectacularly!
yeah i had skin reaction from Imuran... but i just quit taking it a couple weeks ago.

i found that it made my skin get itchy and dry and sometimes i'd get a mild rash around my lower neck.

also, the skin on my face got a bit uneven and blotchy...a few whiteheads.
I also lasted a mere 9 weeks on Azathioprine. I didn't really feel any better and the nausea and extreme hair loss was too much to put up with in the end. I'm glad to not be on it anymore - I'm back on Entocort and it's helping which is great.

There are a number of different medications that come next, 6mp and Methotrexate are similar to Azathioprine but are said to have less side effects as they are metabolised by the body different. There is also always Infliximab and Humira. I suppose it depends what you and your GI feel is most appropriate and what can be funded.

Good luck anyway - hope you're feeling better and brighter soon, Tan. :)
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My partner takes methotrexate for psoriatic arthritis & has lost most of his hair due to this drug. I think most immuno drugs tend to cause hair loss. My hair was falling out before I started aza.
my wife had the same thing, more or less.
Her GI switched her to Cimzia and is planning to start methotrexate soon.
NatalieMT said:
There are a number of different medications that come next, 6mp and Methotrexate are similar to Azathioprine but are said to have less side effectsas they are metabolised by the body different.
6-mp is mercaptopurine, which is the active metabolite of azathioprine. Some people are allergic, or intolerant, to the inactive metabolite whereas I had exactly the same form of reaction to 6mp as I did to the aza.

Methotrexate (mtx) seems to be the last of the non-biologics. It's an anti-folate (as in folic acid). It's taken weekly, often on a monday night, some days later you need to take folic acid to 'rescue' your system from the effects of the mtx, usually friday - easy to remember M for monday and mtx, F for friday and folic acid. The side effects I had led me to come off it: slept most of tuesday and wednesday, felt like a zombie for a couple more days, brain function down a lot - GI reckon the best people who are effected by the 'brain fog' will ever get to when they get used to it is 10 to 15% down on brain brightness. Asthma got a lot worse with pain and tightness across my chest. And then there was the incident where I thought I might have had a heart attack - I hadn't, if anything it might have been a panic attack or similar, but it frightened us enough for me to stop taking it.
Powerful drugs! not to be taken lightly. But then again with the monitoring I had if it had started messing with my liver/etc it would have been spotted very quickly. So no fret.
Hi all,

Thanks for all your replies... I will discuss with my GI next week my drug options I have read so much about Remicade and how awesome it is but not sure Im at that stage yet? I don't really know alot about the drug but heaps of people seem to have success on it. Im sure there are heaps of other drugs the GI wants to try before Remi anyway. I

Is Remi a maintance drug. I think my flare may already be undercontrol as I have now been taken off all drugs. 4 days ago my GI called (day after starting pred again) saying that my test results came back high and I was either having another flare or reaction to imuran. He thought the later but wanted me to go off all drugs and if it was a flare would go downhill again and if not then we def know its the imuran. Im feeling ok at the moment haven't had nausea since going off imuran 4 days ago and have my appetite back, my skin rash has now nearly gone. So I have to call hime next week to re-group and figure out where to go from here. Just so frustrating its all trial and error seeing what works for you. Hopefully the next drug is good for me!


Captain Insaneo
Little late, but Imuran caused me SEVERE nausea and vomiting. So bad in fact I was hospitalized. Good luck and I hope you find a new drug, if needed, soon!!
I get the impression Remi is both. It's good at getting people in remission and maintaining it.

Anyway, good luck with the next drug!