Humira and Imuran together

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CrohnsDaddy
Regular Member


Date Joined Oct 2007
Total Posts : 235
   Posted 1/23/2008 12:17 PM (GMT -7)   
Went to my GI appointment yesterday. Not only did he recommend that I start the Humira yesterday, he also wants me to start 100mg of Imuran as well. After reading all the info I could find on Imuran (the stuff on this forum about all the nausea was *very* interesting sad ), I'm concerned about taking these two things together. It seems like I go from one upper respiratory infection to the next during the cold months. Right now I'm on my fourth sinus infection since September. Combining two medicines, both of which lower the immune systems ability to fight infection, has me concerned. I really should have asked my GI about it, but there were so many things I needed to talk to him about, I forgot this one very important question. The fact that I'm exposed to 1,500+ people (from all over the world) every day I'm at work adds a bit to my concern.
 
I'm sure there's a bunch of people on this board that are taking both an immunomodulator and a biologic. How have you been doing as far as URI's are concerned since you've been taking both meds? More? less? same?
 
 
 
Just trying to be a "Regular Member".
 
Entocort 9 mg/day, Pentasa 4 gm/day, started Humira 1/22/08. I'm convinced that Prednisone is the root of all evil, and primarily responsible for global warming.


CrohnieYogi
Regular Member


Date Joined Oct 2006
Total Posts : 367
   Posted 1/23/2008 1:31 PM (GMT -7)   
Hi CrohnsDaddy. I am not on a biologic OR an immunomodulator, but I have talked to my dr. about them extensively. They can work well together, and keep many people in remission or close to it. There is one concern (besides all of the other risks :). There have been some cases of a rare and fatal lymphoma. I think it's a matter of talking with your dr., figuring out what risk/benefit ratio you are willing to live with, and how severe your CD is.

I hope this helped. Good luck navigating these complex waters.

ski bum
Regular Member


Date Joined Jan 2007
Total Posts : 451
   Posted 1/23/2008 2:09 PM (GMT -7)   
I was on Immuran, 125 mg.  When I started Humira, I decreased the Immuran to 100 mg. Within 1 1/2 months, I tapered totally off the Humira. Psychologically, I couldn't handle taking these two powerful drugs together.  I'm curious why your GI would want you on these two drugs simultaneously.  Keep us posted. 

50 y/o F. CD dx'd Aug 05. Initially on Pentasa, then Imuran 125 mg. Started Humira (very reluctantly) on 10/24/07. Currently on Humira, Imuran and Entorcort. Hope to dc Imuran and Entorcort within one month of starting Humira.


CrohnsDaddy
Regular Member


Date Joined Oct 2007
Total Posts : 235
   Posted 1/23/2008 5:13 PM (GMT -7)   
ChronieYogi, that fear of lymphoma is another concern I have, for sure.

sk bum, thanks for the information. I'm feeling the same way about taking them both together. His plan was to start them at the same time, then three months from now discontinue the Humira, and use the Imuran as my long term maintenance drug. Honestly, I think I'd rather stay on the Humira. I've had no problems at all as far as short term side effects (nausea, headache, etc.) since I did the four Humira injections yesterday. I have a small bruise on my leg from one of the injections, but other than that, nada.

So you are going to taper off of the Humira, and stay on Imuran? I'm asking, because I'm a bit confused: your post says that you tapered off the Humira within 1.5 months, but your signature says that you're hoping to discontinue the Imuran and Entocort after a month of Humira. I'm just wondering which one you're prefering for long term use.
Just trying to be a "Regular Member".
 
Entocort 9 mg/day, Pentasa 4 gm/day, started Humira 1/22/08. I'm convinced that Prednisone is the root of all evil, and primarily responsible for global warming.


ski bum
Regular Member


Date Joined Jan 2007
Total Posts : 451
   Posted 1/23/2008 9:42 PM (GMT -7)   
Oops. I meant that I tapered off the Imuran, not the Humira. I seem to think (write) one thing and say something else, and then not notice it. Whereas your doctor is using the Humira as a bridge until the Imuran kicks in, my doctor prescribed Entorcort for 3 months, until the Imuran became effective. Maybe there's been recent literature that supports your doctor's plan.
50 y/o F. CD dx'd Aug 05. Initially on Pentasa, then Imuran 125 mg. Started Humira (very reluctantly) on 10/24/07. Currently on Humira, Imuran and Entorcort. Hope to dc Imuran and Entorcort within one month of starting Humira.


CrohnsDaddy
Regular Member


Date Joined Oct 2007
Total Posts : 235
   Posted 1/23/2008 9:57 PM (GMT -7)   
Ski bum and Kasper87 have me convinced... I'm not going to take the Imuran. I think I'll stay with the Humira for long term treatment. It just seems safer, and the shots aren't that bad.
Just trying to be a "Regular Member".
 
Entocort 9 mg/day, Pentasa 4 gm/day, started Humira 1/22/08. I'm convinced that Prednisone is the root of all evil, and primarily responsible for global warming.


teddybearweiser
Veteran Member


Date Joined Oct 2004
Total Posts : 3042
   Posted 1/24/2008 3:37 AM (GMT -7)   
Hi, I am on Imuran and Remicade. I have no-side effects from either drugs i have been taking both of these drugs for over 2 years. I do have blood test done on ocassions. When you are on Humiria its the same thing with being on Imuran these 2 drugs work good together.
Hi, I am teddybearweiser, I am a male.
I was diagnosed with crohns disease when i was admitted to the hospital
in 1992, in Jan of 1993 I was back in the hospital for surgery for my crohns. I had part of my right colon resectioned with ilecolonstomy.
 My GI doctor has me on Asacol, Dicyclomine,Imuran,Celebrex and Remicade. B-12 injection once a month.
My Internest doctor has me on Lisnopril-HTCZ and Folic Acid. Diagnosed
with Osteoarthritis July 2007
 


parkersmom
Regular Member


Date Joined Feb 2007
Total Posts : 41
   Posted 1/24/2008 7:28 AM (GMT -7)   
Studies show that Humira alone works and there is no need to be on imuran along with it. To supress your immune system with 2 different drugs is probably not a good idea. The reason a lot of patients were on them with remicade is to decrease antibodies that patients can get from the mouse part of Remicade. Humira is different, it is human.

CrohnieYogi
Regular Member


Date Joined Oct 2006
Total Posts : 367
   Posted 1/24/2008 9:07 AM (GMT -7)   
CrohnsDaddy--I know you said that you started/decided to stay on Humira and I think that is probably the smart choice.  Something you need to know is that anti-tnf drugs are not something that works well when taken sporadiclly.  The data (and patients) say that getting on it and staying on it is the only way to go if you want to acheive the maximum results.  Going off and then trying to get bakc on can cause less to no efficacy.  In other words--do not taper and then try to go on it again.  This is not a drug suited to tapering.

broomhilda
Veteran Member


Date Joined May 2007
Total Posts : 1488
   Posted 1/24/2008 9:10 PM (GMT -7)   
I am on Humira 40mg weekly and Imuran 75-100mg alternating days. I have to alternate the dosage on Imuran because I am one of the few with rare genetics that only allow me to take this dosage. My CD is moderate to severe. I was dx'd in Jan. 06 & have had one resection. I've been on the Imuran from my dx.
Tried Remecaid...built antibodies....hence the Humira. I work in the medical field and am exposed to all kinds of infection every single day. I also have not been able to come completely off predinose for the past 2 years (probably due to the lower than standard dosage of Imuran). I am tested periodically for toxity about every 4 months for the Imuran, never have had a problem. The only side effect for me has been some mild migraines so I started taking it at night so I'd sleep through them. It takes about 4 months for the Imuran to really work well. The Humira I find a whole lot easier than Remecaid and have not had any side effects other than the normal flu effects time to time. The flu effects have been a whole lot less than the Remecaid was too. There is some consideration to weigh the risks of doing both drugs together (cancer). However, in my case this has been the only drug combo that has worked for me so far. So long as I reduce my fat intake to half the RDA, stay away from sugar and trigger foods I do pretty well. I have one bowel movement a day and more often than not it's formed. Again, I stress not eating trigger foods! Is my CD under control, no...I don't think so until I'm able to come off the pred. I've had two infections; viral upper respiratory which I chose not to take anything to loosen the phelm ergo upsetting the balance of mucus protecting my stomach. I went with a neb treatment and albuterol inhaler to help with the cough and congestion. Did it take longer to get rid of, yes, but it was a nasty virus that gave several people pneumonia, however, not me because I was attentive to the problem from the onset and did not wait to get treated. The next infection was fungal and I am still dealing with it mainly because my derm misdiagnosed it as psorasis! I am currently on anti-fungal oral meds and while it is taking longer to clear up, it was very aggressive before it was properly dx'd and fungal infections are notorious for being stubborn anyway! I hope this long post will help you in your decision. It's not an easy one...but for me it's working pretty good right now.
Dx'd Jan'06, 1st Resection 7/06, Predinsone, Humira, Imuran, B12 injections, Nexium. Secondary conditions: Psorasis, Acne, Fatigue, Joint Pain, Lactose Intolerant, gallstones, fibroid cysts, peri-menopausal.


metoo50
Regular Member


Date Joined Aug 2007
Total Posts : 55
   Posted 2/3/2008 5:07 AM (GMT -7)   
I would suggest a second opinion. Also do your own research on the subject. Regarding

Humira I do the shots on my belly. I find it less painfull, only a minor sting.


50+ woman, CD for over 20 yrs. On Humira since Aug.2007. Now taking 2 shots monthly. Having minor cold & sinus problems.

CrohnsDaddy
Regular Member


Date Joined Oct 2007
Total Posts : 235
   Posted 2/3/2008 11:49 AM (GMT -7)   
Broomhilda, thank you for the information. I, too, have had the flu symptoms from the Humira. I'm going to give the Humira two months. If I haven't seen a substantial improvement in my CD symptoms by then, I think I'll start the Imuran as well.

metoo50, your statement to "do your own research" actually brought out a laugh from me. I am currently unable to work because of my CD. I spend a minimum of four hours of every day researching Crohn's disease and every available treatment. I have over 500 book marks to Crohn's related information on the net. It made me laugh, cause it made me think that it was like telling a priest to read the Bible. : ) Research is great, but when you combine research with actual experiences of people taking the medications you are wondering about... well, that's *real* knowledge.

Thanks for the input, everyone!
Just trying to be a "Regular Member".
 
Entocort 9 mg/day, Pentasa 4 gm/day, started Humira 1/22/08. I'm convinced that Prednisone is the root of all evil, and primarily responsible for global warming.

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