So many meds...What to try?

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LesaJT
Regular Member


Date Joined Nov 2008
Total Posts : 86
   Posted 6/10/2010 4:38 PM (GMT -7)   
I am new to this, but since I am seeing my doctor again Monday I need to know what to ask and what I should try. I hear people saying about Maintenance meds. I look them up but they seen to have lots of side effects and risks. Who is taking what and what to try or ask about? I am on pred 5 mg/day and if I miss a dose I am worse. I have IBD among other things and lots of inflamation, pain, migraines, on prilosec OTC 2x day, vitamins B and multi.
Thanks.

NiceCupOfTea
Veteran Member


Date Joined Jan 2010
Total Posts : 8566
   Posted 6/10/2010 5:23 PM (GMT -7)   
Don't scare yourself with side-effects/risks too much; believe me, they're all safer than pred. The thing about side-effects is that pharmaceutical companies are legally obliged to list every single reported side-effect, even if only 1 person in a million suffered it. The vast majority of listed side-effects most people will never get. And common side-effects, such as nausea, often disappear after a few weeks. (If they don't, it's possible you might be on too high a dose or intolerant to the drug.)

It depends partly on disease severity, but I personally would recommend starting with the 5-ASA drugs - Asacol, Pentasa, Lialda, etc. They are all basically the same medication (mesalazine) delivered in different ways or to different parts of the intestines. They're the mildest class of drugs for IBD.

The next class up are the immunesuppressants, 6MP and Imuran. A significant minority (3-15%; the stats vary) are unable to metabolize these properly, suffer from lowered white blood cell count as a result, and have to come off them. That's why regular blood testing is done for the first three months. After that point, adverse reactions are unlikely. Both drugs are usually well-tolerated and many people stay on them for years.

The final class are the biologics, aka anti-TNFs (Tumor Necrosis Factor, a protein involved in causing inflammation). It consists mainly of Remicade, Humira and Cimzia. These are the strongest drugs for Crohn's, and the ones you're most likely to have severe reactions to. But they often have the best results, particularly in conjunction with 6MP or Imuran.

Broadly speaking, that's it. There's also antibiotics, probiotics and supplements. I do highly advise getting onto a maintenance drug, as leaving Crohn's alone to do its thing doesn't really work long-term. (As I found out.) And you really don't want to stay on even a low dose of pred long-term. Good luck!

LesaJT
Regular Member


Date Joined Nov 2008
Total Posts : 86
   Posted 6/10/2010 5:40 PM (GMT -7)   
Wow thanks. I appreciagte your info. I am so tired of this all and feeling exhausted. My friends and family want me to get out there and have a life. yeah...me too. what about pain meds. the doctor says I can take Ibuprophen. Any thing other then Opiates which dont sit well with me. I tend to vomit.

NiceCupOfTea
Veteran Member


Date Joined Jan 2010
Total Posts : 8566
   Posted 6/10/2010 6:13 PM (GMT -7)   
Ah I didn't think of pain meds =/ I don't take any, that's probably why. But whatever you do, don't take ibuprofen! Taking it occasionally may be okay, but taking ibuprofen on a daily basis is a disastrous idea for people with Crohn's. It can cause stomach bleeding and intestinal ulceration. The same is true for all NSAID painkillers, btw. (NSAID = Non-Steroid Anti-Inflammatory Drug)

Alternatives are paracetamol (which you may know better as tylenol) and which is sadly not nearly as good as ibuprofen. Or codeine, but it's an opiate, so...

Hopefully others will be able to make some more suggestions. Also, I would seriously question a doctor who didn't know that NSAIDs were bad for Crohn's sufferers. Even for a general practitioner that would be a poor oversight - and an unforgiveable one in an GI.
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