When do you have to worry about picking up infections on immunosupressants?

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jeanneac
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Date Joined Feb 2009
Total Posts : 1812
   Posted 7/1/2010 1:19 PM (GMT -7)   
At what doseage do you have to worry about picking up infections on immunosupressants?  10 mg of prednisone is safe for the most part right? Do I have to worry about being around people who might have a virus or other infection?
d 1/09 with colitis sigmoid colon with some diverticular disease as well
IBS, asthma/allergies, high BP, fibromyalgia, Mixed Connective Tissue Disease
claritin, singulair, diovan, progesterone, VSL#3 probiotic, Vit. D, colazal, plaquenil back on cymbalta for pain, nexium for reflux, wellbutrin
Blood test positive for Crohn's via prometheus ibd serology panel ASCA
Positive ANA
Collitis doing OK for now, it's fatigue and joint pain that are plagueing me right now!!!


CrohnieToo
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Date Joined May 2003
Total Posts : 9448
   Posted 7/1/2010 3:05 PM (GMT -7)   
When you said immunosuppressants my mind immediately jumped to Imuran which I am on. I haven't ever worried about being more susceptable to infection whilst on Imuran. We monitor my blood periodically. We are at a dose to tamp down the over active immune system in the gut, not the entire immune system. I have COPD and have had LESS colds and NO flus (knock, Knock, KNOCK) since being on Imuran.

I didn't and don't like pred for reasons other than what it might do or not do to my immune system. Glaucoma, osteoporosis .... and its common side effects on mood, personality, hair, moon face, etc.
 
And - I forgot - I volunteered at our local hospital in Messenger Service meaning I traveled thru all the floors and departments each volunteer day the first 4 years I was on Imuran.


My computer says I need to upgrade my brain to be compatible with its new software.

Post Edited (CrohnieToo) : 7/1/2010 4:09:41 PM (GMT-6)


jeanneac
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Date Joined Feb 2009
Total Posts : 1812
   Posted 7/1/2010 3:23 PM (GMT -7)   
I have another apt with my rheumy on the 8th and I think I am going to ask to go on one of the other immunosupresssants like the one you are on. I actually think they have fewer side effects and are better in the long run. I have other auto immune issues and don't want to take pred long term. I do feel better though. It's helped everything that hurts!
d 1/09 with colitis sigmoid colon with some diverticular disease as well
IBS, asthma/allergies, high BP, fibromyalgia, Mixed Connective Tissue Disease
claritin, singulair, diovan, progesterone, VSL#3 probiotic, Vit. D, colazal, plaquenil back on cymbalta for pain, nexium for reflux, wellbutrin
Blood test positive for Crohn's via prometheus ibd serology panel ASCA
Positive ANA
Collitis doing OK for now, it's fatigue and joint pain that are plagueing me right now!!!


NiceCupOfTea
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Date Joined Jan 2010
Total Posts : 8568
   Posted 7/1/2010 3:29 PM (GMT -7)   
I never worry about it. Been on Pred, Entocort, 6MP, and azathioprine and didn't catch colds any more often than usual. Most people will report the same. Simply put, immunesuppressants tone down a malfunctioning / overactive immune system a notch; they certainly don't knock it out completely. If they did do that, a lá AIDS, then you certainly would be right to fear opportunistic infections of all kinds.

Actually, I've noticed that my colds aren't as severe as they used to be. I have a theory that the wonky immune system which causes my Crohn's disease might also go into overdrive on colds and make them less severe than they would otherwise be. Of course, this is just a theory... <_<

EDIT: If you want a long-term immunesuppressant, yes, go for Imuran (azathioprine) or 6MP. Steroids are not safe to be on long-term for all sorts of reasons. But Imuran and 6MP are reasonably safe and well-tolerated over a long-term period. (If you are among the minority who can't tolerate them you will find it out early on - that's what the regular blood tests for the first 3 months are for.)

Post Edited (NiceCupOfTea) : 7/1/2010 4:32:24 PM (GMT-6)


jeanneac
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Date Joined Feb 2009
Total Posts : 1812
   Posted 7/1/2010 6:30 PM (GMT -7)   
I guess what my doc is going to do is try this and then when he tapers me off, we'll see if the symptoms come back. I guess it's the usual way a lot of them go. I seem to have more of a mixed connective tissue disease with colitis, my ANA is positive and so far that's it along with a positive prometheus test for crohn's. I'll talk to him about long term next week. I think I'll need it. He did say the next step was "chemo."
d 1/09 with colitis sigmoid colon with some diverticular disease as well
IBS, asthma/allergies, high BP, fibromyalgia, Mixed Connective Tissue Disease
claritin, singulair, diovan, progesterone, VSL#3 probiotic, Vit. D, colazal, plaquenil back on cymbalta for pain, nexium for reflux, wellbutrin
Blood test positive for Crohn's via prometheus ibd serology panel ASCA
Positive ANA
Collitis doing OK for now, it's fatigue and joint pain that are plagueing me right now!!!


CrohnieToo
Veteran Member


Date Joined May 2003
Total Posts : 9448
   Posted 7/1/2010 8:47 PM (GMT -7)   
Well, that was a poor choice of words by your doctor to say "chemo" which usually conjurs up scarey, unpleasant impressions.

Be aware tho that Imuran can take quite a while to go into full effect. Generally you are started on Imuran and Entocort EC w/a tapering of the Entocort as the Imuran begins to provide some effect. If I remember correctly they figure the usual or average time for Imuran to take effect is 6 months. Whereas pred provides almost immediate effect. Imuran is more a maintenance med than an immediate treatment med is one way of describing it.
My computer says I need to upgrade my brain to be compatible with its new software.


mtgman
Veteran Member


Date Joined Mar 2005
Total Posts : 1289
   Posted 7/1/2010 9:11 PM (GMT -7)   
10 mgs of pred is not much...i've been on much higher and have been on other immunosuppresent...right now on remicade and prednisone. the only time i was ever worried was when i got a bad infection under my fingernail...imagine going to the doc for an infected finger! haha...anyway some antibiotics did the trick...i've never gotten any sicker (cold flu etc) than normal- even with a 4 year old. just wash your hands a lot and keep sanitizer handy.
36 year old male living in AZ.  Diagnosed with Crohns at age of 15.
Currently on 30 mg prednisone.  still taking Asacol.  Just had 3rd Remicade infusion 3 weeks ago
In the middle of a bad flare now for over a year...lost almost 30 lbs. -- gained most of it back now.


sr5599
Veteran Member


Date Joined Aug 2007
Total Posts : 1202
   Posted 7/1/2010 9:25 PM (GMT -7)   
He might have been talking about Methotrexate, which is technically a chemo drug. But, when it's used for Crohn's, it's much, much smaller doses! So, as CrohnieToo says, it's a terrible choice of terms for your doctor to use.

I'm currently on both Cimzia and methotrexate (25 mg IM weekly) and don't seem to get sick (colds) anymore than anyone else I know. I am cautious at the store I wipe the cart handles, but other than that, I don't really worry about it.
1 fistula, crohn's colitis, limited to large intestine
Compounded budesonide 3mg/daily, Cimzia, MTX . Dx Osteoporosis 10/08 started Forteo 1/27/09


sr5599
Veteran Member


Date Joined Aug 2007
Total Posts : 1202
   Posted 7/1/2010 9:25 PM (GMT -7)   
He might have been talking about Methotrexate, which is technically a chemo drug. But, when it's used for Crohn's, it's much, much smaller doses! So, as CrohnieToo says, it's a terrible choice of terms for your doctor to use.

I'm currently on both Cimzia and methotrexate (25 mg IM weekly) and don't seem to get sick (colds) anymore than anyone else I know. I am cautious at the store I wipe the cart handles, but other than that, I don't really worry about it.
1 fistula, crohn's colitis, limited to large intestine
Compounded budesonide 3mg/daily, Cimzia, MTX . Dx Osteoporosis 10/08 started Forteo 1/27/09


jeanneac
Veteran Member


Date Joined Feb 2009
Total Posts : 1812
   Posted 7/2/2010 7:59 AM (GMT -7)   
Yea, I thought it was funny that he termed the drug "chemo".
d 1/09 with colitis sigmoid colon with some diverticular disease as well
IBS, asthma/allergies, high BP, fibromyalgia, Mixed Connective Tissue Disease
claritin, singulair, diovan, progesterone, VSL#3 probiotic, Vit. D, colazal, plaquenil back on cymbalta for pain, nexium for reflux, wellbutrin
Blood test positive for Crohn's via prometheus ibd serology panel ASCA
Positive ANA
Collitis doing OK for now, it's fatigue and joint pain that are plagueing me right now!!!


tez25
Regular Member


Date Joined Dec 2009
Total Posts : 65
   Posted 7/2/2010 2:21 PM (GMT -7)   
i'm on 150mg per day of azathiprine and i have been on prednisolone in the past. i'm a student working in a hospital and so i was a little worried at first about picking up infections etc. iv actually found, however, that i seem to pick up fewer infections than my totally healthy housemates (who are also students in the hospital). I don't know if it has anything to do with the meds or not, but there have been times this yr that all 3 of my housemates have stayed home because they all had colds etc, and i went to work!!!

jeanneac
Veteran Member


Date Joined Feb 2009
Total Posts : 1812
   Posted 7/4/2010 9:00 AM (GMT -7)   
That's good news tez! Glad it is working for you.
d 1/09 with colitis sigmoid colon with some diverticular disease as well
IBS, asthma/allergies, high BP, fibromyalgia, Mixed Connective Tissue Disease
claritin, singulair, diovan, progesterone, VSL#3 probiotic, Vit. D, colazal, plaquenil back on cymbalta for pain, nexium for reflux, wellbutrin
Blood test positive for Crohn's via prometheus ibd serology panel ASCA
Positive ANA
Collitis doing OK for now, it's fatigue and joint pain that are plagueing me right now!!!


tewcute
Regular Member


Date Joined Mar 2010
Total Posts : 300
   Posted 7/4/2010 10:22 AM (GMT -7)   
I have been on 9mg of entocort for 3 months now and am frequently around my 5 year old niece. I have not caught anything. i don't notice my immune system being lower. I do make sure to wash my hands though and now I avoid letting her drink out of my cup and stuff like that. By the time a cold shows up in people it is usually too late to take precautions.
Dx with crohns February 25, 2010. But suspect I had it since 2002 with very mild symptoms.
4 lialda a day.
3 entocort daily for the next few months
hyosamine for daytime
Bentyl for evening
Multigen

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