Tolerate Immuran but not 6MP?

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dietcoke
Regular Member


Date Joined Jul 2008
Total Posts : 186
   Posted 8/27/2010 7:20 PM (GMT -7)   
Hi: In the past, I had an immediate severe reaction to 6MP - literally took one pill and was up all night crying, hunched over with stomach pains, chills, nauseau, etc.

Fastforward about 10 years, I am running out of medicines. My doctor wants to put me on Cyclosporine for three months, then switch me to Immuran. He seems to think that 1/3 of patients can tolerate Immuran even if they can't 6MP. I'm not sure this approach makes much sense.

So, I guess I have two questions:
Have any of you tried Cyclosporine?
Also, have any of you been able to tolerate Immuran and not 6MP?

Thanks.

Nanners
Elite Member


Date Joined Apr 2005
Total Posts : 14995
   Posted 8/28/2010 8:20 AM (GMT -7)   
I was the opposite, couldn't tolerate Imuran but could tolerate 6mp no problem. Wierd huh?
Gail*Nanners* Co-Moderator for Crohns Disease 
Crohn's Disease for over 34 years. Currently on Asacol, Prilosec, Estrace, Prinivil, Diltiazem, Percoset prn for pain, Zofran, Phenergan, Probiotics, Calcium, Vit D, and Xanax prn. Resections in 2002 & 2005. Also diagnosed w/ Fibromyalgia, Osteoarthritis, & Anxiety. Currently my Crohns is in remission, but my joints are going crazy!
*Every tomorrow has two handles.  We can take hold of it by the handle of anxiety, or by the handle of faith"*

80sChick
Veteran Member


Date Joined Oct 2009
Total Posts : 1054
   Posted 8/28/2010 9:00 AM (GMT -7)   
I had side effects on 6mp but was fine on Imuran.
Stephanie, 28 years old
Diagnosed with Crohn's Colitis March 2000
Possible diagnosis of IBS-D
Total Proctocolectomy and Permanent Ileostomy 3/18/10! :)
Blockage/Ileo revision 6/8/10 :/
 
Tried: Asacol, Remicade, 6mp, Humira, Xifaxan, Apriso, Imuran, Rowasa Enemas, Colocort Enemas, Psyllium Seed Powder... Tried Probiotics: Align (with no change except bloating) and VSL #3 DS (AWFUL diarrhea).
 
Currently taking: Prenatal Vitamin, Vitamin B 12 Complex, Biotin, Vitamin D, Calcium, Flomax (for urinary retention). 

NiceCupOfTea
Veteran Member


Date Joined Jan 2010
Total Posts : 8550
   Posted 8/28/2010 12:44 PM (GMT -7)   
It's possible to tolerate Imuran but not 6MP and vice versa. It's not really clear why, but their modes of actions seem to be different enough that that is the case.

I have taken both, and Imuran was a weird one for me. Had no side effects at all for the first three months, then I got hit with the biggest flu-like symptoms imaginable out of the blue. It took two months in total to get over that bout. I stopped taking the Imuran.

Two years later I was put onto 6MP. The main side effect was nausea, but it disappeared after a few weeks. After that I tolerated it pretty well, but I stopped it after six months. Put back on it again this year. I had the nausea again, but not as bad and it disappeared sooner. Been on it for nearly 4 months now and I feel okay, apart from the usual Crohn's symptoms which it doesn't seem to touch. However my white blood cell count has been described as 'borderline' and I do wonder about the possibility of another flu-like reaction occurring.

Haven't tried cyclosporine, so no comments about that, sorry.

By the way, not that it's really relevant, but I had exactly the same reaction (down to the one pill part) to the 5-ASA drugs that you had to 6MP.

NiceCupOfTea
Veteran Member


Date Joined Jan 2010
Total Posts : 8550
   Posted 8/28/2010 12:51 PM (GMT -7)   
There's a little bit about taking 6MP after being intolerant to Imuran here. Click on #6 "Indications" and it's in the last paragraph of that section.

onlinelibrary.wiley.com/doi/10.1046/j.1365-2036.2001.01102.x/full

Mildly interesting, but doesn't clarify very much to put it mildly.

dietcoke
Regular Member


Date Joined Jul 2008
Total Posts : 186
   Posted 8/30/2010 7:40 AM (GMT -7)   
Interesting article.

NiceCupOfTea: I was highly allergic to Asacol too -- but it took over a week to figure it out (twice). I was hospitalized each time for 7 days. The doctors didn't think it was the Asacol (we thought it was just a Crohn's flare) and I didn't know any better because I was just diagnosed then (10 years ago actually). So, after I recovered after the first hospitalization, they prescribed Asacol to me again, and 5 days later I was back and worse. That's when they figured it out. I gotan extremely high fever, everything under the sun basically. Asacol and 6MP were bad bad bad for me.

It's so strange how everyone responds so differently to all the medications out there. For me, they have all made me significantly worse rather than better, except Prednisone unfortunately. So I am down on doctors and meds.

Immuran and Methotrexate are left for me (other than the clinical trials.)
I also might give the SCD one last chance since I wasn't on it long enough to make a determination.
40 years old female
Salmonella - 1996
Crohn's Colitis in entire colon - Diagnosed in 2000
Hypersensitive/Allergic to Asacol/Pentasa/Budonside/6MP/Immuran/Humira/Remicade, and more
Past meds that worked: Cipro, Prednisone

Daily: Folic Acid, Omega 3, Multi-Vitamin, Cipro 1000mg, yummy homemade yogurt

Writer
Regular Member


Date Joined Aug 2006
Total Posts : 443
   Posted 8/30/2010 1:18 PM (GMT -7)   
Regarding cyclosporine, a few years back I read over the limited studies available. For Crohn's disease, it appeared that the risk of side effects outweighed the potential benefit and there was not clear evidence that it was effective for Crohn's. However, your doctor may have more recent data, or may have concluded that it is worth a try if you have limited treatment options. Possibly it has a different mechanism of action than the other immunosuppressive drugs you have tried, and therefore the doctor thinks you might be able to tolerate it better.
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