immunosuppressants and probiotics

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pauly123
Regular Member


Date Joined Mar 2010
Total Posts : 195
   Posted 1/10/2011 11:26 AM (GMT -6)   
hi all i was at the hospital today,and my GI is starting me on a new drug called azathioprine or imunan, it is a immunosuppressants,i have to get my bloods took every week for 8 weeks so they can monitor my cells etc, is anybody on this drug? if so whats is it like? does it mean my uc is bad? it says there is a small risk of lymphoma and skin cancer this has freaked me out too what do u think folks? and last it says DO NOT TAKE PROBIOTICS WHEN ON AZATHIOPRINE, as it can cause serious infection again what do u know about this?.thanks for any info.

quincy
Elite Member


Date Joined May 2003
Total Posts : 25681
   Posted 1/10/2011 2:14 PM (GMT -6)   
never heard that....wonder why it would cause serious infection...?? what do you mean again? did you have serious infection?

Can you email the company?

q
*Heather* I give suggestions, do with them what you will.
Status: ...Asacol 3 @ 2x daily; Salofalk enema @ 3rd night (nightly/ flares, tapered/maintenance)
~diagnosed January 1989 UC (proctosigmoiditis)
~Bentylol 20mg as needed; Zantac 150mg; Symbicort/Airomir (asthma)
~vitamins/minerals/supplements; Probiotics....(RenewLife Ultimate Flora Critical Care+Primadophilus Reuteri capsules @ bedtime)
~Metamucil capsules 6 twice daily with meals; Vitamin D 4000 IU
~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS" worth it !!!

pauly123
Regular Member


Date Joined Mar 2010
Total Posts : 195
   Posted 1/10/2011 2:20 PM (GMT -6)   
i dont know i just read it, do u know the drug tho and whats it like,also my wife and i r trying for another baby and it says not to take the drug if trying so i may not take it im losted
 i have colitis 5 years now. med asacol, suppositories,
 part gluten free diet, multi vitimins,fish oil,aloe vera,
 seems to be in rectum {pro***is}

quincy
Elite Member


Date Joined May 2003
Total Posts : 25681
   Posted 1/10/2011 2:22 PM (GMT -6)   
I personally wouldn't use it, but others use it with success.

have you not used the retention enemas yet? Are you in the UK?

q
*Heather* I give suggestions, do with them what you will.
Status: ...Asacol 3 @ 2x daily; Salofalk enema @ 3rd night (nightly/ flares, tapered/maintenance)
~diagnosed January 1989 UC (proctosigmoiditis)
~Bentylol 20mg as needed; Zantac 150mg; Symbicort/Airomir (asthma)
~vitamins/minerals/supplements; Probiotics....(RenewLife Ultimate Flora Critical Care+Primadophilus Reuteri capsules @ bedtime)
~Metamucil capsules 6 twice daily with meals; Vitamin D 4000 IU
~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS" worth it !!!

notsosicklygirl
Forum Moderator


Date Joined Dec 2008
Total Posts : 10149
   Posted 1/10/2011 2:42 PM (GMT -6)   
I use 6mp which is similar to imuran and I eat yogurt. I haven't been taking probiotics, not because i've heard there was potential for a bad reaction but because I haven't had any and I don't want to spend money on them. Usually people are started on imuran or 6mp when they aren't responding to 5ASAs like Asacol/Lialda/Colazal or if you've been on prednisone and you can't get off without having a flare up. It's easy for people to say "I wouldn't take it" when they have no need for it. When you're ill and not improving with other medications, you don't have much choice, it's 6mp/imuran, biologics, natural treatments/diets (ive tried many and none helped), experimnetal treatments/clinical trials or surgery.

Try not to stress. Are your symptoms bad? are you on prednisone? What were you in the hospital for? I hope you're feeling better.
Co-moderator: Ulcerative Colitis
03/07: Mild Proctitis | 08/08: Pancolitis! | 09/08: FLARE & Anemic Asacol (9) + Canasa | 01/10: FLARE AGAIN!! Asacol + Prednisone + Canasa | Currently: doing OK - Asacol + Canasa + Rowasa + 6mp + Allopurinol + Prednisone (tapering again...) + Ponstel + Klonopin + Ambien

pauly123
Regular Member


Date Joined Mar 2010
Total Posts : 195
   Posted 1/10/2011 2:55 PM (GMT -6)   
thanks q and ntsosicgirl, u hav a point there, ive been on pred 3 times this year and evertime i come of it after a few weeks i flare, i dont think 5ASAs are doing the job, my symptoms are none im good but when i had my scope done 6 weeks ago i was flared and my GI wants me to take imuran, and no im of pred 2weeks, im in two minds because im good at the mo but for how long this drug may help for longer,but as i say we r trying for a baby too, pros,and cons. no q i havivg used retention enemas what r they? i have asacol enemas
 i have colitis 5 years now. med asacol, suppositories,
 part gluten free diet, multi vitimins,fish oil,aloe vera,
 seems to be in rectum {pro***is}

mudlark
Regular Member


Date Joined Feb 2010
Total Posts : 29
   Posted 1/10/2011 4:35 PM (GMT -6)   
Hi Pauly,

I'd never heard of not taking probiotics with azathioprine, there is nothing on the fact sheet I have about it, having a search around I only managed to find one reference to something like what you are saying.....

"There have been rare cases of pathogenic colonization involving Lactobacillus in severely immunocompromised patients. To be safe, patients on conventional immunosuppressants should avoid probiotics."

I'm not sure how seriously I'm taking it, I don't consider that I'm severely immunocomprimised, my rate of picking up colds or getting infected cuts hasn't increased since I went on aza - if I was catching eveery cold going it might be something I'd ask my doctor about.

MyUC
Veteran Member


Date Joined Mar 2010
Total Posts : 640
   Posted 1/10/2011 4:43 PM (GMT -6)   
pauly123:
 
My name here is MyUC.  I was diagnosed with severe pancolitis about 20 years ago through colonscopy.  I was put on Asacol for many years and it failed to do anything for me.  I had a lot of blood loss, urgency, etc...  I was put on Imuran about 2 years ago.  It has put me in remission and has healed my colon.  So I would definitely strongly advise you consider following your doctor's advice.  It's nice to have my life back and not be ruled by my colon.  Imuran has a very long track record treating ulcerative colits and is considered a very safe drug by GI standards.  I spent a lot of time researching it and I felt and feel comfortable taking it.  My GI doc has about 1500-2,000 patients on it and has never had a complication with it for those who do well on it. 
 
I am not sure about having children while on it.  That's a conversation for you and your doc.  I also agree that there are those that say they would never take a medication like this but I agree with notsosicklygirl.  When people do well with the ASA meds they don't want to take meds like this.  UC has taken years from me and I want to try to keep my colon as long as it responds to meds without side effects. 
 
Good luck with your choice.  I am happy with mine to take Imuran.
 
MyUC
39 Year Old Male, Dentist
Dx: Ulcerative Colitis 1996 via colonscopy and biopsy.  Pancolitis with chronic and moderate inflammation.
Started UC around 92.
Past Meds: Asacol and occasionally Prednisone
Have had 6 colonscopies throughout my hx with UC.
Current Meds: Imuran, started with 200 mg and recently lowered it to 150 mg
Most recent colonscopy 2009 after 6 months of Imuran, colon is 90% healed
Currently in remission
 
 

imagardener2
Veteran Member


Date Joined Jan 2010
Total Posts : 3713
   Posted 1/10/2011 4:49 PM (GMT -6)   
pauly

keeping your good health is important but I can understand your fear about not being able to create a baby. Is it possible for your to store your sperm before you start the immuno? Like putting your money in the bank (not trying to make light of your situation).

There are many people here that have had success with what your doc is suggesting. I did not but that doesn't mean you shouldn't try that med, maybe you will be lucky.

Best wishes.
In remission April 2010 after 10 years of UC with no remission ever
Jan 2010 began SpecCarbDiet (modified to remove dairy, fruit & juices)
Gluten-free=bleeding stopped in 3 days, 95% remission in 5.5 months on SCD
SCDiet: Gluten/grain-free, starch-free, low carb, honey as sweetener
spinach+sunflower seeds daily + other nuts/nut flour baked goods
(9)Balsalazide+(6)Citrucel daily+Rowasa as needed

journey2health
Veteran Member


Date Joined Oct 2009
Total Posts : 2669
   Posted 1/10/2011 5:42 PM (GMT -6)   
Before I got UC, believe it or not, I had a longterm boyfriend with UC. He was in constant pain and in the bathroom so much. Years and years later, after we broke up, I told him of my UC, anD THAT I was at a crossroads between giving 5ASA another try and going on 6MP (decided to give 5 ASA another try -- and it is a hassle, but it works) -- anyway, he said that 6MP or Imuran put him into permanent remission and change his whole life. Forget he had UC, that's how great it worked.
In remission--pancolitis. 8 Asacol, Rowesa every other day- with symptoms daily - adding Canasa daily and Psyllium husk.
Align probiotic. Vitamins. Avoid greasy, fried, spicy, citrus, dairy (except yogurt), caffeine, alcohol. Bipolar/anxiety/depression: lamictal, Lexapro; Sleep-zinc magnesium B6--Zyprexa, klonopin if sleep regime fails.

Mackster
Veteran Member


Date Joined May 2007
Total Posts : 715
   Posted 1/10/2011 6:16 PM (GMT -6)   
I've never heard of 'not taking probiotics whilst on azathioprine'. I've been on it for the past four years and taken all kinds of probiotics with no (known) side effects.

The only caveats I can give re aza is that in (my own case), although it put me into 'remission' for about a year, it gradually lost it's efficacy. My GI however, refuses to take me off of it lest I have another major flare like the first one that put me in the hospital for five days.

The other big concern is the skin cancer risk. Again, (in my own case) I contracted BSC (basal cell carcinoma) in three areas (face, back and chest) that required surgical removal. Bear in mind that I'm fair skinned and have been very careless over my many years in (lack of) sun protection. I have a load of solar damage and would have probably been a prime candidate for some form of skin cancer given my stupidity and fondness (trying) to get a bronze tan.

If I wasn't allergic to the 5asa's I would have sooner be on them as a so-called maintenance drug. You will have to get bloodwork done every three months so the GI can monitor if it's harming you (mainly your liver), it's no big deal otherwise.

Post Edited (Mackster) : 1/10/2011 4:20:27 PM (GMT-7)


MyUC
Veteran Member


Date Joined Mar 2010
Total Posts : 640
   Posted 1/10/2011 6:36 PM (GMT -6)   

I forgot to add that I have taken probitics while on Imuran with no problems.  Just wanted add that 2 cents.  No side effects what so ever.

MyUC


39 Year Old Male, Dentist
Dx: Ulcerative Colitis 1996 via colonscopy and biopsy.  Pancolitis with chronic and moderate inflammation.
Started UC around 92.
Past Meds: Asacol and occasionally Prednisone
Have had 6 colonscopies throughout my hx with UC.
Current Meds: Imuran, started with 200 mg and recently lowered it to 150 mg
Most recent colonscopy 2009 after 6 months of Imuran, colon is 90% healed
Currently in remission
 
 

sheree18
Regular Member


Date Joined Aug 2010
Total Posts : 157
   Posted 1/11/2011 3:45 AM (GMT -6)   
Hi i am currently taking imuran or azathioprine and also taking probiotics. My GI was the one who suggested me to take probiotics to balance the good bacteria so it must be ok or he wouldn't tell me to take it. I have only been taking probiotics for a week but been taking imuran for 10 years now.
I am always in and out ofremission because they tapper my prednisolone to fast which puts me right back to the start so i have now figured out that you need to reduce the pred. at a slow rate (5mg week) if not a lower dose until you can stop.
I also havs small skin growths from imuran which i have spoken to the doctor about. As long as you are aware of the skin bumps and have them checked you will be ok. Good luck with it all hope it works out for you.

pauly123
Regular Member


Date Joined Mar 2010
Total Posts : 195
   Posted 1/11/2011 2:38 PM (GMT -6)   
thanks all u guys for your comments,by the sounds of it imuran seems to do the job and that probiotics isnt a problem, as for trying for a baby, my doc phoned me today and said that if my uc is under control at the mo,then i should hold of with the imuran, untill my wife gets pregnant, but that its up to me,well i have stoped pred 2weeks now and im just waiting to c if i flare up i pray i dont because if i do i will have to go on the drug and forget about the baby, i know it sounds bad but we have two daughters age 15 and 10 so we were in 2minds about another child and my wife agrees with me ill keep u all posted, thanks again so much for u info.
 i have colitis 5 years now. med asacol, suppositories,
 part gluten free diet, multi vitimins,fish oil,aloe vera,
 seems to be in rectum {pro***is}
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