Azathioprine dose vs. weight

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James_
Regular Member


Date Joined Feb 2011
Total Posts : 28
   Posted 2/8/2011 1:25 PM (GMT -7)   
I found old threads on this but thought I would look for any new insight.

I've been taking 175 - 200 mg of azathioprine continuously for the last ~9 years, except for a brief break to get it out of my system because of infertility issues. Although the dose was adjusted for my weight (150 lb), I've read that 50 - 150 mg is more typical. If anyone doesn't mind answering, how much do you take and what is your weight? I realize that it also depends on severity of disease, other medications, etc., but it's a start.

thatfield
Veteran Member


Date Joined Jul 2008
Total Posts : 822
   Posted 2/8/2011 1:39 PM (GMT -7)   
I take 150mg and weigh 138lbs. I was told that the dose is not determined by weight but by blood tests and by each person's reaction to the drug. We played with my dosage at first until we found what seemed to be therapeuticfor me. My doctor told me we could go up to 200mg if needed.
36 yrs female
Dx 2006 right after the birth of my daughter
Had baby #2 in August 2010!
Imuran 150mg

notsosicklygirl
Forum Moderator


Date Joined Dec 2008
Total Posts : 10483
   Posted 2/8/2011 1:44 PM (GMT -7)   
I think it depends on how you metabolize the drug. If you're able to take more without liver issues, they will keep upping the dose. I had toxicity to my liver on 50mg of 6mp so my doctor really couldn't raise the dose very much. I tried taking 75mg and it was very toxic to me. If your liver test are ok, you should be ok. Are you having the test that shows whether you're in the theraputic range or just regular liver tests? My regular liver tests always came back normal, it is the other test that showed the toxicity.
Co-moderator: Ulcerative Colitis
03/07: Diagnosis: Mild Proctitis | 08/08: Diagnosis: Pancolitis - FLARE & Anemic! Asacol (3600mg) + Canasa (1000mg morning/night) | 01/10: FLARE! Prednisone + Cortifoam + Asacol + Canasa + Rowasa | Currently: stable - Asacol (3200mg) + Canasa (nightly) + 6mp + Allopurinol + Prednisone + Ponstel + Klonopin + Ambien

James_
Regular Member


Date Joined Feb 2011
Total Posts : 28
   Posted 2/8/2011 3:14 PM (GMT -7)   
I haven't had my 6-MP level checked in a few years, only the complete blood count and metabolic panel. I guess my current doctor figures that 200 mg was already established as a safe level for me. He also dropped me to 175, maybe because my weight was higher from the prednisone when the initial 200 was calculated. I'll ask about the level the next time I see him.

sheree18
Regular Member


Date Joined Aug 2010
Total Posts : 157
   Posted 2/9/2011 3:24 AM (GMT -7)   
I agree with the above comments that they do regular tests to make sure your liver is fine. My doctor has never mentioned anything to do with weight and i am on 200mg azathioprine or imuran a day and have been on for 11 years now.. Its like any drug not everyone can take it. I am also on steroids and i have put on an extra 13lbs (6k) since christmas. I now way 189lbs(86kg) but before the steroids was 171lbs)(78kg)but i am 5'7' tall. Hope this helps

MyUC
Veteran Member


Date Joined Mar 2010
Total Posts : 640
   Posted 2/9/2011 5:47 AM (GMT -7)   
Imuran is definitely weight dependant.  I forgot the actual conversion but if you look up Imuran from a doc's point of view there is max weight dosage.  Many GI docs will start at that dosage and work their way down.  I beleive the dosage is 1-2 mg/kg.  So if a man weighs 200 lbs.  Approximately that weight is 100 kg so the max that person can take is roughlyy 200 mg for treating UC.  Obviously for different conditions there are different ranges.  Also doc use Imuran sometimes as an adjunct med not the primary med.  So one will sometimes see people on daily 5 ASA meds with 50 mg of Imuran.  The Imuran is just keeping things in check. 
 
I myself started at 200 mg and that's where the doc wanted me.  I weighed 187 lbs at the time.  I got him to lower it to 150 mg and I am hoping to lower it to 100 mg this spring.
 
I hope this helps.
 
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
 
 

seconder
Veteran Member


Date Joined Jun 2008
Total Posts : 605
   Posted 2/9/2011 5:48 AM (GMT -7)   
The theraputic dose is often determined by blood tests to measure the drug and how it's being metabolized.  For maintenace, by weight, the rule of thumb is ~1-3 mg/ kg.

MyUC
Veteran Member


Date Joined Mar 2010
Total Posts : 640
   Posted 2/9/2011 6:21 AM (GMT -7)   

If you want a simple rule of thumb here it is.  Most GI docs will prescribe Imuran based simply on your weight, in terms of lbs and mg.  If you weigh 200 lbs you can roughly prescribe 200 mg of Imuran.  If you weigh 150 lbs then 150 mg.  Of course there are blood tests to check to see if your metabolizing it and to see if your in the therapeutic range but your original question had to do with your intake of Imuran and to see if it really differs with other's intake.  My answer has to do with the usual starting point and maintanence dose for Imuran users.  It can be tweaked according to blood tests as time goes on.

Hope this helps.

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
 
 

Eva Lou
Veteran Member


Date Joined Sep 2006
Total Posts : 3149
   Posted 2/9/2011 9:43 AM (GMT -7)   
huh, I weigh about 105lbs & have been on 150mgs/day of Imuran for a long time now, at least 2+ years. I started at 100 mgs/day, & didn't notice much benefit. So after the Prometheus labs showed there was some wiggle room with the dose, we upped it & I really noticed a huge benefit from the increased dose. I also weighed no more than 110lbs, probably less, when I started the drug. I suppose like many meds, the initial dosing guidelines are weight based, but then the doctor goes from there based on labs & therapeutic results.

diagnosed 2002
Asacol
Remicade-10mgs/kg- from 4/07 thru 1/10
Humira
Imuran- 150mgs/day
homemade kefir, probiotic supplement, turmeric

ElephantPipe
Veteran Member


Date Joined Jun 2009
Total Posts : 1809
   Posted 2/9/2011 11:13 AM (GMT -7)   
I weigh... 130? And take 125mg. I was 125lbs when I started.
21yr old female diagnosed with UC in 2005 at age 15
125mg Azathioprine
Just got over flare, but now stuff is happening....
Arthritis
Also: asthma, acid reflux, and Raynaud's Syndrome

MyUC
Veteran Member


Date Joined Mar 2010
Total Posts : 640
   Posted 2/9/2011 4:04 PM (GMT -7)   
Eva Lou:
 
That's right you started at 100 mg and went up.  Usually the weight in lbs converted into mg is the usual starting point and then one can taper up or down as needed.  Again only a qualified GI doc can handle these issues but this is just my quick input on this topic.
 
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
 
 

thatfield
Veteran Member


Date Joined Jul 2008
Total Posts : 822
   Posted 2/10/2011 9:11 AM (GMT -7)   
Eva Lou - I started at 50mg and was moved up to 150 over the course of a few months. My blood was tested monthly at that point to make sure I was doing fine with the increases.
36 yrs female
Dx 2006 right after the birth of my daughter
Had baby #2 in August 2010!
Imuran 150mg
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