Does anyone do remicade and NO 6mp??

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Date Joined Oct 2005
Total Posts : 429
   Posted 11/25/2009 6:48 PM (GMT -7)   
I was just curious. I'm still in the hospital and hopefully getting out tomorrow. My doctor is going to put me back on remicade (I got an infusion on Monday) but hasn't mentioned 6mp or any other meds besides flagyll, entocort, and another antibiotic I can't remember the name right now. I'm going to be on those for a bit. I recall him telling me awhile back that I wouldn't need 6mp anymore. Have any of you heard of that? Thanks again for listening. I'm going mad in this hospital. . .

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Date Joined Nov 2003
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   Posted 11/25/2009 6:55 PM (GMT -7)   
There have been studies that indicate that 6MP or azathioprine products taken together with Remicade might increase the risk for lymphoma. This risk seems to be higher in the younger population taking both medications. Some GIs are taking their patients off 6MP or azathioprine when they go on the biologics while others still use them together to lessen the likelihood of developing antibodies to the biologics.
Moderator Crohn's Disease  & Osteoarthritis Forums
CD, Ankylosing Spondylitis, lupus, small fiber peripheral neuropathy, avascular necrosis, peripheral artery disease, degenerative disc disease, asthma, severe allergy and a host of other medical problems.

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Date Joined Dec 2005
Total Posts : 1768
   Posted 11/25/2009 7:51 PM (GMT -7)   
When I was on remicade that was the only thing I was on.

31 yr old female-dx with Crohn's in '97 after emergency resection and appendectomy, 2nd resection '05, Bilateral pulmonary emboli 10/09
Currently on Humira, Omeprazole, Effexor, Seroquel, Calcium, Vit D, sublingual B12, Coumadin

Regular Member

Date Joined Dec 2007
Total Posts : 63
   Posted 11/25/2009 8:08 PM (GMT -7)   

I'm on Remicade, Entocort and Cipro.    No 6mp.  I was last on 6mp a few years ago, did not work for me.

34 yr old Male from NYC, DX with Crohn's in oct of 1987
Resection in 1990
Switching to Remicade, Aug 6th. 2009
Entocort 3mg 3 pills each morning.
Currently on Humira pen shots, 40mg weekly. Cipro 2x a day.
Anemic again, Start Iron infusions August 31.

Veteran Member

Date Joined May 2009
Total Posts : 703
   Posted 11/25/2009 8:26 PM (GMT -7)   
I've discussed Remicade with my gastro and he said they prefer to use it as a monotherapy.

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Date Joined May 2006
Total Posts : 1177
   Posted 11/25/2009 9:13 PM (GMT -7)   
Our GI also prefers to use remicade as a monotherapy to minimize the risk of lymphoma. However, it seems to vary because there are very valid reasons to use 6mp / imuran / mtx in addition to remicade to help prevent developing antibodies to remicade, so that remicade works longer for you. I've heard that the risks of lymphoma are pretty small even if you are on both remicade and another immune suppressant, but our GI likes to take the safest route that will mean the fewest risks for his patient.

My husband recently has been struggling with arthritis (IBD related or reactive arthritis) despite being on remicade every 8 weeks. He had to see a rheumatologist, who wants to put him on mtx in addition to the remicade. Our GI would prefer to avoid that as much as possible, so we are instead trying prednisone, to treat this flare up of arthritis, and we've moved his remicade infusions from every 8 weeks to every 6 weeks to treat this flare up. Hopefully my husband will be able to taper off the prednisone without problems (his arthritis is now under control with 40 mgs of pred), and then move back to every 8 weeks of remicade, and just treat future flare ups with short term steroids instead of going on mtx.

I think rheumatologists are big on mtx + remicade for rheumatoid arthritis. So, there is a substantial population of people on remicade who are also on another immune suppressant like 6mp or mtx. But on the whole, I think if remicade alone does the trick, why add more medications to the mix? If remicade alone doesn't help enough, add another one. I think that's probably the best approach - take as many meds as necessary and no more.

I hope you get to feeling better really soon. Remicade saved my husband from surgery. I hope it does the same for you. Hang in there sweetie.

I'm sorry you're spending thanksgiving in the hospital . . . but hopefully you'll get better real soon, and be back home and recovering and getting back into good health.

Husband with Crohn's
Diagnosed March 2003 Ulcerative Proctitis
Diagnosed March 2008 Crohn's & C-diff, hospitalized 45 days
Canasa, Lialda, Remicade, VSL#3, Florastor
In Remission since June 2008
Stopped vancomycin for c-diff Jan 1 2009
C-diff free, until Sep 2, 2009
Fighting c-diff, I guess for life

Regular Member

Date Joined Dec 2007
Total Posts : 414
   Posted 11/26/2009 5:25 AM (GMT -7)   
For me remicade is literally a life-saving drug, I've been told that when flaring my Crohns affects too much of my GI tract to be able to operate successfully - as my doc put it "there aren't two good ends to put back together" I go downhill very quickly and remicade is the only thing that can get me better - Humira I'm keeping on a backburner as thats my only option after remicade, theres nothing else for me in the UK after that so I want to keep my remicade working as long as possible at least until there are more options.

So I take methotrexate along with the remicade, the small risk of lymphoma is nothing compared to the quality of life I'd have if remicade hadn't worked in fact sometimes I strongly doubt I'd be alive now if it wasn't for it, so I am willing to chance anything in order to keep the remicade working at its best as my most immediate and likely risk would come from flaring again.

Regular Member

Date Joined Oct 2005
Total Posts : 429
   Posted 11/26/2009 7:30 AM (GMT -7)   
Thanks everyone. Love all the information. I was on 6mp and remicade before and really didn't want to be on it again so that makes me feel better.

Veteran Member

Date Joined Dec 2008
Total Posts : 601
   Posted 11/26/2009 1:37 PM (GMT -7)   
I am suffering from UC. I have just had my fourth Remicade infusion yesterday with still no relief. I am even on the highest dose of Remicade. My doctor gave me a script for Imuran. I got it filled but am afraid to take them both together. I am really feeling sick right now and thinking I may have to start the Imuran. I have been flaring for a year and on and off steroids the entire time. I have been off the pred for a about a month now so that is why I am getting worse.

Has anybody been on Remicade and it take a few infusions to kick in? Should I take the Imuran? Need advice.

Regular Member

Date Joined Mar 2009
Total Posts : 452
   Posted 11/27/2009 5:27 AM (GMT -7)   
I have just recently started taking Remicade and I am not on anything else.  This drug was a last resort for me.  I have had bad reactions to every drug out there for CD.  So far so good with Remicade as I am feeling so much better now.  I wouldn't worry about not taking 6 mp with it.  I have found it still has great results.
36 yr old Male with Crohn's Disease since '88 - No Surgery yet
Been on almost every type of drug with bad results
Remicade since Nov 2009

Regular Member

Date Joined Oct 2006
Total Posts : 239
   Posted 12/1/2009 6:37 PM (GMT -7)   
My Dr is trying to get me to go on 6mp and remicade but i am still not ready. I don't like the idea of the increased chance of lymphoma, I already have too much family history of cancer including lymphoma. He said it is rare like 12 in 100,000. but I also just read that it is estimated that 10- 12 people in 100,000 have crohn's, hmmmm.... I got that.
I am doing fairly well and as long as I can get out of bed and function I am not going to go there yet.
Best of luck!!!!
Dx CD Oct '06  remarried July '05 mom of 3 boys ages 12, 15, and my baby born Oct. 07. 
Asacol, entocort

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