Remicade or contiue with azathiaprine (imuran)

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Numb78
Regular Member


Date Joined Sep 2007
Total Posts : 63
   Posted 2/12/2008 6:49 PM (GMT -6)   
I am currently at the 1 month mark of taking 100mg aza and have noticed no improvement whatsoever. I have been through 3 rounds of prednisone with no improvement. I have been flaring for almost 6 months now and I need to get back to remission.

I am going to see a new GI on thursday but through my family doc we have a good feeling that this doctor is going to recommend Remicade. I'm wondering what people on the board would do...

Do I continue with the 100mg AZA and wait to see what happens or do I go with the remicade?
29 year old male, diagnosed after bad flare in Summer 2005, quickly brought into remission by pred and salofalk.   2 years symptom free after that!! 
Currently in a flare since summer 07 - I desperately miss remission!!!
Current Meds: 15mg Pred, 2000mg salofalk, calcium supplements, Pantoloc, Buscopan, Clonazopam
Started 100mg Imuran Jan 15/08 - no noticeable effect yet...


tooth fairy
Regular Member


Date Joined Jan 2008
Total Posts : 98
   Posted 2/12/2008 6:54 PM (GMT -6)   
Imuran can take up to 6 months to be effective, so give it some more time. I started imuran october 06, and my GI kept me on steroids until jan 08. By that time I was in a nice remission. I know it's awful to be flaring, but if you can, hang in there for another few months to see if the imuran is going to be effective. In the meantime, you should stay on pred to keep at least some of your symptoms in check. Good luck!
Erica, 31
Pancolitis, diagnosed July 2006, at age 29
Imuran, Asacol, Rowasa*(new!)
Still on prednisone (10 mg) taper, two more weeks
Experimenting with low residue diet, live culture yogurt and probiotics


Numb78
Regular Member


Date Joined Sep 2007
Total Posts : 63
   Posted 2/12/2008 6:57 PM (GMT -6)   
The problem with the pred is that it is not doing anything. I feel no different now then I did 6 months ago when I was on a maint dose of salofalk. In fact I felt better back then without the side effects of imuran and pred.
29 year old male, diagnosed after bad flare in Summer 2005, quickly brought into remission by pred and salofalk.   2 years symptom free after that!! 
Currently in a flare since summer 07 - I desperately miss remission!!!
Current Meds: 15mg Pred, 2000mg salofalk, calcium supplements, Pantoloc, Buscopan, Clonazopam
Started 100mg Imuran Jan 15/08 - no noticeable effect yet...


Mamas Boys
Veteran Member


Date Joined Oct 2005
Total Posts : 1460
   Posted 2/12/2008 7:33 PM (GMT -6)   
Imuran takes time to kick in.  You should add in some retention enemas or suppositories to help you over the hump.   They help greatly with the symptoms.  First choice would be Solafolk (Rowasa) enemas or Canasa suppositories.  If those don't work - you can move on to the steroid based enemas - Colocort or Cortifoam.  I personally am on both Remicade and Imuran - but before moving to Remicade I would try to give the Imuran a chance to work.

KTM


Another UC wife
Veteran Member


Date Joined Jun 2007
Total Posts : 2111
   Posted 2/12/2008 9:07 PM (GMT -6)   
I'll try to give the Reader's Digest version....Hubby went into hospital 5/07 after a year of trying various things and it was at this point in time Imuran was started. And yes we were told 3-6 months to probably kick in so one month even though you are going through hell you need to hang in there as others are saying as well. However his Dr put him on 40 mg of prednisone to kick start the Imuran...that was mid May and he was confined to the house due to the urgency and frequency and pain and on July 3rd was the first time he felt comfortable enough to be able to go out in a social setting which was a major event for us.

He was started on a very low dose of 75 mg which was later changed to 150 mg (he weighed almost 200 lbs) and he is now off the prednisone totally and the imuran and asacol have him on a scale of 8 or 9 in comparison to the 0 he was at when admitted to the hospital that May.

Based on advice here we requested a change from the colocourt retention enemas that he just could not hold in for more than an hour or so and it was very uncomfortable - the cortifoam was so much easier to use and way more comfortable and did help.

It stinks that this is such a trial and error thing with the meds and finding what will help and work for you. Try to be patient and see it through - but you might need a higer dose of imuran with monitoring of blood work, maybe a higher prednisone dose to help the imuran with a tapering schedule.

My husband was at the point you could have just gone in there and ripped that colon out for all he cared. I have no experience with Remicade and many do on the board here who can give you advice but it still seems like the imuran is just not being given enugh time yet in your case along with some of the other suggestions mentioned.

Good Luck..............we feel your pain - we honestly do.

61 yr old male~Colitis 1st diagnosed Jan '05-cleared up within a few wks. Flared again in May '06 (now UC) & hospitalized 5/07-currently heading towards a remission. Osteopena of spine from prednisone DX 8/07  Oct 07 feeling quite normal most days.  150mg Imuran  Zero mg prednisone   12 Asacol, Lidocaine Hydrochloride Jelly 2%,multi vitamin, iron 1X day, DanActive, chewable calcium, fiber capsule 1x day, Prilosec 20mg, enalapril 10mg, glipizide 5 mg, zocor 40 mg, baby aspirin, (Fentanyl pain patch 50mg 72 hrs  Morphine Sulf 15 mg twice daily)Cortifoam enema PM, Canasa suppositiry AM, folic acid 1mg, Fosamax 1x month


Numb78
Regular Member


Date Joined Sep 2007
Total Posts : 63
   Posted 2/13/2008 7:30 AM (GMT -6)   
Thank you all for the replies....

The thing that's scaring me is that I have tried all the suggestions that have been thrown out there. My doc has prescribed 5ASA retention enemas, suppositories, cortifoam, prednisone, even a topical called xylocane, but nothing has worked.

What still troubles me is that I have a h pylori infrection that no one wants to treat until the colitis is under control but I'm wondering if the h pylori is causing the symptoms and that's why none of the UC drugs are working?? I'm really starting to loose my mind here, I can't being couch bound any longer. I've started working a few hours in the afternoon which is helping my mental state a little but I want to get back to a normal life. I've got a business trip that I have to take in June and at first I figured I would definitely be better by then but now I'm really starting to wonder if I'm going to have to cancel.
29 year old male, diagnosed after bad flare in Summer 2005, quickly brought into remission by pred and salofalk.   2 years symptom free after that!! 
Currently in a flare since summer 07 - I desperately miss remission!!!
Current Meds: 15mg Pred, 2000mg salofalk, calcium supplements, Pantoloc, Buscopan, Clonazopam
Started 100mg Imuran Jan 15/08 - no noticeable effect yet...

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