6-MP vs. Remicaid

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legalsec
Regular Member


Date Joined Feb 2007
Total Posts : 30
   Posted 3/2/2008 12:57 PM (GMT -6)   
Is it the norm to try 6-MP/Imuran before moving on to Remicaid?
I see so many people having success with Remicaid and I see that many have tried 6-MP/Imuran first.  It seems there are more possible side effects with 6-MP.  Is Remicaid more safe than 6-MP?

Pancolitis - dx December 2006

Colazal 750 mg - 9/day (generic)

Canasa 1000mg 1/day (???)

Women's One-A-Day Multi-Vitamin

Calcium +D 500 mg - 3/day

Coumadin 2.5 mg/day (for DVT, dx 2/13/07)

Asacol (bad reaction); mesalamine supp. (bad reaction); Seasonale (birth control); cranberry pill - 300 mg  3x/day (urinary tract infec.);

Lovenox injec. 2x/day (for DVT); Prednisone - 10 mg/day; Folic Acid - 400 mcg x2/day


hana24
Regular Member


Date Joined Dec 2007
Total Posts : 354
   Posted 3/2/2008 2:56 PM (GMT -6)   
My doctor said we should try remicaid next when I flare again if Encort doesn't work and I haven't done 6-mp. I got the impression that 6-mp and the others take along time to work and remicaid will actually normally get you out of a flare immediately......
Jessica 26/F
Asacol 4pills /three times a day(from 2 pills/ three times a day)
Prednisone 40Mg/day taper every 5 days(at 5 mg currently every other day)
Culturelle once daily/ three times a day
Tried (Entorcort EC 9ml/day)


jujub
Forum Moderator


Date Joined Mar 2003
Total Posts : 10407
   Posted 3/2/2008 4:23 PM (GMT -6)   
Traditionally they have done the 6-MP or Imuran before because it's the older drug, so they know more about it and have really long-term information about its effects. Even though the possible side effects from it sound scary, they really aren't very common. Also there's the cost consideration, because we know what's going on with health care costs in this country. My insurance company could have kept me on Imuran for the rest of my life for less than my Remicade infusions for one year. Unfortunately, Imuran wasn't very effective for me.
Judy
 
Moderate to severe left-sided UC (21 cm) diagnosed 2001.
Asacol, Rowasa, Pentasa, Prednisone, Entocort, Azathioprine
Colazal,  Remicade, Nature's Way Primadophilus Reuteri.
In remission since April, 2006. Remicade has been my wonder drug.
 
Co-Moderator UC Forum


Lonie
Veteran Member


Date Joined Feb 2005
Total Posts : 6447
   Posted 3/2/2008 10:14 PM (GMT -6)   
As I was flyling back from Denver the other day, I sat next to a very young Pediatrician. He was very sweet, and the folks in the seats in front of us started talking about Arthritis, and one person asked the other that had Arthritis if he was using Remicade. I was so surprised to hear him ask about it, that I said to the nice young Pediatrician, "Gee, I'm on Remicade and surprised to hear it being mentioned!" He said, "Really?" And we started chatting about it. He asked me several questions, and I asked him if he had any children on it. He said, "Yes, I do. I believe it's a very fine line....you can be afraid if there will be side effects, but hey, it's quality of life too." Apparently it is a big debate right now because the docs seem to think it's better to give folks quality of life rather than being in a constant flare, and as he said, are the other meds any better? But as we all know, it doesn't always work for everyone. So, interesting dialogue! Guess that's why I love traveling....I meet such interesting people! :-)
Carol

Remicade - will have my 21th infusion on April 17.
Vitamin B-12/Biotin, Probiotics
 
Co-Moderator for the UC Forum
 
 


basa0806
Veteran Member


Date Joined Feb 2005
Total Posts : 2103
   Posted 3/2/2008 11:06 PM (GMT -6)   
When it was time for me to move on to the big guns my GI started me on remicade for one or two infusions and then once I was on remicade regularly he added 6-mp to my medication cocktail. I was extremely desperate, and unfortunately neither worked for me.
Sam
19 years old
Diagnosed March 2005
Remission since January/April 2006 (incident with mono)
3200mg Asacol, 25mg Amitriptlyine, Ortho Tri-cyclen lo, Imodium when I need it
"If you don't like something, change it. If you can't change it, change your attitude"
Maya Angelou


jujub
Forum Moderator


Date Joined Mar 2003
Total Posts : 10407
   Posted 3/3/2008 12:45 AM (GMT -6)   
I'd go for quality of life any time. Before Remicade, I was so sick I think I'd have had to get better to die. I hope the Remi works for me forever.
Judy
 
Moderate to severe left-sided UC (21 cm) diagnosed 2001.
Asacol, Rowasa, Pentasa, Prednisone, Entocort, Azathioprine
Colazal,  Remicade, Nature's Way Primadophilus Reuteri.
In remission since April, 2006. Remicade has been my wonder drug.
 
Co-Moderator UC Forum


serendipity24
Regular Member


Date Joined Jan 2008
Total Posts : 56
   Posted 3/3/2008 1:17 AM (GMT -6)   
I think they try the 6-MP/Imuran before Remicade for a few reasons. It's oral medication, so you can avoid infusions. It also works via a different mechanism--still immune suppressant, but different pathway, so it's worth a try. I've also been told that it's easier to stop taking 6MP in trying to taper off and stay in remission. My doc called Remicade a very long-term option. With my disease being steroid dependent, but mild to moderate, I think we're both still holding out hope that once I'm out of vet school things might get better.
Rachel

23 yrs old
Diagnosed with UC: March 2004 with probable IBS component

Currently taking:
Asacol 4pills 3x/day
Prograf 5mg/day
(Prograf is my miracle drug! It doesn't seem to be well known, but it's fantastic!)

Previously Tried:
Prednisone (works, but such awful side effects!), 6-MP (gave me acute pancreatitis), Entocort, Cipro (antibiotic), Bentyl, Canasa suppositories, a couple different enemas


legalsec
Regular Member


Date Joined Feb 2007
Total Posts : 30
   Posted 3/3/2008 8:40 AM (GMT -6)   

Thank you all for the advise. It is only 6:30 here in California. After a long and painful weekend I will be calling my GI as soon as they open. He discussed starting me on 6-MP, but I cannot imagine remaining like this for a few months until it kicks in. I will discuss Remicaid vs. Prednisone with him.  When I saw him last he seemed to want to go the 6-MP route instead of the prednisone.

I hope he calls me back today. He sometimes calls back the next day.


Pancolitis - dx December 2006

Colazal 750 mg - 9/day (generic)

Canasa 1000mg 1/day (???)

Women's One-A-Day Multi-Vitamin

Calcium +D 500 mg - 3/day

Coumadin 2.5 mg/day (for DVT, dx 2/13/07)

Asacol (bad reaction); mesalamine supp. (bad reaction); Seasonale (birth control); cranberry pill - 300 mg  3x/day (urinary tract infec.);

Lovenox injec. 2x/day (for DVT); Prednisone - 10 mg/day; Folic Acid - 400 mcg x2/day


Lonie
Veteran Member


Date Joined Feb 2005
Total Posts : 6447
   Posted 3/3/2008 8:43 AM (GMT -6)   
Hey Legalsec, I'm in Sacramento, California...yep it's early! :-) Hope your doc gets back to you asap; no need for you to be feeling poorly.

Carol

Remicade - will have my 21th infusion on April 17.
Vitamin B-12/Biotin, Probiotics
 
Co-Moderator for the UC Forum
 
 


suebear
Forum Moderator


Date Joined Feb 2006
Total Posts : 5698
   Posted 3/3/2008 9:01 AM (GMT -6)   
Just remember that quality of life for a person with rhuemetoid arthritis is very different than quality of life for a UC patient. Just like some asthma patients and organ transplant patients, prednisone is a needed drug for quality of life. However, for a UC patient some of these drugs aren't needed long term for quality of life. I am very glad that I never had the opportunity to take Remicade for UC and that I ended the battle on 6mp.

Sue
dx proctitis in 1987
dx UC in 1991, was stable until 1998

1998 started prednisone, asacol, pentasa, nortriptylene, ativan, 6MP, rowasa enemas and suppositories, hydrocortisone enemas, tried the SCD diet, being a vegetarian, omega 3s, flax, pranic healing, yoga, acupuncture, probiotics

2000 lost all my B-12 stores and became anemic

2001 opted for j-pouch surgery- now living life med-free


legalsec
Regular Member


Date Joined Feb 2007
Total Posts : 30
   Posted 3/3/2008 9:41 PM (GMT -6)   

I saw my GI today. He had me do more labs and a C-Diff. He wants me to start back on prednisone, but wants me hold off for 48 hours until he gets the results of my C-Diff. 

He said he will start me on 6-MP next week when all my lab results are back. He wants me to start the prednisone at 60mg for one week then taper down to 40 mg. When I was on prednisone before I tapered by 10 mg each week. Is it okay to go from 60 mg to 40 mg? If I had minimal side effects from the prednisone last time, will it be the same this time around? The only side effects I noticed were night sweats and I had to take benadryl to be able to get 3 hours of sleep. I tapered down without any withdrawls that I noticed.

I pray that the 6-MP will put me back in remission and I have no side effects from either the 6-MP or the prednisone. 

Thank you all for your input and listening!


Pancolitis - dx December 2006

Colazal 750 mg - 9/day (generic)

Canasa 1000mg 1/day (???)

Women's One-A-Day Multi-Vitamin

Calcium +D 500 mg - 3/day

Coumadin 2.5 mg/day (for DVT, dx 2/13/07)

Asacol (bad reaction); mesalamine supp. (bad reaction); Seasonale (birth control); cranberry pill - 300 mg  3x/day (urinary tract infec.);

Lovenox injec. 2x/day (for DVT); Prednisone - 10 mg/day; Folic Acid - 400 mcg x2/day


suebear
Forum Moderator


Date Joined Feb 2006
Total Posts : 5698
   Posted 3/4/2008 8:08 AM (GMT -6)   
Yes, a taper from 60mg to 40mg is safe. It's only when you get to the lower numbers that it gets dicey.

Sue
dx proctitis in 1987
dx UC in 1991, was stable until 1998

1998 started prednisone, asacol, pentasa, nortriptylene, ativan, 6MP, rowasa enemas and suppositories, hydrocortisone enemas, tried the SCD diet, being a vegetarian, omega 3s, flax, pranic healing, yoga, acupuncture, probiotics

2000 lost all my B-12 stores and became anemic

2001 opted for j-pouch surgery- now living life med-free

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