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Regular Member

Date Joined Jul 2006
Total Posts : 179
   Posted 5/5/2008 11:14 PM (GMT -6)   
Hello all,
so i am def. flaring again. I just tapered off the pred today. Started bleeding a week and a half ago and its getting worse. My Gi said that if i stared flaring again then he would put me on 6-mp because i have basically been on pred for almost 2 years. So I see people discussing imuran on here, as well as 6-mp. I was wondering what the difference between all the immunosuppressants was. \
I cant take asacol, but colazal was my wonder drug for a little bit there, and i dont want to get on the wrong immunosuppressant, like i was on the wrong 5 asa at first.
Winni, 24

Diagnosed UC july 2006.
medications: colazal 9 daily, cortifoam 2x daily, just tapered off pred.
supplements:calcium, aloe gel, pro-biotics, tumeric
osteopenia from all this prednisone.

Elite Member

Date Joined May 2003
Total Posts : 30998
   Posted 5/6/2008 12:02 AM (GMT -6)   
Hi...although I've never been on immunosuppressants...I don't think we can know what's the right one or the wrong one until we try them.

I hope the 6-MP works for you.

*Heather*Status: mini flare Dec 28... tapered to every 4th night
~diagnosed January 1989 UC (proctosigmoiditis)
~5ASA: Asacol (6 daily) + Salofalk enemas (increase for flares tapered to maintenance)
~Bentylol (dicyclomine) 20mg as needed
~Probiotic 3(Natural Factors Protec) bedtime + 1 (Primadophilus Reuteri) occasionally
~multi-digestive enzymes as needed ....zymactive 3 - 5x daily
~Ranitidine,Pariet (reflux) Effexor XR 75mg;  Pulmicort/Airomir (asthma)
~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS"  worth it !!!

Elite Member

Date Joined Apr 2004
Total Posts : 23551
   Posted 5/6/2008 6:03 AM (GMT -6)   
Usually the doctor should run a few blood tests to determine which one you will most likely respond to - either the Imuran or the 6mp. And if you should have any adverse reactions to it, it's can be caught rather quickly because you will have to go in for weekly blood tests until your doc tells you can do them farther apart. When I first started 6mp, I had the initial bloodwork for the baseline and then I had to go in 3 days later, then a week later and I did the weekly blood draws for a short time then it became every 2 weeks and so on. Whenever he had to increase my 6mp, I had to start the cycle over again.
Moderator for Allergies/Asthma and Co-moderator for UC
~Left sided Uc-'92-Colazal(9 daily),6mp(50-100mgs),Prilosec,Biotin,Forvia,Pro-Bio**Unable to tolerate Asacol, Rowasa or Canasa**~Allergies-Singulair
~Secondary Reynauds Syndrome-'04-Norvasc~Spinal Stenosis~Sacroiliitis-epidural injections
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Regular Member

Date Joined Oct 2007
Total Posts : 486
   Posted 5/6/2008 7:15 AM (GMT -6)   
Hi Winni,

Are you using the cortifoam 2 x a day like it says in your signature? I wonder if that is helping with the bleeding. I find that it works if I'm really diligent about using it.

I've been on 6MP since Feb 2006. It took nearly 6 or 7 months for me to feel that it was working. I nearly stopped taking it around month 5 when I got really discouraged. I'm glad I stuck it out though because I really feel that it's my safety net. I still flare but it's not as bad as it was before. It's raised my baseline, if that makes any sense. I was in remission for about 8 months but the rest of the time I've been up and down in minor flares. So it's not my miracle drug but I think it makes a difference. The worst I've been on 6MP is no where near as bad as I was before.

By the way, it took some time to get the dose right. You just need to get your blood checked regularly. The one test that can tell you whether the drug is being metabolized correctly can be done by only one lab in the U.S. (as far as I know) which is Prometheus Labs in California. That test is expensive if your insurance doesn't cover it. That's one of the downsides. But if you're insurance doesn't cover it, you can get a discount for pre-paying by credit card. That's something that even my doctor didn't know and I found on the Prometheus website. (Just something to keep in mind if you need to pay for the test yourself! I think it's about $225 with the discount.)

I don't know the difference between Imuran and 6MP. Your doctor should be able to explain why s/he is choosing one over the other for you. I don't think you can ever know ahead of time which drug is going to work for you. We all get to enjoy a lot of trial and error. What fun for us, right?
UC for the last ten years
Current Meds: 6MP since 2006, Cortifoam
Past Meds: You name it; I've tried it. (Asacol, Colazol, Pentasa, DiPentum, Rowasa, Canasa, Cortenema, sulfasalazine)
5ASA drugs don't work for me. Canasa seems to make me worse.
Alternative treatments I have had success with: Acupuncture, Hypnotherapy

Veteran Member

Date Joined Apr 2008
Total Posts : 1339
   Posted 5/6/2008 7:50 AM (GMT -6)   

Hi Winni

I just started Imuran. It's been 4 weeks. Asacol and Colazal made me feel worse.Cramps,gas, more blood then when I went off those drugs. I know it usually takes a while for these drugs to kick in. I feel much better in only a month. Still bleeding, but a lot less. I added Probiotics,Turmeric and Boswellia to the mix. Hope this was helpful. Faith


Diagnosed with UC. in 05
Meds- Azathioprine,50mg
Omega Fish oils
Multi Viamins
Evista for bones
Dicyclomine when needed for pain

Paul L
Veteran Member

Date Joined Dec 2005
Total Posts : 647
   Posted 5/6/2008 8:57 AM (GMT -6)   
Imuran and 6MP are very similar. In fact Imuran is metabolized in the liver into 6MP and then into 6-TGN and 6-MMPN. Some people do not properly metabolize Imuran into 6MP. For them 6MP would be a better choice. 6-TGN is the active ingredient that suppresses your immune system and 6-MMPN is associated with hepatotoxicity and can cause liver problems. The Prometheus test measures 6-TGN and 6-MMPN levels and your dosage could be adjusted depending on the results of the test. I had a similar test done at a lab here in Toronto. I was on 6-MP at the time and the test showed that the 6-TGN levels were far too low to be effective and the 6-MMPN levels were too high that I was risking liver problems. This meant that my dosage could not be increased so I had to stop the drug.
Diagnosed in 2000 at age 43 with UC extending half way across transverse colon.
Bad reaction to Asacol, Pentasa and Dipentum - can’t take any more 5ASAs.
Prednisone - worked well for 1 month, then side effects became unbearable.
6-MP - blood tests showed not metabolizing properly.
Corticosteroid enema, Flagyl, Ciprofloxin, VSL#3, Adacolumn Apheresis – no effect
Methotrexate with Remicade - 7 infusions with no improvement
Folic Acid and B12 injections.
Abatacept trial - no effect

Regular Member

Date Joined Jul 2006
Total Posts : 179
   Posted 5/6/2008 1:43 PM (GMT -6)   
Thank you all for the info!
Yes I am doing the cortifoam twice daily, and 9 colazal, probiotics, aloe gel, omega 3 oil, tumeric and a vitamin e enema a day and only eating well cooked veggies and fish and eggs. still bleedng, cramping etc... its rather discouraging.
hopefully 6 mp will help. but i was on it briefly a year ago, only for a week or so, and it gave me migraines.
Winni, 24

Diagnosed UC july 2006.
medications: colazal 9 daily, cortifoam 2x daily, just tapered off pred.
supplements:calcium, aloe gel, pro-biotics, tumeric
osteopenia from all this prednisone.

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