Changeover from azathioprine to mercaptopurine.

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Scottishcammy
Regular Member


Date Joined Nov 2007
Total Posts : 124
   Posted 7/20/2008 2:18 PM (GMT -6)   
Hi,
I've been taking 150mg of azathioprine for several months now. Unfortunately I've now been suffering from terrible joint pain for quite a while as well. My consultant thinks it's either arthritis associated with the UC, or a side effect of the azathioprine.
I believe I may have to switch to mercaptopurine to see if the joint pain goes away. However, my GP mentioned I would have to go back to baseline (50mg) and work back up to the 150mg, which took 3 months to do with the azathioprine.

My worry is that I may flare again if I change over and have to build up the dosage again. Does anyone have experience of this? I take it I couldn't just switch straight over to 150mg of mercaptopurine from my azathioprine?

Cheers.
Diagnosed Indeterminate Colitis 25/11/2007 (update: told by consultant 15/01/08 in his opinion definitely UC).
150mg Azathioprine/Imuran.


Red_34
Forum Moderator


Date Joined Apr 2004
Total Posts : 23551
   Posted 7/21/2008 5:38 AM (GMT -6)   
I have never had to change over but I just wanted to comment on the mg's. Aza and 6mp have different dosing mg's. For every 25mgs of 6mp it is equal to 50mgs of Aza. So basically it is half the dosing of Aza. And the reason they have you start back at the baseline is because 6mp is the purer form of Aza meaning that Aza has to break down into 6mp in the liver to be of use. Even though you have already been on Aza for a while, I think that jumping into high mg's of 6mp would be a shock to the liver. If any doc wants you to go up to 150mgs of 6mp, question their decision because that is a HIGH dose of 6mp.
 @--->--SHERRY--<---@
Moderator for Allergies/Asthma and Co-moderator for UC
~Left sided Uc-'92-Colazal(9 daily),6mp(50-100mgs), Hydrocortisone E's, Prilosec,Biotin,Forvia,Pro-Bio**Unable to tolerate Asacol, Rowasa or Canasa**~Year-round allergies-Singulair, Allegra
~Secondary Reynauds Syndrome-'04-Norvasc~Spinal Stenosis~Sacroiliitis-epidural injections~bulging and herniated discs C5,C6&C7~2nd epidural injection 8/14
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PaloPalo78
Regular Member


Date Joined Feb 2008
Total Posts : 42
   Posted 7/21/2008 11:31 AM (GMT -6)   

wow i havn't been on here for a while but im glad i did today and read about the dosage

I was on Aza for a few months .. went from 25 to 75  but only had a few weeks at 75 before my docs and IBD nurse jumped and told me to stop as i had a liver problem with it .

So i have tried again with mercaptapurine ( 6mp ) and was told to start at 25mg and be very careful not to miss a blood test , which i was as i was doubting there would be much difference between the 2 drugs .

 I seem to be fine with 6mp but i had increased to 37.5 ( 3/4 pill ) and then gone to 50mg   ,      all without seeing the consultant ( I got messed around and couldnt get an appt )

but i was wondering about going further to 75mg etc

Now I think i wont !! ... but will wait for the consultants advice /appt

thankyou for posting the dosage information ...i had not read that anywhere , although could have missed it ,  as i had in my head that it was the same drug but just broken down differently

Is it based on weight too ? ..im very skinny ( 5ft 10 , 60kg ) -


Red_34
Forum Moderator


Date Joined Apr 2004
Total Posts : 23551
   Posted 7/21/2008 12:51 PM (GMT -6)   
At first they base it on weight and tweak it according to how you are metabolizing it. I only weigh 128lbs and I take 100mgs on Mon, Thurs and 50mgs rest of the week.
 @--->--SHERRY--<---@
Moderator for Allergies/Asthma and Co-moderator for UC
~Left sided Uc-'92-Colazal(9 daily),6mp(50-100mgs), Hydrocortisone E's, Prilosec,Biotin,Forvia,Pro-Bio**Unable to tolerate Asacol, Rowasa or Canasa**~Year-round allergies-Singulair, Allegra
~Secondary Reynauds Syndrome-'04-Norvasc~Spinal Stenosis~Sacroiliitis-epidural injections~bulging and herniated discs C5,C6&C7~2nd epidural injection 8/14
To help Healingwell - click here: DONATE
 
 
 
 

 
 


PaloPalo78
Regular Member


Date Joined Feb 2008
Total Posts : 42
   Posted 7/21/2008 1:01 PM (GMT -6)   

oh Okay

silly question perhaps , but do you know how they check how you're metabolizing it ?

I get regular blood tests , i.e ESR , FBC , Bone Profile , U & E Creatine , CRP and Liver 

would it be on that or is it a very specific test


Red_34
Forum Moderator


Date Joined Apr 2004
Total Posts : 23551
   Posted 7/21/2008 1:30 PM (GMT -6)   
Are you in the states? Here in the USA they use a lab from California called Prometheus Labs. The doc will have the blood drawn and they send it off to have the metabolites test. Not sure what they do outside the USA though. The metabolites test then tells you how well your body is metabolizing it. I'm not sure of the technical terms in regards to what they look for though.
 @--->--SHERRY--<---@
Moderator for Allergies/Asthma and Co-moderator for UC
~Left sided Uc-'92-Colazal(9 daily),6mp(50-100mgs), Hydrocortisone E's, Prilosec,Biotin,Forvia,Pro-Bio**Unable to tolerate Asacol, Rowasa or Canasa**~Year-round allergies-Singulair, Allegra
~Secondary Reynauds Syndrome-'04-Norvasc~Spinal Stenosis~Sacroiliitis-epidural injections~bulging and herniated discs C5,C6&C7~2nd epidural injection 8/14
To help Healingwell - click here: DONATE
 
 
 
 

 
 


Scottishcammy
Regular Member


Date Joined Nov 2007
Total Posts : 124
   Posted 7/22/2008 12:29 PM (GMT -6)   
Hi,
many thanks for replying.
I was at the consultant's today. It was a bit strange really, in that they made no mention of changing the drug regime.
However, I've to be referred to a rheumatologist, so we'll see what happens.
The bugger is I'm in pain now, and am somewhat fed up with it. It's really not good with my job either, it's difficult to even put a jacket on!

Hopefully it won't be long until I'm seen.

Anyone had any experience of seeing a rheumatologist / what happened?

Cheers.
Diagnosed Indeterminate Colitis 25/11/2007 (update: told by consultant 15/01/08 in his opinion definitely UC).
150mg Azathioprine/Imuran.

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