6mp vs imuran(azathioprine)

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Regular Member

Date Joined Jun 2008
Total Posts : 80
   Posted 11/21/2008 6:44 AM (GMT -6)   
Iknow they are in the same class of drugs but the question is if I was toxic on low levels of 6mp, am I going to be the same if I try imuran?(azathioprine)

Elite Member

Date Joined Apr 2004
Total Posts : 23551
   Posted 11/21/2008 7:39 AM (GMT -6)   
Not necessarily. Sometimes people need that break down of Aza to 6mp in order for it to work properly. When you become toxic on 6mp, it may be beause you are lacking a certain enzyme to properly break it down and that can cause complications. That is why some docs prescribe Aza over 6mp. So if you are missing that enzyme, by taking Aza, it breaks down in the liver before getting transformed into 6mp. 6mp is the purer form of the 2.
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Regular Member

Date Joined Jul 2008
Total Posts : 94
   Posted 11/21/2008 11:56 AM (GMT -6)   
I am in the same boat as you...my body just doesnt want to tolerate 6-MP, even on lower dose. My doctor is considering trying Imuran or maybe just going to Remicade instead...waiting to hear back from him...
Diagnosed with UC 3/2008
10mg Prednisone
75mg 6-MP
Calcium + Vit D
Entocort 9mg daily
800mg Asacol 3X daily

Eva Lou
Veteran Member

Date Joined Sep 2006
Total Posts : 3442
   Posted 11/21/2008 12:40 PM (GMT -6)   
It must be your GI's personal preference, which one they try- I've been on Imuran for a long time, at least 3 years. My GI has NEVER mentioned 6MP, not once. We've messed around wtih the Imuran dose, & finally I seem to be actually seeing real results.
diagnosed with UC '02
Asacol- 8 tabs/day
Remicade-10mgs/kg- since 4/07
Imuran- 150mgs/day
Fiber supplement

Regular Member

Date Joined Aug 2008
Total Posts : 149
   Posted 11/21/2008 6:29 PM (GMT -6)   
I tried 6mp in the begining i wasnt on a week, 2 days in a row i woke up at night all sweaty and my chest hurt. I discontinued it right there and never took it again. I take azathioprine now never had and side effects from it, truthfully i dont know if it even does anything for me.
27y old male. Diagnosed with UC (lower proctitis) in 2004.
Current daily treatment:                             Probiotics & supplements:
2400mg oral asacol                                       Digestive enzymes
75mg azathioprine                                        folic acid & calcuim with V-D
20mg Prilosec                                              VSL#3 probiotic 
Diet:Little/no sugars, fats, carbs, caffine,yeast,breads,alcohol. Stay natural as possible. A not so strict form of the SCD.  
Results:1 Bowel movement in the morning no blood! Remission since 08Sept08

Regular Member

Date Joined Jun 2008
Total Posts : 80
   Posted 11/22/2008 7:13 AM (GMT -6)   
thanks for the replys...My doc and I are at wits end.....been on remi for over a year...no D, narrow stools that hurt coming out with some dried up blood that he says is from internal hemmies he sees ont he scope. I have mucus during the day...no stool...and he says I have IBS, but I obviously still have inflammation due to formed but narrow stools with fiber supplement......it feels as if I am passing a football somedays.....tried the cortifoam with no improvment, maybe even makes it worse...intolerant to ASA for inflammation.....kind of at a loss from where to go...he wants to try methotrexta which scares the hell out of me....we are going to wash out of the remi this time and see what happens. It sucks to be so close yet so far away ...I know the stress of worrying about it makes me worse but what can do...He gave me somethig called librax to take at night which does nothing that I can tell.

Regular Member

Date Joined Jun 2007
Total Posts : 364
   Posted 11/22/2008 8:42 AM (GMT -6)   
My son had issues with 6mp (high liver enzymes and low white blood counts), but has done well on Imuran. My daughter does fine on 6mp.

Mom of Son 17 UC dx 07/02, Sulfasalazine, Imuran, Cortafoam, folic acid, L. Reuteri, Culturelle, Zyrtec, Iron, Vit/Min

Daughter 9 UC dx 08/07 Colazal, 6MP, Iron, Vit/Min., Culturelle

UC Mom
Regular Member

Date Joined Jun 2007
Total Posts : 146
   Posted 11/22/2008 10:05 AM (GMT -6)   
My son is on 6mp, and it has worked great.  It took 6 months to do the trick.  He gets blood drawn monthly.  He has had several episodes of nausea, but that passes quickly. All in all, we are very excited, and hopefully he can finish his senior year, go on the college, and enjoy his life.

UC Mom
Son diagnosed 10, 2006 at age 15
6MP 100 mg. per day
Vitamin Supplements

Big Dog
Regular Member

Date Joined Aug 2008
Total Posts : 62
   Posted 12/1/2008 3:05 PM (GMT -6)   
Daughter began the Imuran two weeks ago today.  SHe had to come off the 6MP Purinethol as she was at toxic levels.  However, the drug was working on the UC.  The side effects were awful - weight loss, hair loss, acid reflux, tired, etc.
Now 2 weeks today into the Imuran she is having the same problems.  They started on Thurs (thanksgiving).  Wonder if the dose is too much?  Taking 50mg 3x day.  I keep reading how a lot of you are taking it only at night.
Having bloodwork done today to check on pancreas.
Mother of 8 yo UC patient
2 mg prednisone daily
Lialda 3 pills daily
Prevacid every other day
Purinethol brand name 6MP 75 mg daily
Fish Oil, Probiotics, Immune System Boosters

Regular Member

Date Joined May 2008
Total Posts : 172
   Posted 12/1/2008 3:42 PM (GMT -6)   
HI,  been reading about the 6MP levels and remember my son's doctor making him have for a special test to measure just how much of 6 MP he could tolerate.  It is 150 mgs a day.  Any more would be toxic.  He had to have the blood work sent to a lab in California because it is the only place who could do it.  Did any of you  do this?  He is about to start Remicade Friday.

Big Dog
Regular Member

Date Joined Aug 2008
Total Posts : 62
   Posted 12/1/2008 11:00 PM (GMT -6)   

Wasn't aware of a test that would indicate her tolerance to the Imuran or other 6MP, but her blood work gets sent routinely to that lab in California.  It is Prometheus Labs.  I will ask if there is a way to see how much she can tolerate, thank you!

Mother of 8 yo UC patient
2 mg prednisone daily
Lialda 3 pills daily
Prevacid every other day
Purinethol brand name 6MP 75 mg daily
Fish Oil, Probiotics, Immune System Boosters

Veteran Member

Date Joined Aug 2008
Total Posts : 5975
   Posted 12/5/2008 6:46 PM (GMT -6)   
     Sounds like a high dose of 6MP for an 8 yr old.  I am on 50 mgm.  The 75 mgm was giving me side effects.
62 yr old granny. South Jersey
Diagnosed with ulcerative proctitis in 1998 in hospital
Hospitalized (2nd time) in May 2008
Update 11/03/08...finally in remission!!  Hope I don't jinx myself.  Off the prednisone since 11/01/08...now see if I can stay off for longer than two weeks.  Other meds: 6MP (75 mgm), colazal (6 per day), Benicar and Toprol (high blood pressure meds), Probiotic (2 per day), fish oil capsule and multi-vitamin and calcium with vitamin D.

Regular Member

Date Joined Jul 2007
Total Posts : 84
   Posted 12/6/2008 4:15 PM (GMT -6)   
Big Dog -

The test is called a TPMT, which will show if you have the enzyme activity to properly metabolize 6-MP. It's only done by Prometheus Lab in California. I have been taken off of 6-MP twice as it lowered my white blood cell count, and once had the dose lowered as it was becoming toxic to my liver. I was recently tested again and found that my enzyme activity is below the low end of normal, so I've recently started Remicade instead. Thankfully, that kicked in on the third day after my first infusion (I've had two so far). I've been on Prednisone for two years and every time I taper to the lower doses (5 or 2.5), I flare again. I won't go up again and my GI doesn't want to raise it again, either, so I'm now on Remicade and that's working. I'm tapering the Prednisone by 2.5mg about every 7-10 days and hopefully can get off it.
Ulcerative Pancolitis (dx'd 6/2002)
Pentasa (4gm/day); Prednisone 5mg am, 5mg pm; Aranesp injection every week for anemia;
Started iron infusions 7/18/08; starting Remicade 11/12/08
6-MP (discontinued as it lowers my white count)
Immodium-AD (occasionally)
various meds for other conditions

Regular Member

Date Joined Aug 2005
Total Posts : 188
   Posted 12/6/2008 6:29 PM (GMT -6)   
Big Dog -
I had problems on Imuran originally. I had to start on 50mg for one week, then add another 50mg a week later, and then the final 50mg a week after that. Working up to the 150mg helped. Also, taking it with a large meal before bed has helped me a lot. The initial side effects may go away after a couple of months. I had nausea at the beginning but it went away after a couple of months.

Suffered for my whole life before being diagnosed.

Told to "Eat more fibre "

Currently on:

1500mg x 4/day
Entocort 6mg once a day Completely off as of 10/21/08. Took 2 years!
Imuran 150mg once a day

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