Remicade vs. 6MP

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sweetmelody
Veteran Member


Date Joined Aug 2007
Total Posts : 650
   Posted 7/5/2009 2:19 PM (GMT -6)   
Which do you think is better to take if you have to move up from 5asas... and if you don't want to take pred. anymore.

Which has less side effects or less severe... ?


I'd think Rem since it's an immediate kick in...
Kara, 22F Married.
Latest - Lialda 2 twice a day. Left Sided Colitis 40cm up...flare. Also IBS.
Medications: Lialda 2 twice a day, Align probiotic, Hyomax as needed, 6mp 50mg a day, Rowasa enemas.
I am so sick of this disease!
 
 


pam222
Veteran Member


Date Joined Jun 2009
Total Posts : 985
   Posted 7/5/2009 2:36 PM (GMT -6)   
Well, it seems most people do the 6MP first, and I was told by someone on here that I went to Remicade too fast. My GI went right to Remicade because he said the side effects were worse, I would have to wait longer to feel better, and I would need a lot of blood work and monitoring if I went on the other drugs, but I am far from an expert on any of this so I don't know if it was the right choice or not, especially since it's been a month almost and the Remicade is not working for me yet anyway.
26 year old female
Diagnosed with unspecified UC 11/08 by flex. sig. as I was pregnant at the time and did not want to be put under for a colonoscopy
Breastfeeding my baby boy (born 4/8/09)
15 mg Prednisone AM, 15 mg PM (tapering from 60mg a day)
Started Remicade 6/11/09
Was on Asacol (2400mg or 3600mg a day) for 6 months with no success


sweetmelody
Veteran Member


Date Joined Aug 2007
Total Posts : 650
   Posted 7/5/2009 2:45 PM (GMT -6)   
hm... well all I know is my doc told me a month for 6mp to kick in.... and people on here are saying it can take up to 6 months.... I can't wait that long. I'll give it two months....if not by then... I'm asking for Remicade because I need to keep my job at fulltime.
Kara, 22F Married.
Latest - Lialda 2 twice a day. Left Sided Colitis 40cm up...flare. Also IBS.
Medications: Lialda 2 twice a day, Align probiotic, Hyomax as needed, 6mp 50mg a day, Rowasa enemas.
I am so sick of this disease!
 
 


pam222
Veteran Member


Date Joined Jun 2009
Total Posts : 985
   Posted 7/5/2009 3:02 PM (GMT -6)   
sweetmelody said...
hm... well all I know is my doc told me a month for 6mp to kick in.... and people on here are saying it can take up to 6 months.... I can't wait that long. I'll give it two months....if not by then... I'm asking for Remicade because I need to keep my job at fulltime.


I believe my doctor said "a few months" for the 6MP to start to work
26 year old female
Diagnosed with unspecified UC 11/08 by flex. sig. as I was pregnant at the time and did not want to be put under for a colonoscopy
Breastfeeding my baby boy (born 4/8/09)
15 mg Prednisone AM, 10 mg PM (tapering from 60mg a day)
Started Remicade 6/11/09 (2 infusions so far)
Was on Asacol (2400mg or 3600mg a day) for 6 months with no success


fruitgirl
Veteran Member


Date Joined Feb 2009
Total Posts : 7150
   Posted 7/5/2009 3:43 PM (GMT -6)   
My GI said that if the 5ASAs fail, he'd suggest I go ahead and use Remicade rather than trying 6MP or Imuran. He thinks that it tends to have a higher success rate and that there is evidence that patients are better off in the long run to just skip the immune suppressants. And honestly, I don't think I'd want to wait for 6MP to kick in, mostly because I'd likely have to be on pred to be able to function until it does, and I'm really hesitant to be on pred much at all.
Status: Remission since late May 2009!
Symptoms began in November 2008, ~4 weeks after giving birth to my son.
Diagnosed with pancolitis on 1/30/09
Currently taking Apriso (4 pills ONCE!! daily), Rowasa twice weekly, Natural Factors Ultimate probiotic 12/12 Formula, and Zoloft (25 mg).


sweetmelody
Veteran Member


Date Joined Aug 2007
Total Posts : 650
   Posted 7/5/2009 6:39 PM (GMT -6)   
yeah i'm pretty much thinking of telling my dr i want remicade at our apptment on the 10th
Kara, 22F Married.
Latest - Lialda 2 twice a day. Left Sided Colitis 40cm up...flare. Also IBS.
Medications: Lialda 2 twice a day, Align probiotic, Hyomax as needed, 6mp 50mg a day, Rowasa enemas.
I am so sick of this disease!
 
 


Old Hat
Veteran Member


Date Joined Feb 2007
Total Posts : 5182
   Posted 7/5/2009 9:28 PM (GMT -6)   
There's a line of thinking initiated by a Dutch IBD gastro who lectured widely in the U.S. last yr that advises treating patients who don't respond to 5-ASAs with the "big gun" meds instead of steroids. The idea behind that is to bring about remission as quickly as possible & to reduce the chances of flare-ups, in an effort to change the course of IBD before it damages the intestinal organs. At this point in time the top research-oriented gastros conclude that steroids should be avoided in most cases because of their many side effects, especially osteoporosis. / Old Hat (30 yrs with left-sided UC ... [etc.])

princessb
Regular Member


Date Joined Jan 2009
Total Posts : 24
   Posted 7/5/2009 10:07 PM (GMT -6)   
I have heard the same thing as Old Hat.  I did the traditional route of 5 ASAs, then entocort, pred, Imuran and then finally Remicade.  I wouldn't do the same thing again.  I am in remission and went off Remi and am now just on 5ASAs.  We talked about going on 6mp to maintain remission, but the side effects are what's keeping me from doing that.  I had no side effects with Remi and was so much better after the first dose, so my thought would be to go for that first. 

Ulcerative Colitis, Hyperthyroidism
Lialda 2.4 Gm, Methimazole 5 mg, Atenolol 25 mg
In remission after almost 3 years :)


Katmom
Veteran Member


Date Joined Mar 2008
Total Posts : 1202
   Posted 7/6/2009 10:53 AM (GMT -6)   
6mp did not do it for us, but our research oriented doc.wanted my daughter to stay on it, even when the Remi kicked in. We didn't want to mess with what is working, but her 6mp levels are quite low-at only 50 mg, daily- and she is not at Therapudic levels-just took the expensive Prometheous test. The question is, should she stay on it anyway? There is some research to suggest that it keeps the Remi working longer( a goal for a tough case like this). That said, I don't know what anyone else should do, there is a lot of trial and error with this disease. We wnet down the road quickly from Pred, 5ASA's, 6MP, to the big guns.
Daughter,15 diagnosed 1-08 w/ UC .
Previous drug sampling: Asacol, Prevacid, Flagyl, Prednisone- 50mg to 0, 4 major flares '08.Hospital four x. Low residue diet,
6MP, Colazal , Cortifoam enemas,
Trying probiotics, Niferex, fish oil, Magnesium, Acupuncture.
Remicade 10mg per kilo@ 8wks, since 10-08. Still on 6mp and Colazal


sweetmelody
Veteran Member


Date Joined Aug 2007
Total Posts : 650
   Posted 7/6/2009 1:00 PM (GMT -6)   
I dunno but when i researched remicade I saw this and was like ahhh

Using Remicade may increase your risk of developing certain types of cancer such as lymphoma (cancer of the lymph nodes) or autoimmune disorders (such as a lupus-like syndrome). This risk may be greater in children and young adults. Talk to your doctor about your specific risk.

that freaked me out
Kara, 22F Married.
Latest - Lialda 2 twice a day. Left Sided Colitis 40cm up...flare. Also IBS.
Medications: Lialda 2 twice a day, Align probiotic, Hyomax as needed, 6mp 50mg a day, Rowasa enemas.
I am so sick of this disease!
 
 


Butterfly Kisses
Regular Member


Date Joined Aug 2008
Total Posts : 32
   Posted 7/7/2009 8:11 AM (GMT -6)   
Sweetmelody - the lupus like syndrome has been said to go away after stopping the use of Remicade. Just to help ease your fear. Also almost all of the UC meds can increase your chances of some type of cancer but w/o them we're hurting our bodies also so it's kinda like a risk some of us just have to take. What does your doctor say? My doctor waited to put me on Remicade until other drugs didn't seem to be helping me fast enough. I was having my worst flare ever and he said I didn't have the time to wait so we had to start it right then. That was last year so about 5 years after my initial diagnosis I started remicade. I'm happy with it so far. I go see my doctor today and I want to see if some of the issues I'm having are related to remicade but if they're not then I haven't had any problems with it. I just have some random dry patches of skin and sometimes itchy bumps. Also my scalp is itchy. Nothing that I can't handle though. I'd rather have itchiness than UC symptoms! Also I just read a few articles that suggest that remicade in combination with an immunosuppresant like 6mp or Imuran increases the likelihood of remicade working and with less symptoms.
26 years old...Diagnosed with Ulcerative Colitis in 2002

Currently taking: Colazal 750mg 3 pills 3x a day, Imuran 50mg 3 pills 1x a day, Remicade & B12 Injections.

Have taken: Asacol, Lialda, Entocort, Prednisone, Limotil, Nulev, Librax, Canasa & Rowasa.


bookgal77
Regular Member


Date Joined Jul 2009
Total Posts : 83
   Posted 7/7/2009 4:47 PM (GMT -6)   
I've heard that the immunosuppressant drugs (Imuran & 6MP) take 3 months to kick in. In the meantime you need to be on some other drug to help manage symptoms/potential flare.
**Diagnosed with ulcerative colitis in 2001; diagnosis changed to Crohn's disease in 2009 (but still only impacts colon)
**Asacol (4800 mg daily), 6-MP (100 mg daily -- recently switched from Imuran), Prednisone (8 mg daily...for a few more weeks), Flagyl (250 mg every other day), Nexium (40 mg daily)
GOAL of one day being immunosuppressant free...still working on my doctor on this one but I am a world traveler who desperately wants to go to Africa one day!

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