First flare (on Azathioprine Imuran) do I need pred?

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tums
Regular Member


Date Joined Apr 2008
Total Posts : 128
   Posted 9/1/2009 7:43 AM (GMT -6)   
Hi, not been on here for so long as I have been feeling great but here I am again the first thing I turn to when unwell!
 
I started Azathioprine in April 2008 and now in Sept (just) 2009 I am flaring pretty good going compared to prior to starting Azathioprine.  Anyway I have started morning and night predsol to try and get it under control but my question is if I do have to start on oral pred will it be a lower dose as I am taking Azathioprine.  Always started 40mg before aza drug but would hope that I shouldn't need as high a dose as my immune system is already supressed.
 
Any experience on this welcome.
 
Thank you.
33 year old female
UC diagnosed 2001
Asacol 6 per day
Azathioprine 100mg started 4/08
 


Mamas Boys
Veteran Member


Date Joined Oct 2005
Total Posts : 1460
   Posted 9/1/2009 7:49 AM (GMT -6)   
I would up the asacol dosage and add in rowasa or steroid enemas first.  If that doesn't seem to work then you can discuss prednisone.

Mamas Boys
Colazal, Azathioprine, Remicade
Culturelle, MultiVitamin, Folic Acid, Viactiv
Status: Remission!!


UCisMyTeacher
New Member


Date Joined Aug 2009
Total Posts : 10
   Posted 9/1/2009 1:20 PM (GMT -6)   
I've been on AZA for 8 years and in remission for most of that time. I've had a very severe flare these past 3 months... started pred at 40mg, recently went up to 60mg. So, my experience is that a lower pred dose isn't necessarily a given on AZA. Hope that helps.
Diagnosed in '99 with severe pancolitis at 24 yrs. old. Consultant/Intuitive Coach. Father of Two.
Remission from predisone, azathioprine and asacol.
Went into remission in '01 and stayed for 8 years on 50 mg. azathioprine only.
New flare in May, 09 (had almost forgotten how rough it can be!).

Long journey with alternative treatments - some good, some not. Found that a blend of western drugs and complimentary herbs worked best for me, especially for mild symptoms and maintenance.


tums
Regular Member


Date Joined Apr 2008
Total Posts : 128
   Posted 9/2/2009 3:56 AM (GMT -6)   
oh cr*p, I was hoping I wouldn't have to go on high dose pred.  I am using the pred enemas but don't think they reach high enough, whole colon has been affected before.  Speaking to my gastric nurse today so wait to see what is in store for me.  Hate this freakin disease!!!!!!!!!!!!!

33 year old female
UC diagnosed 2001
Asacol 6 per day
Azathioprine 100mg started 4/08
 


mindstyle
Regular Member


Date Joined Aug 2009
Total Posts : 62
   Posted 9/2/2009 7:26 AM (GMT -6)   
Thats your GI to decide. If you notice in my signature, I am on AZA and on pred too since last 2 weeks.
Male, Diagnosed with Ulcerative Colitis since 2006, at the age of 30 years

Currently taking
100mg of Azathioprine, twice a day
2250mg of Balsalazide Hydrochloride, 3X a day
1mg of Vit. B12, once a day
500mg Salazopyrine suppository once a day.

30mg/day of Prednisolone since 2009/08/21 to control recent flare up, will reduce the dose by 5mg each week. (hoping not to swell up)

250mg Neproxen as and when required for migraine (usually twice a week and I don't know if this is side-effect of Salazopyrine)


saskia
Regular Member


Date Joined Dec 2007
Total Posts : 31
   Posted 9/2/2009 4:59 PM (GMT -6)   
While on Azathioprine, I have had some success treating flares with entocort (oral capsules containing a steroid but which have a far reduced systemic effect than pred) and with cortofoam (a steriod foam which has mostly a localized effect). What really helped put me into remission was an increase in the aza dose fro 75mg to 100 mg a day.
*saskia*
pan colitis (diag: Nov 05)
Meds: salofalk7 to 10 tabs/day depending on disease status; imuran 75mg/day; entocort when flaring; cortifoam when flaring; pantoloc; VSL#3; vitamin D and calcium; fosomax


tums
Regular Member


Date Joined Apr 2008
Total Posts : 128
   Posted 9/3/2009 8:26 AM (GMT -6)   
I am already on 100mg azathioprine which I think is a dosage determined by my weight so wouldn't want to increase it any further. 
 
I have spoken to the specialist nurse today who has told me to continue with enemas twice per day increase my asacol to 3600mg was previously taking 2400mg and I have to do usual stool sample to check for infection and get a CRP blood test (think thats what it's called) to check my inflammation markers but they have never risen before when in a flare up so think thats pointless but hey ho.  Appt scheduled for next wk to see if I require to start pred.  It kind of gets to me that it's another 6 days before I go for the appt and I know how much worse things can get in 6 days but again hey ho.  I am trying not to get stressed out about this.
33 year old female
UC diagnosed 2001
Asacol 6 per day
Azathioprine 100mg started 4/08
 

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