MTX to Immuran

[Psyborg]

So I feel significantly less drained on Immuran. But the Prednisone effects are becoming more pronounced on Immuran. Did anyone else feel like MTX reduced the Pred effects? I feel hungry more often now and have sugar cravings. I've finally started gaining weight...which to an extent a bit was needed, but I am worried I'll put on more than I should. Given my background with previously being considerably overweight I'm finding I'm a bit paranoid about putting too much back on now. It's weird to see the scale start swinging the other way I guess.

[vdub]

I really can't speak to pred specifically, because I wasn't on pred at the same time I was on mtx. However, I was on cortef (hydrocortisone) at the same time. Now that I'm off the mtx and still on cortef, I have noticed a weight gain. I go on HGH as soon as the pharmacy can get it in and it also has weight gain as a side-effect. Oh joy....

[RudiK]

I was never on MTX, I switched from CTX to Azathioprine (generic Immuran) and I'm on 7.5 mg Pred. I gained 10 lbs since September to 195 lbs and have trouble containing my weight much less reducing it. I'm 5'10" heigh and 68 years old.

[pberggren1]

It is so weird that so many of us do so differently on mtx and aza.

[Dryhill]

I have been overweight for some years but was just begining to lose weight when they put me on Pred, I put all the weight back on plus some. Even though I have gone from 60mg daily to 15 mg daily I still find it difficult to lose weight again. :crying:

[Psyborg]

I think I'm probably just paranoid about gaining weight. I have been arguably too thin since May of 2010, but after being severely overweight in the past and going through bariatric surgery to correct it I'm just very wary of weight coming back on. Just to explain I was about 340ish before surgery, and my target for weight was to reach 230....I ended up at 175. At 6'2" that's thin for my bone structure...but now I'm freaked out for going up in weight...at least in part because I know I'm eating things I shouldn't.

[pberggren1]

I think I'm probably just paranoid about gaining weight. I have been arguably too thin since May of 2010, but after being severely overweight in the past and going through bariatric surgery to correct it I'm just very wary of weight coming back on. Just to explain I was about 340ish before surgery, and my target for weight was to reach 230....I ended up at 175. At 6'2" that's thin for my bone structure...but now I'm freaked out for going up in weight...at least in part because I know I'm eating things I shouldn't.

I can certainly understand this Bob. It is very hard to eat right all the time. Are you still on Pred right now?

[Psyborg]

Yeah, only 9mg a day now though. Would think it'd be getting better.

[drz]

Yeah, only 9mg a day now though. Would think it'd be getting better.

Nine is better than 40 or 50mg a day but still enough to create some problems with elevated blood glucose level according to my endocrinologist so it might affect your diet and weight gain programs. I am now down to 5 mg but have only lost a couple of the pounds i gained last year from the higher dosage of pred. I haven't gained any more recently but not having much luck at losing much either. My BG levels are getting much better though and easier to control at the lower dosage of pred.

[Sangye]

I still had an increased appetite (though not greatly increased) at 2.5 mg pred. Being on hydrocortisone now I can really tell the difference. I don't have it at all.

[Psyborg]

I am down to 6 mg of prednisone now. So that's a relief, but I'm not sure if the Immuran makes me sick to my stomach or if it's been there all along masked by the Prednisone. It's weird because I do not have a proper stomach so I get nasty gaslike pain. Not sureif thats even a side effect of the Immuran.

Other than the stomach issues, I generally feel a ton better. I have a VO2 test today and they said I tested as physically fit :blink: which absolutely boggles me. Now I suppose that maybe the breathing has improved post-RTX and with the use of the stupid CPAP at night, but that is strange to me.

[vdub]

I just got off a spike/taper of pred. Started at 25mg then tapered over a week. I had a touch of psoriasis and it took care of it.

I have the ole CPAP, too, Bob. Pain in the butt to pack around when we head out hither and yon. But, between the CPAP and reconstructive nose surgery, I breathe pretty well.

Glad you are feeling better! Hang in there!

[Al]

I am down to 6 mg of prednisone now. So that's a relief, but I'm not sure if the Immuran makes me sick to my stomach or if it's been there all along masked by the Prednisone. It's weird because I do not have a proper stomach so I get nasty gaslike pain. Not sureif thats even a side effect of the Immuran.

Other than the stomach issues, I generally feel a ton better. I have a VO2 test today and they said I tested as physically fit :blink: which absolutely boggles me. Now I suppose that maybe the breathing has improved post-RTX and with the use of the stupid CPAP at night, but that is strange to me.

Physically fit? Great, Bob! You want to do an iron man with me...? (What a thought!)

Your Imuran experience is pretty typical, actually. I've had some strange (and transient--fortunately) nausea, which is also normal, apparently.

Al

[pberggren1]

What's a VO2 test?

[Psyborg]

VO2 is a exercising PFT basically. They have you either on a treadmill or a bike and ramp up the exertion. I rode a bike for it. I've either improved a bit in the last few months or that type of exertion isn't setting me off as much. I definitely got short of breath eventually, but it wasn't horrible like when I was at the gym and had to basically stop for 10 minutes when I pushed too hard.

[Sangye]

That's great, Bob! Maybe the CPAP is allowing you to breathe deeper and exercise your lungs better.

[Psyborg]

I'm actually a bit concerned about the imuran. The nausea is unfortunate but tolerable, but I'm concerned about the abdominal pain as I don't have a good liver in the first place and that is vaguely where I'm getting pain after the night time dose. Trying to decide if I am being paranoid on that one as it only recently started to be an issue.

[vdub]

I'm sure you googled this subject just like I did, Bob. Yeap, it's a prodrug and converted in the liver like mtx is. When I was on the mtx, I really watched my liver function tests carefully. AST and ALT are the ones I homed in on, but there are others.

IMHO, I don't think you would necessarily feel pain near your liver if you were having liver function problems, but I have absolutely no basis for saying that. I think in the case of Imuran, your most likely cause of abdominal pain would be a side-effect of the drug and not a liver issue. For some reason, I just don't think a liver problem (short of a tumor) would cause pain. Seems to me that liver failure would manifest itself in ways other than pain, such as jaundice.

On edit.... I might have to take that whole "pain thing" back. I remember the doctors always poking at the liver and testing for tenderness (nearly 50 years ago when sick). Maybe it gets tender when inflamed. So, I don't know, but I'd still lean toward a side-effect of the imuran rather than a liver problem.

[Sangye]

Bob, I'm assuming your docs are keeping an eye on your labs that check liver function. They should be looking at least once a month. It's not like a liver problem goes from 0 to 10 in an instant. It occurs over time. Pain is a potential sign of trouble (and yup vdub, your edit is correct-- liver problems can cause pain).

[Al]

Bob, here is my experience with AZA. (I am down to 5mg of pred, so that should not be contaminating my observations.) The latest liver panel is all fine, but I still get fleeting nausea, of this kind: Someone says, "you must be hungry", but I have to respond, "Uh, I don't think so". At these times, even the though of food makes me queasy. Drac asked if it was related to meat. I am not a meat eater, but there are other foods that have casein, the main protein in meat, so it is perhaps hard to tell. Apparently, meat nausea is related to AZA, or an interaction with steroids. Anyway, fruits and raw vegetables do not do this for me (cooked vegetables sometimes do). One thing I am thinking is that AZA tends to kill off gut flora, so maybe what's left are the rowdier gut soldiers. Perhaps pro-biotics would help.

Al

[gunnyl]

I'm starting MTX this week. Reducing CTX to 100mg, Start MTX at 1 pill this week, 2 pills next week, 3 pills the following week and drop CTX to 75mg and that's what I know right now. Also on 5mg Pred. Think she's going to drop CTX at that point and go to 8 pills MTX and keep the pred. I'll keep posting how it goes!

[Sangye]

I hope it goes well for you! :thumbsup:

[Psyborg]

Managed to go on my cruise without getting ill (bit sunburned though). Funny thing is I didn't feel sick to my stomach at all, i'm now suspicious that it's something I'm eating or drinking at home that is making me sick to my stomach.

I gotta say it was nice to get some sun for once. I know we aren't supposed to, but I felt positively like a lizard on a rock ;)

[KathyB]

Sounds like a great cruise! Nothing like some sun to boost your spirits!!

[Sangye]

Wow, I'm so happy you were able to enjoy it, Bob. Some sun is healthy. I wish I could tolerate more, in fact.

What kind of water do you drink at home? Tap?

[Al]

Managed to go on my cruise without getting ill (bit sunburned though). Funny thing is I didn't feel sick to my stomach at all, i'm now suspicious that it's something I'm eating or drinking at home that is making me sick to my stomach.

I gotta say it was nice to get some sun for once. I know we aren't supposed to, but I felt positively like a lizard on a rock ;)
Interesting, Bob. My wife lusts after a cruise, but I have always been reticent. Partly, it is being with crowds and their possible microbes. I also worry about all that salty food and such. But it is also therapeutic, as you note, to sometimes get away from home. A change can reveal matters of habit that can cause one grief. Besides, even sick folks deserve a little fun!

Al

[Psyborg]

Wow, I'm so happy you were able to enjoy it, Bob. Some sun is healthy. I wish I could tolerate more, in fact.

What kind of water do you drink at home? Tap?

Usually filtered water at home, bottled at work. But I have to admit I have a bad habit with drinking a sugar free energy drink too regularly. No sugar, but I know the cafeine isn't good for me. But I got hopped up on it during a particularly rough patch with the MTX when I couldn't stay awake adequately at work.


Interesting, Bob. My wife lusts after a cruise, but I have always been reticent. Partly, it is being with crowds and their possible microbes. I also worry about all that salty food and such. But it is also therapeutic, as you note, to sometimes get away from home. A change can reveal matters of habit that can cause one grief. Besides, even sick folks deserve a little fun!

Al

I absolutely detest crowds Al, so I can sympathize there, but it's nice to get away someplace that work can't call and you are really free for a few days. That said I was pretty paranoid about the microbes while on board :)

As far as food goes I actually lost 2 pounds on the cruise so I think it probably depends how much you eat of it really. I indulged a bit, but probably ate less overall than normal, just better quality stuff than normal

[gunnyl]

Bob,

I have to ask, what were the major side effects of MTX? I started this week with 1 pill 2.5mg and my rheumy lowered my CTX to 100mg, next week I go to 2 pills 5mg and then the following to 3 pills 7.5mg lower CTX to 75mg. She's doing it this way so I don't go for an extended period with nothing since it takes 6 to 8 weeks for MTX to take hold. So far not too much effects but only one pill. I will eventually be on 8 pills 20mg as my MTX dosage when she get's me up to full strength and she'll drop the CTX somewhere in between. I'm currently on 5mg Pred but she may adjust that up or keep it the same depending on my labs and how I react.
I eventually got used to the CTX and quit taking the Nausea medication altogether.

Thanks,

GL

[Psyborg]

I wouldn't say I had major side effects, I had headaches and semi-frequent fatique. My main issue is my liver enzymes bounced around a lot and I already have liver issues before this whole disease medication cycle started. So if I had to I'd go back to MTX if I had issues with the immuran.