Maintenance Meds

[HopeinTN]

My next appointment is 6/25 and if all goes as planned I will get to stop Cytoxan and move to another medication for maintenance. Thank goodness because I’m on month 20 of this crap and ready for a change.

What are the advantages or disadvantages of Methotrexate or Imuran (Azathioprine)? Both have been kicked around and not that I will have a choice, but curious about both. Is one safer than the other?

Thanks for your input in advance!

Katrina...not the Hurricane

[Dirty Don]

I'm on mtx for maintenance...no side effects cept for early hair loss which was corrected with vitamins, folic acid triple dose.

[drz]

My next appointment is 6/25 and if all goes as planned I will get to stop Cytoxan and move to another medication for maintenance. Thank goodness because I’m on month 20 of this crap and ready for a change.

What are the advantages or disadvantages of Methotrexate or Imuran (Azathioprine)? Both have been kicked around and not that I will have a choice, but curious about both. Is one safer than the other?

Thanks for your input in advance!

Katrina...not the Hurricane

MTX is not good if you have kidney damage or neuropathy. Not good if you drink alcoholic beverages. It can be given once a week and injection is option. MTX can cause sores in mouth, irritation in lungs, scarring of the liver.

Azathioprine is not good if you have liver damage or lack an enzyme to digest it. They should test for this before starting you although it is rare to lack it. It is taken daily by mouth. May increase risk of blood cancers in people taking it for transplant rejection.

People react differently to them and may find one intolerable and the other no problem. Both cause increase risk of infection and require regular blood work. The above info is from NIH so I would ask your doctor which they recommend for you. MTX was not consider as an option for me because of my medical history.

[HopeinTN]

I did have the test and should be fine with Imuran. We'll see and I think this is what they are leaning towards. I thought getting all the info I could on the two might be helpful. I'm such a planner by nature and this disease has changed that part of my life for sure.

[marylz]

Good to know. Hopefully I'll be in the same situation come August and the docs will switch me over. Since I have only 1 kidney and it has been affected by wegs, MTX probably isn't an option for me. Thanks for the info. (Not happy about the prospect of more hair loss though, Don!)

Mary

[HopeinTN]

I thought that too about the hair, but I'm thinking that if 20 months of CTX doesn't take my hair (mostly thinned out), then surely this one won't! I hope but who knows. I have involvement in both lungs so I'm guessing Imuran is best for me.

[Debbie C]

Katrina..I thought they took you off that a long time ago,I know you were taking about it...why are they waiting soooooo long ?

[mishb]

I don't know much about the others because I have only been on MTX......but I like drz's explanations.

I hope the choice is a good one for you.



I just wanted to say that I miss Al calling you Hurricane :crying:

[annekat]

I thought that too about the hair, but I'm thinking that if 20 months of CTX doesn't take my hair (mostly thinned out), then surely this one won't! I hope but who knows. I have involvement in both lungs so I'm guessing Imuran is best for me.

Katrina, I think I'll remember your name now. The avatar is a bit of a clue! And I'll think of Al.

I'm finding that after switching to MTX from CTX, the hair loss is much less and it is actually growing back, although quite slowly. I don't know how azathioprine is with hair loss or anything else. I did have lung involvement, though probably not as bad as yours. The MTX hasn't caused any lung irritation that I know of. I'm sure your docs will make the right choice, but isn't it nice that we have this forum to get a lot more detail about options and what to expect.

[HopeinTN]

Nope, I thought the the Dr. at Johns Hopkins would talk my doctors at Vandy into taking me off the CTX back months ago but nope. They all agreed that mine was a tough case and I wasn't in remission just yet.

Yes, I do miss Al and the Hurricane comments. He was such a good egg!

Exactly Annekat. This group is awesome and who better to ask than my fellow weggies that have been there before me?

[drz]

Nope, I thought the the Dr. at Johns Hopkins would talk my doctors at Vandy into taking me off the CTX back months ago but nope. They all agreed that mine was a tough case and I wasn't in remission just yet.

Yes, I do miss Al and the Hurricane comments. He was such a good egg!

Exactly Annekat. This group is awesome and who better to ask than my fellow weggies that have been there before me?

Hurricane comments??? I remember Al but not sure what this refers to?

[HopeinTN]

My name being Katrina and the association with Hurricane Katrina.

[drz]

My name being Katrina and the association with Hurricane Katrina.

DUH??? I don't drink coffee but must need something now.

[Randy]

I take Azathioprine, 100 mg a day. I've been on it for 3 years and it seems to work fine. I had slight hair loss in the begining but nothing to worry about. My white blood cell count is consistently low. The doctors tell me it's because of the Azathiprine. I get upset stomach often, and have to watch cuts as you are much more susceptible to infection. otherwise I feel fine and haven't had any bad reactions to it. I'm happy with it.

[Alysia]

I couldnt bear Imuran. 3 weeks after I started it, I vommited and had diarhea an hour after taking it. it felt like being poisonned. so my doc swithched to MTX.

[HopeinTN]

Drz- It's the drugs we stay on so no worries. LOL!

It's nice to know how everyone has reacted to the meds. Thanks for all the info.