Azathioprine Question.

[woz]

Just started my new med, azathioprine, starting on 25mg for the first week, then 50 mg for the next 2 weeks,
after that I dont know? Can anyone tell me how much azathioprine do you end up on, and how long before you can start
to knock the pred down, and then knock the azathioprine down. I know It varies from person to person.

Also how much alcohol is safe to drink, I am not a big drinker (used to be, but then got older and wiser).

Thanks Woz.

[Randy]

Azathioprine, I take 100 mg a day and have been on it for three years. My doctor says I should stay on it for the rest of my life. He has toyed with the idea of reducing the amount I take but hasn't done it yet. It's the only drug I take. I've been off the pred for 3 years, about the same time I started azathioprine.
As for alcohol, I've never been more than a social drinker but a bottle or two of beer or a shot of scotch doesn't have any negative effect for me.

[woz]

Thanks for the info Randy, beer and scotch, my Favourite drop.
If only I could swap them for pred and Azathioprine.

[drz]

I got up to 200mg azathioprine but then liver readings got too high so was cut back to 150mg and then flared so was put back up to 175 mg daily. Dosage is some what weight variable too. I would guess the max would be around 1 mg per pound but maintenance can be less as long as it seems to be working. It is used very long term for many people with organ transplants so there is more info on this drug and its safety record. Both alcohol and azathioprine putload on liver so I think there is need to be conservative about how much you use. I find a couple drinks a month seems OK for me so far.

[Christina32]

Hi Woz, I started on 50mg Azathioprine dropping 5mg pred at the same time, I did this again 2 weeks later. Last week I went up another 25mg Azathioprine and down 2.5mg prednisone. And have been instructed by my rheumatologist to drop another 2.5mg pred in 2 weeks. ( I don't recall him saying to up the Azathioprine again but maybe this will be done at my next appt or after bloodwork) ? As far as alcohol I don't know.... But if you're feeling good and you'd like to enjoy a nice cold beer I say go for it!!!

[DJS]

My wife just had her monthly blood test and before she got home, she got a call from her Rheumie to stop taking her Azathioprine because her white count was too low. She was taking 75mg per day, most days (50 mg pill and then 1/2 in the evening when she remembered).
Now all she is on is Mepron until the end on August when she does blood work again. She has been off Pred since about March.
So is exercise the only way to build up the white cells?

[drz]

My wife just had her monthly blood test and before she got home, she got a call from her Rheumie to stop taking her Azathioprine because her white count was too low. She was taking 75mg per day, most days (50 mg pill and then 1/2 in the evening when she remembered).
Now all she is on is Mepron until the end on August when she does blood work again. She has been off Pred since about March.
So is exercise the only way to build up the white cells?

No, it won't help. Your body will usually rebound in a few days off the meds. I did this several times while on CTX andit usually took less than a week before they resumed the immunosuppressant meds. One time I think it took over a week because I was really low, much less than 1.

[Randy]

My white blood cell count is always low. It was 2.9 in the last test. Normal I think is 4-10. I saw my Rheumie on Monday, he is concerned, but not enough to alter the dosage of Azathioprine because it has been so successful at controlling the Wegner's. I've been as high as 3.9 and as low as 2.5, it always seems to come back to the 3 range. I exercise a lot and I don't think it helps my white cell count but it does make me feel better.

[drz]

My white blood cell count is always low. It was 2.9 in the last test. Normal I think is 4-10. I saw my Rheumie on Monday, he is concerned, but not enough to alter the dosage of Azathioprine because it has been so successful at controlling the Wegner's. I've been as high as 3.9 and as low as 2.5, it always seems to come back to the 3 range. I exercise a lot and I don't think it helps my white cell count but it does make me feel better.

Do they cut it back or hold the meds if you go under 2.5? I was in the same range most of the time while on CTX. My WBC went up when I got infections but otherwise ran pretty low.

[Randy]

He told me if it fell below 2.5 for more than a month he would cut the med. probably to 75 mg. from 100 and go with a blood test every two weeks instead of once a month until all tests stabilize. I hasn't gone below 2.5 yet. In the past, it has always come back up on it's own.