Imuran and vomitting

[mrtmeo]

My mom took 50mg 2x's per day imuran for over a week one month ago and didn't have any nausea or vomitting.
She had to stop it due to too much bone marrow suppression.
I tried starting her on 50mg once per day and she threw up 2 hrs after one.
Her dr wants her back on it now that her hemoglobin is up to 11.7.
She took it with food.

Anyone have issues with taking it a 2nd time?

[gilders]

No issues with vomiting with me. Over the last 20 years I've been on imuran for about 14 years in total, on and off. So don't think it's anything to do with imuran.

[me2]

I did not have that problem when I took Imuran but of course we all react differently to different meds.

It sounds like vomiting might be fairly common with Imuran. I found this on a search :







Imuran Overview - Patient Information: Side Effects. You may experience stomach/intestinal symptoms such as nausea, vomiting, diarrhea, or loss of appetite. If these effects persist or worsen, notify your doctor immediately. These symptoms may be reduced by taking the medication after meals.


Side Effects of Imuran (Azathioprine) Drug Center - RxList (http://www.rxlist.com/imuran-side-effects-drug-center.htm)www.rxlist.com/imuran-side-effects-drug-center.htmRxList










Hopefully she might do better taking it AFTER food rather than with.

[mrtmeo]

She is much better today, but even after eating food, she wasn't feeling better yesterday.
It only lasted a day, so will hold off on imuran.
She had rtx so, she shouldn't need the imuran until she reaches remission or after 6 months.
She is still in the 3rd month from her first rtx infusion.

[Rose]

I had a similar experience with imuran. I am one of a small percentage of people who cannot metabolize the drug because the enzyme required to do so is missing. There is a blood test available to check for this enzyme and infact some doctors will not put a patient on imuran without doing this test first. Please google for more info. "Imuran blood test" should turn something up
I should also mention that I was taking 100mg daily for 5 weeks with no apparent ill effects when suddenly the vomiting started. The drug was not being metabolized and after 5 weeks my body let me know. I stopped the drug for about 10 days and restarted it thinking maybe it was not that ( as I had been ok for5weeks) but within a few hours the severe vomiting started again.

Prose

[mrtmeo]

I had a similar experience with imuran. I am one of a small percentage of people who cannot metabolize the drug because the enzyme required to do so is missing. There is a blood test available to check for this enzyme and infact some doctors will not put a patient on imuran without doing this test first. Please google for more info. "Imuran blood test" should turn something up
I should also mention that I was taking 100mg daily for 5 weeks with no apparent ill effects when suddenly the vomiting started. The drug was not being metabolized and after 5 weeks my body let me know. I stopped the drug for about 10 days and restarted it thinking maybe it was not that ( as I had been ok for5weeks) but within a few hours the severe vomiting started again.

Prose

It looks like it is the TPMT enzyme.
Thiopurine methyltransferase (TPMT) is the main enzyme responsible for inactivating toxic products of azathioprine (AZA) metabolism.
Should we test TPMT enzyme levels before starting... [Hematology. 2007] - PubMed - NCBI (http://www.ncbi.nlm.nih.gov/pubmed/17654066)

I have read something about this in the literature, but my mom was never tested for it.
I will ask her dr.

Thanks Prose!

[mrtmeo]

Prose,
What alternative immunosuppressant did u use if u couldn't use imuran?

[Rose]

Because my kidneys had been affected and that I had a bout of drug induced hepatitis , methotrexate was not suitable. The next alternative was cellcept. I started on that in January 2009 and it has done its job very well. It is very expensive and I battled to get the medical insurance to pay at first. After a few months on it generics came on to the market and the insurance insisted that I take them. Luckily the ones that I was prescribed work for me but I do know that all generic cellcept is not the same and some work for some people but that may not work for another. Better to stick with the brand one if possible.

Rose.

[mrtmeo]

Because my kidneys had been affected and that I had a bout of drug induced hepatitis , methotrexate was not suitable. The next alternative was cellcept. I started on that in January 2009 and it has done its job very well. It is very expensive and I battled to get the medical insurance to pay at first. After a few months on it generics came on to the market and the insurance insisted that I take them. Luckily the ones that I was prescribed work for me but I do know that all generic cellcept is not the same and some work for some people but that may not work for another. Better to stick with the brand one if possible.

Rose.

Thank you Rose.
I was considering cellcept but didn't see much success with it.
Thanks for the info on getting the standard brand instead of generic.

[mrtmeo]

Because my kidneys had been affected and that I had a bout of drug induced hepatitis , methotrexate was not suitable. The next alternative was cellcept. I started on that in January 2009 and it has done its job very well. It is very expensive and I battled to get the medical insurance to pay at first. After a few months on it generics came on to the market and the insurance insisted that I take them. Luckily the ones that I was prescribed work for me but I do know that all generic cellcept is not the same and some work for some people but that may not work for another. Better to stick with the brand one if possible.

Rose.

What dose of cellcept were you on?
Did you start off on a low dose and work up?

[Rose]

What dose of cellcept were you on?
Did you start off on a low dose and work up?

I have been on 1.5g daily (750mgs x 2 daily) since day one, It will be 6 years in January 2015. I think the thinking was to increase it if need be but I have done fine on this relatively low dose. I know most people are on higher doses.

Rose

[mrtmeo]

Thanks Rose.
My mom's nephrologist wants to start her on 250mg 2x's per day to start.
She is only 107 lbs, so not sure if the weight makes the difference in dose.

[mrtmeo]

I have been on 1.5g daily (750mgs x 2 daily) since day one, It will be 6 years in January 2015. I think the thinking was to increase it if need be but I have done fine on this relatively low dose. I know most people are on higher doses.

Rose

Hi Rose,
Just started my mom on the mofetil today.
Wish us luck!

[RudiK]

I relpased in February 2014 and my docs put me on 3g (1.5 g 2x day) per day. It took a while, at least 4 weeks, before we noticed any improvement. The high dosage did cause some intestinal discomfort, very loose stool. I stayed on that dose until early September and then reduced it gradually to 1.5g (750mg 2x day) daily. My brand is Mycophenolate. I was told the dosage depends on your body weight.

[mrtmeo]

I relpased in February 2014 and my docs put me on 3g (1.5 g 2x day) per day. It took a while, at least 4 weeks, before we noticed any improvement. The high dosage did cause some intestinal discomfort, very loose stool. I stayed on that dose until early September and then reduced it gradually to 1.5g (750mg 2x day) daily. My brand is Mycophenolate. I was told the dosage depends on your body weight.

What kind of improvements did you get?

[mrtmeo]

Because my kidneys had been affected and that I had a bout of drug induced hepatitis , methotrexate was not suitable. The next alternative was cellcept. I started on that in January 2009 and it has done its job very well. It is very expensive and I battled to get the medical insurance to pay at first. After a few months on it generics came on to the market and the insurance insisted that I take them. Luckily the ones that I was prescribed work for me but I do know that all generic cellcept is not the same and some work for some people but that may not work for another. Better to stick with the brand one if possible.

Rose.

I just noticed the brand of my mom's script is Teva which is generic.
I hope she doesn't have any problems with it.

[Rose]

Hi Rose,
Just started my mom on the mofetil today.
Wish us luck!

Good luck!!! I really do hope it works but as Rudik1 says it will take a while to see the effects. I take the generic Mycophenalate Hexel manufactured by Sandoz.

Rose

[mrtmeo]

Good luck!!! I really do hope it works but as Rudik1 says it will take a while to see the effects. I take the generic Mycophenalate Hexel manufactured by Sandoz.

Rose

Thanks again Rose and I will update.

[brew22]

I am taking Imuran and started on 50mg for a month and then up to 75 for a couple weeks but when it was increased to 100 about 20 minutes after taking it I would feel like I was going to vomit and then the feeling would go away in about 5 minutes .After several days of this I started taking half in the morning and the other half at night and I have been fine so far..... but of course check with her Doc .Good Luck ....I know it is frustrating!!! Yours Susie

[mrtmeo]

I am taking Imuran and started on 50mg for a month and then up to 75 for a couple weeks but when it was increased to 100 about 20 minutes after taking it I would feel like I was going to vomit and then the feeling would go away in about 5 minutes .After several days of this I started taking half in the morning and the other half at night and I have been fine so far..... but of course check with her Doc .Good Luck ....I know it is frustrating!!! Yours Susie

Hi Susie,
My mom could not handle any dose and it caused horrible nausea all day long on a lower dose.
She is on the mofetil now and will see how this works.

[Miranda]

I was just put on imuran a couple weeks ago. Threw up everything i ate. Made me so sick. So they stopped me immediately and now starting me on methotrexate (spelling?) Doc said vomiting is a rare side effect of imuran.

[mrtmeo]

I was just put on imuran a couple weeks ago. Threw up everything i ate. Made me so sick. So they stopped me immediately and now starting me on methotrexate (spelling?) Doc said vomiting is a rare side effect of imuran.

I hope you have good luck with the methotrexate.

[mrtmeo]

So far, my mom is tolerating the mofetil except for a high wbc count.
She gets an elevated temperature in the mornings but it goes down in the evenings.
Her dr upped the dose to 500mg in the am and 250mg in the pm.