Azathioprine (Imuran vs.Methotreate (Rheumatrex,Trexal

[alhartzler]

Haven't posted in a while, as I returned to school/clinical and have been doing well. I was on cytoxan for three months, and I just made the switch to Azathioprine. I have started at 100 mg per day, and am weaning down on the prednisone by 5 mg per 7-10 days. Now at 35 mg per day. Other than some tingling to hands and feet, and have noticed that my jaw kind of aches, I am feeling pretty well. Sinuses are pretty much clear, and lung CT came back with only one small 3mm nodule in LLL. (Improved from CT done 3 1/2 months ago prior to cytoxan) I am hoping that I stay in this state with the Imuran. Has anyone else had the weird tingling/numbness, and strange jaw symptoms- especially when chewing, etc.? I am guessing it's due to coming down on the prednisone. Also, wondering what the right dose of Imuran should be? Forgot to ask Dr. Langford at CC, and my rheumy here just started me on 100 mg/day to see how I would tolerate it initially. (rule out allergic reactions) Not sure what she will increase the dose to? Hope everyone doing well!

[Jeff vinc]

I am on MTX since january 2nd and i have no side effect. I actually have to talk to my doc because i feel like its not working at all for me due to some symptoms that i suspect to be WG.
oral 20mg/wk.
Seems like MTX is not working well for a lot of people actually...

[pberggren1]

I think you are right Jeff about mtx not working well for a lot of people.

I just started on Imuran at 150mg, based on 2mg/kg of body weight. That is what my doc feels comfortalbe doing and said that it gives me a better chance of a longer lasting remission. He is also a Wegs specialist.

[drz]

I think you are right Jeff about mtx not working well for a lot of people.

I just started on Imuran at 150mg, based on 2mg/kg of body weight. That is what my doc feels comfortalbe doing and said that it gives me a better chance of a longer lasting remission. He is also a Wegs specialist.

In US they estimate about 1 mg per pound as maximum dosage. They may try get by with a little lower dosage to reduce risk of liver problems and see if the lower dosage will hold you. They generally start out lower and build up to see how you do with it like any new drug.

[alhartzler]

I guess that seems reasonable about starting lower and increasing if needed, regarding the Imuran. Im scared it won't hold me in remission?! I guess everyone has the same fear when switching/starting new drugs. Unknown territory.

[Sangye]

Yup, I think we all have the same fear. After my first round of rtx I thought I'd have to go on something in-between rtx rounds but Dr Seo said I don't. I felt naked!

[pberggren1]

I will be starting Aza again a week after the fourth infusion.

[Kathie28]

I just started MTX 3 weeks ago and the only issue I have had is some slight stomach issues for a day after I take it. I actually have been feeling a little better with it so hopefully it is going to work for me. I tried Imuran but unfortunately I am one of those who can't take it. I got pretty sick with it. It was like having a stomach virus and I was out of work for a couple of days.

[jeriorleans]

AJ seems to be doing well on the Imuran. Not one complaint of nausea. Blood test for liver function will be done next week. Hopefully, this will bring ANCA to negative. I know that the doctors say that the ANCA level isn't a prediction as to whether the disease is active, i would feel better if it was negative. if its not so important, why do they even bother checking?

[JanW]

For what it's worth, Jeri, my doc doesn't check ANCA or P3 for me very frequently at all (I go every six weeks). Mine have never lowered substantially and I have been considered as being in remission for more than four months (slowly reducing mtx trying to go drug free). The numbers didn't move much and didn't correlate with other inflammatory markers, or how I was feeling.