Azathioprine (Imuran vs.Methotreate (Rheumatrex,Trexal

**Sangye** · 05-20-2011, 01:41 AM

No, no... I just wanna get the Wegs dog to go to sleep. A nice lullaby is all he needs.

**CODavid** · 05-20-2011, 01:51 AM

For me the MTX did not work. I didn't have any stomach problems, but I have a cast iron gut.

**jeriorleans** · 06-14-2011, 01:23 PM

Daggar, how did Holly do with the Imuran. A.J.'s doctor switched him today because of all the stomach issues he was having with the Methotrexate I have read some bad recent research on Imuran saying that is causes a rare blood marrow cancer.

**vdub** · 06-14-2011, 04:20 PM

I'm on 25mg/week. It's really difficult to seperate out what is wegs, mtx, side effects, or just plain ole arthritis, but 1 to 2 days after taking my mtx, I feel like crap. Aches and pains as if I have the flu. It only lasts two days, sometimes it begins 1 day after the mtx..... Other times it begins 2 days after the mtx..... Not in totally bent over agony, but darned uncomfortable.

**Daggar** · 06-15-2011, 02:38 AM

Originally Posted by jeriorleans

Daggar, how did Holly do with the Imuran. A.J.'s doctor switched him today because of all the stomach issues he was having with the Methotrexate I have read some bad recent research on Imuran saying that is causes a rare blood marrow cancer.

Hello Jeri -- sorry to hear about AJ's stomach problems. Holly hasn't made the switch yet due to the recent taper of pred -- the doctors wanted to have some time to evaluate that before messing with the immune suppressant. I've heard of the risk of cancer with tnf blockers just like ctx but it is really hard to evaluate based on the very low percentage of patients who report it (i believe 1%). Mtx has its own risks with bone marrow disorders as well. Imuran becomes a necessary risk when the kidneys are involved -- mtx isn't an option. Lab work consistency and watching for any symptoms is the best we can do. Symptoms are very similar to WG (joints/fever/weight loss/skin/etc.) so it is continuing to do the same as usual. I've heard that imuran can cause stomach issues as well so it'll be interesting to see how AJ and Holly do with the switch. The ctx caused Holly a lot of nausea at the start but subsided after a month or so. May need ondansetron again? Double check with the doctors about drug interactions because we've been told that Holly will start on a lower dose of imuran than normal due to this. I believe the rare cancer you are talking about has been reported while taking in combination with "infliximab" for Crohn's.

**Chris G** · 06-15-2011, 02:55 AM

Originally Posted by vdub

I'm on 25mg/week. It's really difficult to seperate out what is wegs, mtx, side effects, or just plain ole arthritis, but 1 to 2 days after taking my mtx, I feel like crap. Aches and pains as if I have the flu. It only lasts two days, sometimes it begins 1 day after the mtx..... Other times it begins 2 days after the mtx..... Not in totally bent over agony, but darned uncomfortable.

Vdub: What's your folic acid schedule? I found it helpful to take a little extra folic acid the day I take my mtx, and the day after......2mg each day on those 2 days, rather than 1mg. My doc doesn't have a problem with me doing that.

**gurinbasra** · 06-15-2011, 04:21 AM

Originally Posted by marta

I have the same question as Red, my rheumy gave me a homework assignment: read up on both and decide which one I think would be better for me, so I'm looking forward to hearing some feedback. I haven't heard too much negatives about AZA but have heard of yucky side effects with MTX - everyone on it seems to get a kick in the but a day or two after taking it, and the stomach issues with it (I'm a total 'stomach issue' whimp - I'll take ten head colds over a stomach flue any day). What do you mean by 'eventually' Jack? Did you have problems when you first started taking it?

I've been on Methotrexate for 2 years now, no issues with me! No side affects, just having to inject it once a week, it takes one big breath and to not think about it too much. But, here's one person who's good on it!

**Jules** · 06-15-2011, 05:04 AM

Made the switch from ctx to aza 3 weeks ago as and reduced pred to 5mg at the same time - made me really sick to start, but huge break through today. . . nausea but no physical sickness!

**vdub** · 06-15-2011, 05:26 AM

What's your folic acid schedule?

I take 2mg a day on the days that I don't take mtx. Its interesting that you take folic acid on an mtx day. I'm going to have to read up on the mtx/folic acid relationship to make sure I understand what's going on behind the scenes. With any amount of luck, I'll be seeing my rheumy in SLC in a couple days and I'll ask him the question.

no physical sickness!

That is super! :-)