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Infliximab + Azathioprine combination doses

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Ulcerative Colitis
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Posted 4/8/2015 2:26 PM (GMT -5)
Hi all, question for those on combination therapy: what is the recommended dose of Azathioprine when using in combination with IFX? I am about to start on this and doc is saying to stay on 2.5mg * 1kg but I would like to hear what everyone else is doing. Thanks
Posted 4/8/2015 4:54 PM (GMT -5)
The ulcerative colitis dosage for Azathioprine/Imuran is 2.0 to 2.5 mg per kilogram, so that sounds right to me.

I'm using 6mp at 1.1mgs per kilogram (normal, as 6mp is given at half the dosage of Imuran). I'm also on Infliximab/remicade. The combination has worked fine for me, I've been at thus dose for 1.5 years.
Posted 4/8/2015 5:03 PM (GMT -5)
Thanks Poop. You were the man I was targeting!
Posted 4/14/2015 2:28 PM (GMT -5)
I have another question for you iPoop or for anyone else with an opinion - if Azathioprine has done nothing for you on its own, would you still expect to take it in combination with Remicade?
Posted 4/14/2015 2:37 PM (GMT -5)
Maybe, it supposed to help to keep your body from building up antibodies to Remicade. Have you been tested to see if your therapeutic with Aza? If you're not, it is a lot less likely to help. I was on 6mp for a long time on a therapeutic dose and I had a flare up so I stopped it. Then I started remicade and I wished I hadn't stopped it for the antibody purpose but I ended up being a nonresponder to remicade so it didn't matter regardless. Now I take entyvio without imuran/6mp
Posted 4/14/2015 2:43 PM (GMT -5)
Yeah, my levels were tested and are apparently good. I thought I was seeing some benefit at first but it didn't last. I've been on Aza for like 5 months and will start Remicade next week. If there's a benefit to staying on Aza I would keep taking it because it took so long to get to the therapeutic level. However if there's no benefit I would rather be on as few drugs as possible. My doctor is really good but his answer is a blanket "yes - stay on both" which I suspect is what he tells everyone irrespective of their individual experience.
Posted 4/14/2015 2:48 PM (GMT -5)
well if it's the difference between having remicade work for you for 20 years, or having it work for one year and then you build up antibodies, I'd take the aza personally. Unfortunately neither worked very well for me. :(
Posted 4/14/2015 2:51 PM (GMT -5)
Totally agree. I guess I will stay on both. I would hate to sabotage the chances of Remicade working long-term. Thanks for your input!
Posted 4/14/2015 2:52 PM (GMT -5)
Aza and remicade are often taken together to prevent antibodies against remicade.
Posted 4/14/2015 4:59 PM (GMT -5)
Yep, I still take aza with my biologics even though aza by itself doesn't work for me. I want to stop but am concerned about the antibodies
Posted 4/14/2015 5:05 PM (GMT -5)
Hey malaika, what is your dose in relation to body weight?
Posted 4/14/2015 5:09 PM (GMT -5)
My doctor tried adding aza after a year on remicade, but it didn't agree with me. Felt nauseous and dizzy constantly with violent vomiting. A bit of a bummer because it could have increased the time between flares, but it was just too much.

I've heard that people who don't have side effects with remicade have less of a chance at developing antibodies. Like the side effects such as hives, rash, stuff like that where they give you benadryl and tylenol with your remicade to prevent. I've never gotten benadryl or tylenol with my infusions. Strictly remicade and I've never experienced any side effects. Not even a headache like some report. So hopefully what I heard rings true that I am less likely to develop antibodies to it. Especially since I'm kind of at the end of the medication ladder lol.
Posted 4/14/2015 5:32 PM (GMT -5)
I hate Aza, I always feel run down and not quite myself. And its not even helping with my UC! Grrr

Can't wait to get started on Remicade. I can't even remember what a normal life feels like.
Posted 4/15/2015 5:18 AM (GMT -5)

kiwi- said...
Hey malaika, what is your dose in relation to body weight?

I weigh about 101lbs, and I'm on 75mg Aza. (I was on 100mg, but it was starting to toxify so had to reduce).

Hope the Remicade works for you!
Posted 4/15/2015 2:27 PM (GMT -5)
Wow that's light! Thanks for the info
Posted 4/15/2015 6:19 PM (GMT -5)
I am on 50 mg of azathioprine M - F, 25 mg on the weekends, along with 100 mg Allopurinol daily.

And 7.5 mg/kg Remicade every eight weeks.
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