Metabolism of Imuran (Azathioprine)

[Gabe]

Hi - Haven't posted for a long time. I had a rough late Summer and Fall. Found out the hard way that I can't metabolize Imuran. Apparently there is a blood test that should be done before a person starts the medication that can determine if you have a genetic mutation to the enzyme thiopurine
S-methyltransferase (TPMT) that metabolizes thiopurines. If you have poor metabolism, the Imuran builds up and becomes toxic and can be very serious. There is a simple blood test that determines if you have the defective gene. They should do the blood test before starting the medication...in my case they didn't. I'm off the Imuran and started CellCept on Thanksgiving, am back on Prednisone and getting IVIg every two weeks.

Here is a link that might explain the TPMT enzyme better.
http://www.specialtylabs.com/education/download_PDF/TN_1196.pdf
Gabe

[Maxwell'sMom]

Hey Gabe, long time no chat...lol..
I got sicker than sick on Imuran. With in 7 days, I got so violently ill, I never want to try that again.
With the Cellcept you should be getting routine blood work as well, about every few weeks.I had to stop it,as it started to shut down my kidneys, so becareful.
I'm now on Cyclosporine, and so far so good, still on prednisone.
Sorry you had to go through this..just awful
love Lizzie

[Gabe]

Thanks Lizzie...
I was on Imuran for over a year so feel like I wasted my time (and my liver)...I go up to 100mg of CellCept twice a day Thursday - I get IVIg every two weeks and they do blood work every other time. We'll see if this one works.
Gabe

[Gabe]

Hey Lizzie - I said stated the wrong dose on CellCept - I go up to 1000 mg twice a day starting tomorrow not a 100 mg twice a day...My fingers still don't type like I tell them to.:eek:
Gabe

[Maxwell'sMom]

LOLOL>>that's okay, I would have known what you meant.
I really loved Cellcept. I thought it was going to be my miracle drug. well...except the that little kidney issue. So please be careful. Now that I'm on the cyclosporine, I have to have blood work every two weeks, and I'm really getting tired of it. I mean, don't I need to have at least some left..lol
Love Lizzie