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JellyJazz
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Hello,

Last time i went to the rheumy she had my blood tested to see if i was able to take Azathiroprine (think i got the spelling right?! Not sure of it's general name...)

I was very apprehensive as to whether to take it or not as i read the side effects which put me off big time. So we came to a comprimise of me staying on 5mg steroids alongside my plaquenil but she gave me enough steroids so that i can up them to 10mg if i needed but no more without calling her etc... I had managed to stay on 5mg (even through the dreaded time of the month!!) and am really proud of myself:blush:

My question is..if i am coping ok now then is there any real reason for me to take another drug which is a long term one? Why would i be put on this particular drug?

Any thoughts or people taking this most appreciated!

xxxx
 

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Hi Jellyjazz,

Normally doctors try not to use steroids as a long term treatment because of the many side effects. Instead in a case like yours where the Plaquenil is not helping enough another drug like Azathrioprine would be added to it.

I thought this site showing the side effects of Prednisone might help you make a better informed decision.

http://www.mayoclinic.com/health/steroids/HQ01431

Take care,
Lazylegs
 

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HI,

I hope maybe my experience may be helpful to you in your decision.

Like you I was initially satrted on just plaquenil. This heped heaps, but not completely and I had chronic low grade proteinuria, so my rheumatologist added prednisolone. The proteinuria dissapeared within days as did most other symptoms.

The problem was that I couldn't wean off pred without flaring. I gained 15kg and developed mild insulin resistance. My rheumatologist didn't feel it was essential that I start azathioprine with any urgency, but agreed that long term steroid use wasn't a great option. He asked me to convince him that azathioprine was what I wanted/needed. This was just what I wanted him to say, because I really hated the pred, but my quality of like on just plaquenil alone was not worth it too me. I was also anxious about the renal problems reoccuring if I stopped pred without adding azathioprine.

So, I asked to go on Aza. It has been the best decision ever. I get much better symptom relief than I did on pred even. I have had no proteinuria for ages. The side effects are minimal, and I'm slowly losing weight too.
So, no regrets!

All the best with your decision.

X C X
 

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Hello again :)

I too was put on azathioprine (imuran) in order to better control disesase activity. Plaquenil alone was definitely not enough. The initial aim was to help me decrease and hopefully eliminate any need for prednisolone. Unfortunately my disease activity continued to progress and other complications have meant that I have needed to stay on prednisolone.

The side effects of any drug can be scary when we read them up but, on the whole, docs would far rather see their patients on drugs such as aza (said to be "steroid sparing") than on prednisolone which has bad long-term side effects.

Imuran has worked very well for me and I am lucky to tolerate it very well. It is important, if you start taking the drug, to introduce it slowly in order to avoid any nausea while your body adapts to it. I certainly don't regret taking it and if I didn't I would probably need a far higher dose of steroids than I do now.

The fact that your rheumy has mentioned using imuran is a mark that she considers that your quality of life is important and that she has listened to you.

Katharine
 

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I can't remember how long you've been treated with Plaquenil alone (since July?). If it's only been since July then I can see waiting a few more months to see if that alone can help enough. For me it took 9 months before I saw an improvement with Plaquenil.

I am in a similar boat to you where I can still have a lot of pain/fatigue/symptoms, but my personal decision is to stay on just the Plaquenil and I will occasionally do a stint on prednisone when a flare is really bad. I am not on it continually however - maybe 1 time a year (or two) I'll go on it for a few weeks to a few months. The longest I've been on it is 5 months.

Ultimately, the decision is yours to make. Many here have found a great deal of relief from Imuran with little to no side effects. If your symptoms prevent you from doing too many things in life for too much of the time, I think it may be wise to give Imuran a trial for 4-6 months at least and then re-evaluate.
 
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