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Azathioprine Reviews

Have you taken Azathioprine to treat your colitis?

A common brand name for this medication is “Imuran® or Azasan®”

If you’re answer is “yes”, please click the review button below and add your review of your experience. There’s alot of UC’ers who are wondering how other’s like you have done with the medication.

Here is an informational page from the National Institute of Health – azathioprine page

Copied from wikipedia:

Azathioprine (INN, /ˌæzəˈθaɪɵpriːn/, abbreviated AZA) is an immunosuppressive drug used in organ transplantation and autoimmune diseases and belongs to the chemical class of purine analogues.[1] Synthesized originally as a cancer drug and a prodrug for mercaptopurine in 1957, it has been widely used as an immunosuppressant for more than 50 years.

A few stories from writers on the site who have used azathioprine (also called Imuran):

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 60 reviews
 by Johan
Aza gave me my life back

My colitis could not be managed by steroid treatment. After a 4 year long flare, 20kg of body weight lost and a lot of fighting with docs I finally found a doctor who would listen to me and he put me on Aza. 14 years on and I haven't had a flare. I thought my life was over. I've had two kids, heart surgery to deal with the consequences of being on steroids on and off for 10 years. I have a quality of life that I couldn't even imagine in my wildest dreams. When I was in remission I managed to make the life choices that will probably help me stay in remission. I've chosen a career path that lets me manage stress much better, I've cut alcohol almost completely and a lot of sugar. I'm also exercising a lot more, but by no means a health freak.

I cannot emphasize enough how much Aza changed my life. I'm monitoring my blood every two months and I have had some dips below where I want to be on white blood cells, but small changes when that happens keeps me healthy. I've gained back the weight and then some and my life is amazing. I've been asked if I want to go off the Aza but the doc says the relapse is 50/50 and as long as I can keep flare free I'm happy. I'm not one to sit in the sun and the hospital does a good job of monitoring my stats and health. Every time I have an endoscopy they conclude that I still have signs of inflammation, but I don't notice it at all.

Being monitored regularly even though I'm in remission is also a big stress relief.

In summary:
Benefits: 0 flares for 13 years
Drawbacks: none, not even more susceptible to infection

 by Michael Horn
Aza treatment, it didn’t work for me!

I tried Aza in 2017 after Balsalazide stopped working for me. After about 3 days I started to feel awful - lethargic, nauseous and sick. I continued to take it for about a week, and these side effects didn’t dissipate. My bloods showed that my liver enzymes had skyrocketed, so I had to come off the drug immediately.

I’m now taking Humira. However, I’m starting to build up antibodies to Adalimumab, so once again I was prescribed Azathioprine, but this time on a much reduced dose. Unfortunately, after around a week I started to notice similar symptoms as before. My ALT level had increased dramatically, so again I was taken off the drug.

 by David

Diagnosed in 2004. Asacol and sulfasalazine since. Short courses of prednisone for flares. I have a mild case of UC. Had a bad flare in 2017 that was probably partly due to work stress, couldn't get rid of it. That was new for me. Usually prednisone and enemas got rid of flares. Not this time. 60 mg of prednisone for 3 months plus enemas didn't work. I lost 18 lbs and was skinny to begin with. GI doc put me on Imuran 100 mg daily. Was still taking asacol and sulfa (still am). Flare went away quickly, but that may not have had anything to do with the Imuran based on how long it takes to start working. I think it was more that I took a month off work that started the healing. Been on for 2 years with no major side effects that I can directly attribute to the drug. 2 months after starting Imuran, my knees went bad. I never had any issues with my knees before. They are still not good. GI doc said he didn't think Imuran was to blame. I still wonder. I do think my hair is thinner now. It was thinning before, so it is hard to tell how much happened since starting Imuran. I will have lab work done today to check my levels. Imuran also keeps my eczema in check. I am so much happier now that eczema isn't an issue. I always said I would get rid of my eczema before I got rid of my UC since my UC is a mild case. I haven't seen any posts that talk about Imuran helping their eczema, but it does for me.

 by Kim Friberg

I was not able to use Immuran due to my immediate pancreatic pain.

 by Nicole
not the best

Recently weaned off it after taking it for two years and feel tremendously better in every way. Not a good drug.

 by El Herr

I have been on Imuran for 8 years. I was skeptical at first because of the possible side effects and did not go into remission until I added Remicade. I did try to get off Imuran a few years ago but within a month I was having severe symptoms again. I have to be evaluated for TB, low white blood count and skin cancer but, so far, so good.

 by Rex Gass
Azathioprine (Imuran) is a wicked drug

I was given azathioprine for the treatment of a UC flare-up back in 2005. I know it is labeled as an "immuno-modulator" however, I regard it to be a "chemical immuno-suppressant". While taking azathioprine for just over 13 years, I very well know what the drug did to me. On the positive, it did help (along with big doses of steroids) to calm down my colon bleeding from my 2005 flare-up. I also believe it did help stretch out the time between flares. When I had a major flare up on December 23rd, 2013, my Gastro Doc put me on Humira Biologic Immuno-Suppressant with the azathioprine and more steroids. On the downside of the combo of these drugs, it seems I could catch as cold by just looking at someone with a cold. Also, it seems I would catch a stomach bug just by being in the same room as someone with a stomach bug. When Humira gave me heart failure after only 8 months of use (= August 2014), my gastro doc changed me to SimponI biologic immuno-suppressant injections. In early April 2018, I came down with a severe sinus infection. AND, the sinus infection was quite contagious. After almost 4 months of taking large doses of antibiotics and up to 30 mg of steroids a day for the sinus infection, I went to my gastro Doc and demanded he take me off Azathioprine AND Simponi Biologic Injection. I couldn't beat the incredible sinus infection. Once off azathioprine and Simponi and after 40 days of huge doses of antibiotics, the sinus infection cleared up enough for my ENT Doc to do sinus surgery to suck out the remaining infection. I am now on Entyvio IV infusion. During the 13 years of taking Azathioprine, I had 8 teeth die and fall apart. These 8 teeth were all my chewing molars on my upper row of teeth. It has taken 9 months for me to get through the azathioprine withdrawals.

 by Paul S
Worked Well

I am 63 years old and was diagnosed with UC about 20 years ago. I am allergic to sulfa drugs and found this out due to an allergic reaction to Asulfadine that put me into a terrible flare. Prednisone and a long hospital stay ended the flare and I then transitioned to Imuran. In spite of not liking potential side effects the Imuran helped me to stay in remission for 10 years. I tried to wean myself off of Imuran, with my doctor's agreement, but wound up in another flare. At that point Imuran stopped working for me, I tried to get back on it, but it didn't work the second time. I am now on Humira. For those it works for Imuran is a great option. I wish it would have continued to work for me so that I was taking a pill, not a shot with the Humira.

 by John Cesarone
Worked for a long time, then....

I was on Azathioprine for about ten years, and it did a great job keeping me in remission. I kind of worried about side effects (cancer, etc.) but they never happened. Then one fine day, it stopped working! Oh well, it was a good run. With this disease, you take it one day at a time.

 by Mary

I am 65yrs old and was diagnosed with mild UC in 1979. I was fortunate that my symptoms went into remission for 23yrs.
From 2003 I started to have mild symptoms which would settle after a course of prednisolone.
Then in 2014 I had a major flare and was in hospital for 2weeks after having three Infusions of Remicade I was then put on 100 mgs a day of azathioprine. When I first started taking it I was feeling nauseous so I was told to split the dose and take 50mgs in the morning and 50mgs in the evening which helped. I did loose some hair but in time my body a justed to it the hair loss stopped.
In April 2018 I was feeling better and symptom free and was following SCDiet and making my own yogurt and not wanting to take azathioprine because of it's repercussions stopped taking azathioprine. Big mistake! With in 6 weeks started having symptoms so went back on azathioprine and a course of prednisolone which did not work .
Ended up in hospital for two weeks with severe Ulcerative Colitis and nearly lost my bowel. My blood results kept showing I had elevated reading's from azathioprine so now I am on 50mgs a day plus Remicade Infusions every 8 wks.
I sometimes think I would rather be rid of my bowel than be on these medications but in saying that the azathioprine did work for me for a few years giving me quality of life.

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19 thoughts on “Azathioprine Reviews”

  1. Been taking azathioprine for about 3 weeks now. The only side effect I’ve had is feeling a little tired and a little dizzy and a bit spaces out at times. Small price to pay if it helps me sty flare free for longer periods. I have just come out of a stubborn flare. Stopped prednisolone a couple of weeks ago and have been told aza will kick in at 4-6 weeks

  2. I tried azathioprine once and it make me violently ill. Matter of fact, I had just had open heart surgery two years ago and while in the hospital recuperating a nurse mistakenly gave me azathioprine instead of my regular dose of mercaptopurine, They had to bring in a specialist to give me two intravenous shots of an anti-something to get me out of a violent regurgitation episode. Mercaptopurine is my wonder drug. I have been symptom-free of UC for 10 years now. It is my lifesaver.

  3. I am prescribed azathioprine when in flare up mode. It concerns me that regular blood tests have to be administered monthly and I wonder and worry about the penalties we may have to face in the long term. My specialist would rather I continue on a maintenance dose but I can’t wait to get off it. I prefer to take a probiotic which is much less harmful. keeping my diet in check is the best cure in my opinion

  4. Shirley:
    I can understand your predicament.
    I was diagnosed back in the early 1990s and went through the hell everyone else has gone through. I was on prednisone, off prednisone, on prednisone, off prednisone, asacol and others …. I am sure you and most others know the routine. I won’t even go into it but I could write a book on it.
    Meanwhile my gastroenterologist had been suggesting, not forcing me, to try mercaptopurine, an old blood cancer chemo pill that was used successfully in the 1950s but I think was set aside for newer treatments.
    Studies showed that mercaptopurine was rather successful in treating UC. I keep putting off the doctor and putting him off because I didn’t want to take a chemo pill, until one day, out of desperation, I gave in and tried it. Within around three months I saw some excellent relief. I can truthfully tell you that I have been in complete remission for at least 12 years and take 50 mgs of mercap daily. My diet is anything I want to eat, including spices and hot peppers with absolutely no effect. I don’t know the overall rate of success of mercap on others but for me it was a miracle drug. I wish you luck.

  5. Shirley:
    Regarding diets, I forgot to mention, I read a lot about people who are trying all types of diet to control their UC. It is my understanding that UC is not a diet issue. It is an autoimmune disease in which the body attacks its own tissue and cannot be cured, only controlled. It is my understanding also, the only time diet comes into play is when a person is in a flareup. This is a misconception of those close to UC patients that the cause must be something they are eating, i.e. too much roughage, too much alcohol and so forth. Those who don’t understand UC, albeit well-meaning, are misguided. Nothing, to my knowledge, as of today, will cure UC. As my doctors says, “You will take it to the grave.” Unfortunately, there is not enough money going into UC research for a cure. It is not one of those “popular’ diseases.

    1. Thank you for talking about the diet factor of UC
      There is not much said about diet and the disease. I’ve seen books claiming their diets will cure UC, it’s sad to think people will go down that road believing that to be true.

  6. The SCD diet was created for those who have
    inflammatory bowel disease. It’s a great way for anyone to eat a healthy balanced diet
    actually. There are different foods causing the
    person with UC or Crohn’s ( or both) to have
    their immune system respond to foods differently than a normal intestine. Some foods
    actually cause inflammation. Not because it’s
    the food itself, but the UC person’s body
    responds that way. Other foods pull water
    Into the colon causing watery stools. Other
    foods ferment in the colon causing all kinds
    of the above mentioned symptoms all at once.
    A wholistic MD would be much more aware
    of this food Involvement, but your average
    GI doc will poo poo the idea. They are more
    interested in “big pharma”. There is lots of
    info on how starches, grains, and sugar are
    not doing us any favors to begin with. These
    three are very hard on inflammatory disease.
    Not to mention the obesity epidemic. We all
    would be healthier if we followed the SCD
    diet as much as possible. Eating in this way
    could foster a healing gut so hopefully those
    meds everyone is nervous about can be dialed
    down or stopped, and remission will be
    the reward. In my humble opinion :)

    1. RE: SCD diet. I’ve been on it for 3 weeks now. I really did not want this diet to work because I love grain products, and it sounded so faddish, but I was between doctors and running out of meds, so was desperate.

      Well, it worked. And no one was more surprised than me. .

      Within 3 days I was no longer bloated. I was down to 2 or 3 BM’s a day from 6-10. Very little bleeding and usually none at all. I am still on it. I wish I could say I lost a lot of weight, but only a couple of pounds and I have 1 or 2 usually normal BM’s. Some gas, I think due to the probiotics. I will stay on this for a year or two and then challenge my diet.

      The SCD diet worked for me.

  7. Hi all,
    I took azathioprine for 6 years and it worked well for me… I am 45 now.
    I was diagnosed with UC back in 2000 after quitting smoking. I never managed to put the two together until I started smoking again after a year of being ill. During that year there was a hospital stay for 10 days where i was being pumped full of steroids and immuno suppressants. When my symptoms finally eased and I was beginning to feel better my UC specialist Dr Rose (an absolute Hero) prescribed 400mg Asacol am and pm as a maintenance dose and also put on 100mg Azathioprine, which was calculated according to my weight at the time.
    So I had been in remission and taking Azathioprine for 6 years with little or no side affects. I did notice my urine was like a fluorescent orange colour, and a slight sensitivity to sunlight, which I overcame with allergy pills (piriton). Apart from that I was lucky and no other symptoms arose. I do believe that the side affects are the biggest issue with this drug, but if your body can handle it, it does help to keep UC in remission long term.
    This lasted until a routine visit to my specialist around 2006. He recommended that I stop taking the azathioprine as he felt that I had taken all the therapeutic effect it could give and my body was now used to it. As I was still smoking around 20 a day there was no noticeable effect at this point. During 2010 I tried to quit smoking but immediately flared up and became ill. I made a choice at that point to start back on the cigarettes, and as soon as the symptoms came ( 5-6 days) they went away again.
    So I had been smoking 20 a day since 2010 and taking 400mg asacol am and pm and had another long period in remission with few issues of any note. Then in Sept 2014 i quit smoking again. I have been in an active flare up since… I am taking prednisolone 40mg daily and 1600mg asacol twice daily with a 1mg mesalazine suppository…. Unfortunately they will not prescribe any azathioprine.
    Thats been 4 months now and no real changes, I will give it till the new year and then I am going to start smoking again.!!
    In 14 years my longest remission periods were while I was on azathioprine and also smoking.
    I hope you good folks all manage to find some quality of life from this illness as I have on and off. Keep up the good fight.. :)

  8. Gabby M

    So I am currently taking Humira. June will be about 2yrs. Back in October I started having a flare while taking the Humira (1 injection every other week) so my doctor put me on Prednisone starting at 60mg and slowly tapered down which took about 2months all together. While predisone was kind of working, she decided to increase the amount of Humira I used, so now I currently do Humira, 1 injection every week. I started flaring again about a month ago,and was sent for a colonoscopy. The scope/biopsies showed I’m still actively flaring, just not the entire left side of my large intestine, just the rectum and sigmoid colon now. So apparently Humira is doing it’s job just not as well as it should be. My Dr. wants to start me on Imuran daily, on top of Humira. Has anyone else had to do that? Or something similar where using 2 immunosuppressant medications at the same time??? I’m kind of freaking out honestly, and I’m not sure if I want to do this, and contemplating getting a second opinion. Help :-/

  9. I don’t do well on pred at all, Asacol didn’t work, Canasa did, but only when using it, mesalamine enemas, same thing. I was in a 4 year flare with almost no let up, lots of blood, diarrhea then constipation and a twice a week 4 hour episode during which I couldn’t get out of the bathroom. Changed gastroenterologists after old doc prescribed aziothiaprine then didn’t get blood test results to me to clear me to take it and then called to yell at me for not taking it. I already have one dysfunctional a$$hole in my life, didn’t need another one. So between docs, and waiting for my appt in Sept with new (and nicer) doc out of desperation I tried the SCD diet and within 3 days, I was no longer bloated and had zero bloody diarrhea and am only using a part of a mesalamine enema every 2 or three days when I used to have to used daily. I’ve only been on the SCD diet 2 weeks and have normal stools every couple of days, a few small bouts of gas and no nausea. The SCD diet has been almost a miracle for me. I can’t imagine going back to eating the way I did, even though it was a fairly healthy (I thought) diet. Tons of recipes and support on the web. It is way better to eat a grain-free, no sugar diet than take all the UC meds in the world. They all have side effects and the SCD diet is no risk, period, unless you are allergic to eggs or nuts. I think I’d rather heal my colon rather than treat the symptoms and so far, I’m doing much better with the diet changes than I did with any med they gave to me and it is WAY cheaper to eat this way than most of the meds. I urge anyone with UC/IBS/Crohn’s to at least give the SCD diet a try for 2 weeks and see how you do.

  10. Started on Azathioprine nearly one month ago. Have built up to 100mg (50mg morning and night), with my specialist visit in another three weeks. Liver function is normal (at the moment), no nausea on taking it and symptoms subsiding. I have been on prednisone for months, and gained about 8kgs, so you can imagine I want to get off this necessary evil! If the Azathioprine works, then I’ll come off prednisone. When I start to think about it, it does concern me what it does long term, but seems to be having an effect, with no discernible side effects for the time being. It’s nice to be able to feel normal again!

    1. As an update: went into a lovely remission, but received a call from my doctor at the end of November. Liver enzymes were elevated so cut back to 50 mg (25mg bds). Was OK for about a month, then a flare-up. Went back to Prednisone and was then put back on 100mg of AZA. Now almost back in remission. I have to see the gastroenterologist next week and I think he is going to try another drug, possibly 6-MP.

      1. A quick update. Spoke to my gastroenterologist last week, and we have agreed to tolerate slightly higher liver function tests, on the condition that it doesn’t deteriorate. Feeling very good now. Fingers crossed!

  11. I was too scared to start azathioprine due to potential side effects. I went on the SCD diet, stayed very strictly within the bounds and my symptoms went away in about 2 weeks. They return only if I go off the diet and eat wheat, rice or white sugar. Corn to a lesser degree. I lost some weight, felt good, no bleeding, no frequency, no bloating. You might try it. I use Asacol suppositories as needed, but they are only needed if I go off the diet. Otherwise, no symptoms. I’ve been on the SCD diet 1 1/2 years, ate things off the diet to challenge the diet and see if I’m cured. Not yet, but my tolerance for wheat, sugar and corn are higher than they used to be.

  12. I posted here Nov. 2016. Update June, 2018: Continuing with 150 mg Imuran-Azathioprene snce last flare. No other meds for U.C. , Crohn’s. ❤️So fortunate. Frequent labs to check liver, etc. For now I must stay with 150mg and live with the otherrisks. 30 years in with disease, now 80 yrs. young.

  13. After being diagnosed at 47 years old and in the hospital for 10 days, I was diagnosed with Severe UC. My wife immediately researched diets and placed me on the SCD strictly almost 1 year. Went off prednisone gradually a month after leaving the hospital and began taking Balsalazide Disodium 3 Capsules 3 x a day and Imuran 100 Mg daily. Reduced Balsalaide to 2x a day . Not as strict on the SCD, but no longer drink Beer and try to stay away from foods that do not agree and processed and sugar! Juicing as well.
    Also I was taking Freeda SCD vitamins . I have been in remission for 3 years. I am back to a healthy weight after 1 year. Blood work every 6 months and DR. Visit every year now.

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