Immunosuppressants - Ciclosporin and Azathioprine

I was just wondering if anyone has experience of these two immunosuppressants being used in combination?

I have been on Ciclosporin since July 09 at varying doses to control my idiopathic urticaria /anaphylaxis which play havoc with my asthma and make me itchy and miserable. It stabilised for 3-4 months on 200mg a day but my blood pressure has been persistently high for the last month and I've had my dose cut. I've since had 3 anaphylactic reactions, each with biphasic 'second wave' reactions. My consultant immunologist is now proposing to put me on to Azathioprine as well as Ciclosporin and then after a while reduce and stop the Ciclosporin. I was just wondering if anyone had experience of being on more than one immunosuppressant at once. I'm concerned about the risk of getting more infections and after the problems with my blood pressure what other side effects I might encounter. I'm hoping to make it to my consultants appointment in Leeds tomorrow although I'm currently flaring up and have a very swollen face again.

Many thanks

Sparkly Fairy

2 Replies

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  • Sorry, don't have any idea about using both at the same time, however my understanding is that Cyclosporin is the most immunosuppressive drug out of the 3 used for Asthma and would expect the immune system to be pretty suppressed already so doubt adding in Azathioprine would make much difference at all.

    I can see the logic adding one and getting to a theraputic dose before reducing the other too much as it is likely to cause a flare up.

    My son has trialled both Methotrexate and Azathioprine but his consultant is very reluctant to go with Cyclosporin due to side effects. He is now having another go with Xolair as his IGE levels have reduced by half for some unknown reason and are now in the limits. Can't remember if you have tried Xolair or whether there was a reason you couldn't.

    Hope you get some more informed answers.

  • Hi My Hubby has crohns and is on 2 immunosuppressants, he has been on azthioprine for 8 years and infliximab infusions for 3 years. He has regular blood tests to check all is o.k and the only other thing we were told is to make sure we have no more children. We were told we would have a deformed and disabled child if conceived whilst hubby was on azathioprine. I'd had 5 pregnancies before so it's been quite a challenge.My hubby is the healthiest he's ever been since diagnosis in 1997, the combination together work, also weirdly enough he seems to get less colds and infections than us!!! He was on steroids for 5 years but they made him moody and unbearable to live with. He was on 12x 5mg a day, reducing 1 a week, he always got to 5 then had to go back to 12, it was hell.They didn't seem to help much either. If they help get your health back it's worth it. My hubby is also on another 8 tablets a day and liquid meds am and pm but he's got his life back. We laughed as I may end up on azathioprine as steroids don't work for me either!

    Kate

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