Azathioprine hydroxychloroquine steroids and dent... - LUPUS UK

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Azathioprine hydroxychloroquine steroids and dental extraction

cakerbaker profile image
17 Replies

Hello lovely people. I am due to have a dental root extraction and are on the above drugs. I am finding it hard to get to see my rheumatologist so in the absence of a GP who understands lupus does anyone know if there is anything that I need to particularly be aware of or do before or after?

I am quite nervous as my lupus still isnt settled down ..... if it ever is!

Thanks in advance ☺️

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cakerbaker
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17 Replies
sarahalice profile image
sarahalice

morning. There are issues with the steroids (i think about bleeding), not sure about the anothers. I had to have a crown but my dentist was very good and took extra care, all went well. I talked to my lupus nurse 1st.

Have you got a helpline number for ypur nurse to get back to you?

Best of luck

PMRpro profile image
PMRpro in reply to sarahalice

There isn't too much of a problem with pred really - I am on long term pred (over 13 years and currently 10mg). I'm also on an anticoagulant. I had the upper back left molar out last week - no problems at all. After pulling it out the dentist put a bit of gauze over the socket - I assume soaked with a haemostatic agent and said no eating or drinking for 2 hours. And that really was it - I was amazed! No bleeding at all.

cakerbaker profile image
cakerbaker in reply to sarahalice

Hi sarahalice thank you for replying - the rheumatologist nurse is so hard to get hold of and is as grumpy as when you do. Also wasnt at all helpful last time i needed her so might give that one a miss and just google. thanks for the advice though. 🤗

KnitSewPurl profile image
KnitSewPurl

hi cakerbaker( love that name),

I think the drugs they are usually most concern about is ones that cause bleeding the ones that thins the bloods like warfarin and heparin. some cardiac patients are usually are on them . I would call up your dental surgery if you are concern to find out if there is any thing you need to stop to take before the extraction. if they were really concern they would have told you not to take certain tablets as they should have a list of your meds on their system.

posthinking01 profile image
posthinking01 in reply to KnitSewPurl

You should ask for - non-adrenaline injection i.e. adrenaline free.

cakerbaker profile image
cakerbaker in reply to posthinking01

Thank you for the advice re the adrenaline. I didn't know that.

cakerbaker profile image
cakerbaker in reply to KnitSewPurl

I had a brilliant dentist who retired sadly - i was bereft! i then had a new one who i have no confidence in so I changed again and I have only seen my new dentist for 1 quick visit. He seems to know what he is doing so will contact them - thank you

PMRpro profile image
PMRpro

Can't comment on the other drugs but do make sure the dentist is aware of how long and how much pred.

I used to be terrified about extractions - I had to have a wisdom tooth out a few years ago, on a much higher dose of pred than I am at now, and my excellent dentist here almost laughed at me, He was right! Last weeks was a much larger effort after a fractured root - it remained in the gum after the main tooth was out but came out easily enough in the end. Despite the anticoagulant I am on (2x daily, I was about 2 hours before the next dose was due) I had almost no bleeding - even before the haemostatic gauze was applied.

cakerbaker profile image
cakerbaker in reply to PMRpro

i will do thank

LuluM25 profile image
LuluM25

I have recently started taking Azathioprine instead of methotrexate and have the leaflet and advice from rheumatology.

Make sure dentist is aware of steroids and hydroxychloroqine but they absolutely must be aware and may have to deal with your dental problem differently because of the Azathioprine. Apparently it can affect your jaw bone so extractions or any invasive work like that, root canal etc, your dentist must be aware that you take that drug.

Might be worth phoning to make them aware in case they want you to stop it for a while beforehand. But apart from all that, hope you get the work done safely and without pain.

PMRpro profile image
PMRpro in reply to LuluM25

Are you sure you aren't confusing aza with something else? I have never heard of that - do you have a link?

LuluM25 profile image
LuluM25 in reply to PMRpro

I’ve been checking and many apologies, you’re right, I was thinking of Alendronic Acid and it is certainly listed as a drawback if taking that drug.

So no apparent risk from Azathioprine, just ensure Dentist knows you’re taking it. Thanks PMRpro for picking up on that.

PMRpro profile image
PMRpro in reply to LuluM25

Not at all - sorry to poke my nose in in public xx Too many different long names that all sound similar!

Paprika60 profile image
Paprika60

Hi, I just had spent four months getting twelve teeth bridges done. I am currently taking hydroxy 200mg daily and Bilimumab (weekly). I made sure to request for adrenaline free anaesthetic. This is important for people like us. Hope that helps.

cakerbaker profile image
cakerbaker in reply to Paprika60

it does thank you. I will remember to discuss with my dentist

Froggie70 profile image
Froggie70

Hi Cakerbaker. I take Azathioprine (100mg daily) no Hydroxy or steroids. I’m in a similar situation needing a back tooth out. Phoned Consultant as dentist doesn’t want to go ahead without me checking with her first. Consultant said to come off Aza for a week before appointment and only to restart if there is no infection needing antibiotics. Hope this helps and best of luck.

cakerbaker profile image
cakerbaker in reply to Froggie70

thank you so much. Appointment on 6th October so i still have time to ask. 😀

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