Thiopurines for inflammatory bowel disease

   

Taking thiopurines

Benefits

Fewer flares	Better control of your disease	Reduced need for steroids
Better healing of bowel wall	Lower risk of hospitalisation and surgery	Improved quality of life

 

Things to consider

 

Questions to ask my doctor IBD team

 

Further information

• Crohn’s & Colitis Australia crohnsandcolitis.com.au
• GESA – Inflammatory bowel disease patient factsheet gesa.org.au
• Download the MedicineWise app to keep track of your medicines and access health information such as blood test results. nps.org.au/medicinewiseapp/

 

Before starting a thiopurine

	Get blood tests to check your full blood count, liver and kidney function, immunity to certain infections
	Determine your TPMT level (the enzyme activity in your blood that determines how you process, or metabolise, thiopurines). This helps your doctor decide on a suitable dose for you
	Have vaccinations (eg, influenza, pneumococcal, HPV, hepatitis B, varicella-zoster, MMR)
	Get a baseline skin check (adults)

Tips

• Protect your skin from the sun
• Try taking your medicine with food or at bedtime if it upsets your stomach
• Take your medicine in the same way each day
• Continue taking your medicine even if you feel well

My thiopurine dosage

Date started	Medicine name – Active ingredient	Tablet strength (mg)	Number of tablets	How many times per day?
	azathioprine
	6-mercaptopurine (6-MP)

Regular monitoring and checks

Speak to a doctor about which of these tests and vaccinations you will need once you are taking thiopurines

Test	How often	Next appointment/notes
Blood tests, full blood count, electrolytes, liver function tests	At first every 1–2 weeks depending on your result, then every 3 months or as required
Flu	Every year
Pneumonia	Every 5 years
COVID-19	As directed
Skin check (adults)	Every year

When to contact my doctor

Urgently, if I get any of these symptoms	As soon as possible, if I	Regularly, when I
Fever, sore throat, chills (signs of infection or bone marrow suppression) Unexplained bruising or bleeding Blood in urine or black stools Yellowing of skin or eyes, dark urine or pale stools (signs of liver toxicity) Severe upper abdominal pain, vomiting (symptoms of pancreatitis) Stop taking this medicine until you speak to your doctor	Feel sick and lose my appetite Have an open sore that isn’t healing Develop an unexplained rash	Have appointments for tests to monitor my IBD and medicines even if well Am taking or plan to take any other medicines, including over-the-counter, herbal or naturopathic medicines and treatments

 

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Action plan: Thiopurines for inflammatory bowel disease

Date published : 13 August 2021

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