Yesterday I had my first Rheumy appointment since starting the azathioprine, so I was kind of anxious to see if it was working. I was on a low dosage (50 mg), and I wasn't sure if it was making much of a difference. I've been experiencing some stomach discomfort and nausea, especially when I don't have time to eat breakfast with my meds. I've also still been experiencing joint pain and fatigue, although it may be because I've been busy with the house and haven't been getting my required nine hours of sleep.
My blood test results showed that my Erythrocyte Sedimentation Rate (ESR) was down to 24 mm/hr, the lowest it has been since I was diagnosed with lupus in January! As I mentioned earlier, 20 mm/hr is considered normal for women, so I am not too far off. My red and white blood cell counts were still a little low, but my kidney, pancreas, etc. all looked normal.
We are raising my azathioprine dosage from 50 mg to 75 mg (1-1/2 pills). If my stomach is able to handle that over the next two weeks, then I'll raise my dosage to 100 mg (2 pills). If I experience too much nausea or stomach upset, I should take the highest dosage I can handle. Rheumy thinks that 2 pills should be a good maintenance dosage for me, but said that some patients take 3.
We are also lowering my prednisone dosage from 5 mg to 2.5 mg. If you remember, the last time I tried weening off the 5 mg, I went down 1 mg at a time, and my symptoms came back when I was down to 3 mg. The decision to cut the prednisone more dramatically is because I have been gaining a lot of weight due to it and am now above my normal pre-diagnosis weight. We are also hoping that the azathioprine will help manage my symptoms in the absence of the prednisone.
My next visit is in 4 weeks, so let's hope I keep showing improvement!
- a little lupie -
Always praying for you honey.
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