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Is It Safe To Take Azathioprine And Prednisone When Undergoing BCG Treatment?
Question: I am going to start treatment for bladder cancer with BCG. I have been taking Azathioprine 150mg. and Prednisone 71/2 mg a day for seven years. Azathioprine is an immune suppressant drug and ,as I understand, your immune system plays a big part with BCG treatment. I feel I should stop the Aza.
and Prednisone. I have been told by my Dr. that it's ok to continue these drugs during the BCG treatment.
It's not making sense to me, to engage your immune system in a treatment yet continue to take a drug that suppresses it. Please comment/explain.
Thank You. XXXXXXX Gardner e-mail YYYY@YYYY
and Prednisone. I have been told by my Dr. that it's ok to continue these drugs during the BCG treatment.
It's not making sense to me, to engage your immune system in a treatment yet continue to take a drug that suppresses it. Please comment/explain.
Thank You. XXXXXXX Gardner e-mail YYYY@YYYY
Brief Answer:
Treatment Modification
Detailed Answer:
Good evening
Thank you for writing on health care magic
Well i see you are on full dose of AZA and been on a long course of Prednisolone. What i would like to know is the condition you have been started these drugs for? Was it for SLE or some other Connective tissue disease?
Well as of know, AZA is a relatively safe drug which you can continue with BCG treatment as well. BCG treatment mostly induces a local reaction in the bladder as it destroys the macrophages there. But yes more than AZA, prednisolone is more of a risk factor for side effects of Tuberculosis due to BCG Treatment. SO i would like to know the condition you were started the medication for, how will is the disease control and has it been under remission since last few years?
If that has been the case, we can plan on tapering these medications and plan the treatment for BLadder Cancer
Awaiting your reply
Regards
Dr Naval
Treatment Modification
Detailed Answer:
Good evening
Thank you for writing on health care magic
Well i see you are on full dose of AZA and been on a long course of Prednisolone. What i would like to know is the condition you have been started these drugs for? Was it for SLE or some other Connective tissue disease?
Well as of know, AZA is a relatively safe drug which you can continue with BCG treatment as well. BCG treatment mostly induces a local reaction in the bladder as it destroys the macrophages there. But yes more than AZA, prednisolone is more of a risk factor for side effects of Tuberculosis due to BCG Treatment. SO i would like to know the condition you were started the medication for, how will is the disease control and has it been under remission since last few years?
If that has been the case, we can plan on tapering these medications and plan the treatment for BLadder Cancer
Awaiting your reply
Regards
Dr Naval
Above answer was peer-reviewed by :
Dr. Raju A.T
Thank you for your quick reply Dr. My condition is Polymyositis. My ck's were in in the 400 to750 range. As an average. My Dr. tried many combinations of Aza. and Prednisone. finally my cks are in the 200 to 250 range and holding. This finally came together early 2014. Also had breathing problems for about 2 years and the prednisone was increased to 71/2 from 5 and I was instructed to go to 10 if I was really having problems. The 71/2 seems to do the trick. Hope I ans, all your questions. Thank you again. XXXXXXX
Brief Answer:
Management of Bladder Cancer
Detailed Answer:
Good evening
Thanks for your reply.
Well i guess you had lung involvement along with the myositis, so they are not able to taper your steroids. As for the BCG theraphy, as mentioned it is more of a local inflammatory reaction created by the Mycobacteria which acts through the macrophages present inside the bladder to destroy them. But one has to be very careful while implanting it, as we cannot afford seeding around.
As per your query, AZA and prednisolone are quite ok to go with even with BCG Theraphy. It wont alter your immune response as it is a local reaction. Especially in the country I stay in, Tuberculosis has a very high prevalence. But if theraphy is needed for Tuberculosis, we normally combine with these drugs and give. So dont worry about that part.
My other school of thought is, what if polymyositis was all due to this Cancer. It is very proven fact, that Polymyositis and DErmatomyositis can be a part of the malignancy as well. They normally present much before the presentation of Cancer and once cancer is treated it disappears with treatment. You can discuss it out with your doctor about it. Although Bladder cancer is not such a common thing, it can still be present as paraneoplastic manifestation
hope the information was useful
Do let me know for more queries
Regards
Dr Naval
Management of Bladder Cancer
Detailed Answer:
Good evening
Thanks for your reply.
Well i guess you had lung involvement along with the myositis, so they are not able to taper your steroids. As for the BCG theraphy, as mentioned it is more of a local inflammatory reaction created by the Mycobacteria which acts through the macrophages present inside the bladder to destroy them. But one has to be very careful while implanting it, as we cannot afford seeding around.
As per your query, AZA and prednisolone are quite ok to go with even with BCG Theraphy. It wont alter your immune response as it is a local reaction. Especially in the country I stay in, Tuberculosis has a very high prevalence. But if theraphy is needed for Tuberculosis, we normally combine with these drugs and give. So dont worry about that part.
My other school of thought is, what if polymyositis was all due to this Cancer. It is very proven fact, that Polymyositis and DErmatomyositis can be a part of the malignancy as well. They normally present much before the presentation of Cancer and once cancer is treated it disappears with treatment. You can discuss it out with your doctor about it. Although Bladder cancer is not such a common thing, it can still be present as paraneoplastic manifestation
hope the information was useful
Do let me know for more queries
Regards
Dr Naval
Above answer was peer-reviewed by :
Dr. Shanthi.E
Thank You Dr. Mendiratta for your explaination of my questions regarding this situation. You have put my mind a ease regarding the Aza and Prednisone. You have also explained in more detail than I have been given before. As I am scared to death of all of this I want to be sure I am getting and understanding everything.
Again, Thank You. If I have any other questions I will be in touch.
Regards XXXXXXX Gardner
Again, Thank You. If I have any other questions I will be in touch.
Regards XXXXXXX Gardner
Brief Answer:
Bladder Cancer
Detailed Answer:
Good evening XXXXXXX
Well, I am glad i could be of some assistance to you and helped you resolve your query.
Yeah do let me know if anything. Would be happy to help out
Regards
Dr Naval
Bladder Cancer
Detailed Answer:
Good evening XXXXXXX
Well, I am glad i could be of some assistance to you and helped you resolve your query.
Yeah do let me know if anything. Would be happy to help out
Regards
Dr Naval
Note: For further information on diet changes to reduce allergy symptoms or to boost your immunity, Ask here.
Above answer was peer-reviewed by :
Dr. Pradeep Vitta
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