
Strong Aversion To Smell Of Coffee, Makes Nauseated, Stomach Problems, Flu Like Symptoms. Are All These Related & What Is The Remedy?

XXXXXXX
Thanks for the query
Strong aversion to the smell of coffee is due to side-effects of the medicines you are taken.
Currently the medicines you are taking for the treatment of Polyarteritis Nodosa such as Azathioprine (Imuran 150mg) can cause gastrointestinal toxicity. Nausea, metallic taste, sensation of altered taste and smell, abdominal discomfort are few of the features of the gastrointestinal toxicity of the drug Azathioprine.
The gastrointestinal toxicity will be reduced once the drug is stopped. Moreover you are taking lot more other medicines, such as prednisolone, amitriptyline, venlafaxin, etc. which can disturb the gastrointestinal tract.
I would suggest you to discuss this matter with your doctor and request for dose reduction or altering the drug.
Hope I have answered your query; I will be available for the follow-up queries.
Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon


Thanks for writing back
The description you have mentioned seems to be of Seborrheic keratosis. Seborrheic keratosis are noncancerous wart-like lesions on the surface of the skin, which are benign and do not cause any problems.
These lesions are more common in older individuals and have a variety of clinical appearances, and they develop from the proliferation of superficial layer of cells (epidermal cells). Although no specific etiologic factors have been identified, they occur more frequently in sunlight-exposed areas. Sometimes it is triggered by other malignant skin lesions, pregnancy, estrogen therapy and various other medical conditions.
There are no ointments or medications which can neither cure nor prevent seborrheic keratoses. Cryotherapy or freezing, electrocautery or curettage can be done to get rid of these lesions.
It would be better if you can consult your dermatologist for a thorough examination and management.
Wish you good health
Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon


Hello Dr. XXXXXXX Sorry for misleading you but I have one final question: is it likely that I would like to start feeling side effects approximately 4 months after starting to take Imuran? XXXXXXX
Welcome back
Temazepam like other hypnotic drugs can cause physical dependence and addiction particularly when used for long duration. Hence, withdrawal from Temazepam after regular use often leads to withdrawal syndrome, with symptoms like restlessness, insomnia and depression. In your case, insomnia is primarily due to Temazepam rather than Amitriptyline.
Secondly, Azathioprine (Imuran) is an immunosuppressive drug which is used to treat auto-immune condition and the dosage of the drug can be altered only after thorough assessment of your clinical features and this will be done by either your medical oncologist or your physician. The side effects of Azathioprine are totally different from that of the Amitriptyline or Temazepam and your insomnia cannot be cured by the withdrawal of the same. Regarding this, you need to discuss with your physician and start on a low dose of amitriptyline to alleviate your nightmares and get rid of insomnia
Yes, the side effects can be noticed even after four months after starting the drug. The side effects of Azathioprine are more when used for a longer duration. This is mainly attributed to the toxicity of the drug in the body and the bone marrow suppression. Hence, the patients will be more susceptible to infection because of this bone marrow suppression.
Hope this answers your query; wish you good health
Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

Answered by

Dr. Dr. Naveen Kumar Nanjasetty
Otolaryngologist / ENT Specialist
Practicing since :2001
Answered : 2545 Questions
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