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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Is It Safe To Withdraw Azathioprine With This Platelet Count?

Hi Doctor,I am consulting you for my mother (65 years) with Fall in ITP case for last 20 years. She is also diabetic and have Blood Pressure.Case History:Diagnosed with ITP in 1996, with platelets count of 21,000 with light bleeding.Her platelets count usually used to come below 50,000 twice or thrice a year and when doctor used to give 10 mg Prednisolone tablet for around 1 month, it used to came back at normal level. But since last 1 years, whenever she stops Prednisolone tablets, her platelets drops below 50,000.We were seeing a hematologist for last 5 years in our native. But recently, we have moved to a different city and started seeing a different hematologist. He started entirely new line of treatment with Azathioprine tablets, which seems not to be very beneficial. We taken CBC every week to find that platelets is decreasing, once doses of Prednisolone tablet decreases. We did not found any benefit with increasing dose of Azathioprine tablets. Doctor had prescribed following medicine per day:1. Prednisolone tablet - Wyslone - 5 mg 2. Azathioprine tablet - Azoron - 100 mg 3. Rabeprazole tablet - Rabicip - 20 mg 4. Calcium Carbonate tablet - Shelcal - 500 mg x 2 5. Folic Acid tablet - Folvite - 5 mg We were approaching doctor for past 4 months, and everytime he increased doses of Azoran tablet from 50 mg to 100 mg. But platelets was coming down, if Presisolone tablet dose was coming below 10 mg. When tested CBC on 04.09.2015, her platelets count was 40,000.We started taking Papaya leaf juice for 4 days and Giloye Juice (Ayurvedic plant juice) along with 12 days of taking above mentioned medicines, when she taken test again, her platelets count was 90,000. She is taking following medicines from last 4 years for Blood Sugar and Blood Pressure :1. Amlodipine + Atenolol tablet - 5 mg + 50 mg - Amlopres AT 2. GLIMEPIRIDE + METHFORMIN TABLET - 1 mg + 500 mg - Glycomet GP -1 Kindly suggest further dose of these medicines, she need to take from today. As platelets count have gone up, I would like to minimize dose/stop these medicines, as she have became very weak and her Blood Sugar count PP have gone to 306. I am little anxious as I have came to know about increased chance of Cancer with Azathioprine tablets. She is on Azathioprine tablets for last 3 months and Predisolone (5 - 10 mg) tablets on past 1 year. I would like to stop Azathioprine tablets as platelet is 90,000. Should we stop immediately or there is any procedure of stopping it by decreasing its dose? Kindly also suggest any change required for Blood Sugar tablet (it has gone up to 306, after taking these tablets.Regards,Rohit
Fri, 17 Apr 2020
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General Surgeon 's  Response
Hello,

* The Azathioprine is used as an Immunosuppresant which is used to modify the rate of basic pathology progress or rate at which it damages to the underlying body system.

* Azathioprine is not meant or used to increase your platelet couts.

* Steroid role is exceptionally proven and best in idiopathic thrombocytopenic purpura and has to be continued life long along with folate and other supplements.

Hope I have answered your query. Let me know if I can assist you further.

Take care

Regards,
Dr. Bhagyesh V. Patel
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Is It Safe To Withdraw Azathioprine With This Platelet Count?

Hello, * The Azathioprine is used as an Immunosuppresant which is used to modify the rate of basic pathology progress or rate at which it damages to the underlying body system. * Azathioprine is not meant or used to increase your platelet couts. * Steroid role is exceptionally proven and best in idiopathic thrombocytopenic purpura and has to be continued life long along with folate and other supplements. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Bhagyesh V. Patel