What are immunosuppressive drugs and when are they used?
Immunosuppressives such as 6-mercaptopurine (6-MP or purinethol) or azathioprine (imuran) are increasingly used in treating more severe IBD that does not respond to 5-ASA therapy and short term steroid therapy. The most frequent use of these drugs is in the context of inability to reduce the steroid dosages in steroid dependent patients without causing a disease flare. Physicians without significant experience in their use can be reluctant to try them because they rarely can have extreme side effects. Generally these side effects occur at higher doses than are used in the treatment of IBD. However, the emphatic opinion of most physician experts in the management of IBD is that they are significantly safer and more effective than long term use of high dose steroids. The side effects that occur in a small minority of the patients who take them can include various blood problems, bone marrow suppression, extensive immune suppression, kidney damage, liver damage and others. There is no con
