I have to be honest, there are gaps in your knowledge. I haven’t told you everything, so it isn’t your fault but mine. The blame is entirely on me. After I had the seizure episode in June this year I didn’t take any steps to fill you in on the new medications I was starting.

Oh, that I told you about them, there is no doubt. There is no denying also that I have discussed some of the medicines I began taking following that seizure, namely the anti-seizure drug Epilim. However, I neglected to discuss the latest Vasculitis preventative treatment or the latest prednisone managing medicine. There was a reason for the omission of the former and it was really quite simple (no funny business I swear!)

For the most part I was being cautious. It was my third attempt at a treatment course following a significant and clear failure at the first two. Topiramate took my diet, my mental well-being and my attention span. Propanolol induced skin lesions from an allergic reaction. I had researched, discussed and poured good intentions in to each and then watched as they nose dived over a cliff attached to a rope tied about my waist.

I was being wary.

Now, though, it has been five months without a significant incident so I will once more introduce you to my medicine cabinet.

Azathioprine (Brand name Imuran)

I initially began on this at 50mg as a fast onset to a high dosage can have side effects and reactions in some patients. After three months without incident it was time to start the titrate up to a realistic long-term dosage and wean down the 50mg steroids (Prednisone/Prednisolone).

I suppose what I have to say about this new drug is paraphrased from documents I have read. Why? Because I have not had any noticeable side effects or outward physical, cognitive or behavioural indication that I am taking the medication. I am aware that it lowers my immune system and that it may have an impact on my kidney and liver function, but proudly I have not really noticed the drug working on me. Which is exactly how it should be. I should say here though that I have not have even a slight black-out, seizure or stroke style episode. My attention, confusion and concentration are all clearer and stronger. I have not had anywhere near as many sparkling dots in my eyes and absolutely no migraine auras, even if the migraines still appear from time to time.

So now I titrate up in 50mg increments. Admittedly I am still on 100mg at present. I expect in December to go to 150mg (at which point my inkling is that the dose will stabilise). The prednisone wean down from 50mg is in smaller increments and at a slower pace than usual. I have been on 20mg for the last three weeks and next week I go down to 15mg. You know I hate the drug but I like that there is no potential for a whiplash effect this way. I have had that and it’s not pleasant.

Pantoprazole

This drug is a protection and preventative measure for the body against damages that can occur internally with regular steroid consumption. Steroids run a high risk for causing internal injuries such as ulcers and abscesses in the digestive tract if there is not sufficient protection between them and the lining of the organs. The easiest and most effective way to avoid this and protect your innards is by taking medicines after food when the label recommends. The stomach is not empty then and the bile and stomach acid is too busy with breaking down food.

Unfortunately, sometimes people are naughty or the drug is too strong. In these cases the damage may be unavoidable and then bad things happen. As I have had a medicine such as this in each instance of going on a steroid treatment I can only assume that these drugs are the strong kind, not the ones likely to be taken regularly and irresponsibly by every person prescribed them. Earlier life situations have put me on Omeprazole during these times, and thought I don’t know how they are different, or what changed this time, I have been taken Pantoprazole.

This is currently where I am at. I cannot say what is expected to stick long-term. I can say what I expect will go. I think the Pantoprazole is only around while the Prednisone is around. I believe the Imuran may be a long-term therapy. All else I cannot say.

Have you ever been on Imuran (Azathioprine)? If so, what was your experience?

Why were you prescribed this drug and did you scroll through a range of other drugs before coming to this?