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Autoimmune Hepatitis
I am curious about the dosage of Azathioprine for AIH. Liver Enzymes were highly elevated and I was put on Prednisone and then weaned off for Azathioprine (100 mg) per day. Liver Enzymes starting rising again and was placed back on a prednisone taper for one month (half way through now). I am wondering if anyone else experienced elevated enzymes with 75 or 100 mg. Also wondering about anyone's experience with just 50 mg of Azathioprine. I was diagnosed with PBC in January 2024. Unable to tolerate Ursodiol and was placed on Ocaliva, then liver numbers skyrocketed. Stopped Ocaliva and now I also have Auto Immune Hepatitis. Appreciate hearing your experience with AIH and Azathioprine. Also interested in hearing from anyone who may be on low dose ongoing prednisone. Thanks.
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Hello @boomcan, Welcome to Connect. @justmike started a similar discussion here and may have some thoughts or suggestions - https://connect.mayoclinic.org/discussion/aih-autoimmune-hepititus/.
You might also find it helpful to scan through the comments by other members who have mentioned AIH and Azathioprine in a post - https://connect.mayoclinic.org/search/comments/?search=AIH%20%20Azathioprine
Hi Booncam
I'm interested in talking with you.
What state are you in ?
It does take a little time with azathioprine I was on it alongside with budesonide. After coming off Prednisone. Took about a month for enzymes to come down. Then I had a strange side effect where all my muscles were stiff, felt awful, enough where I quit taking it. Now I'm on 2000mg of mycophenolate. It's working took a little time too. Way better than the steroids, but has its side effects too... Just my input AIH is frustrating Its a mental battle too. Mayo has been amazing
Thank you so much for sharing. Yes, AIH is frustrating and a constant mental battle. I appreciate your input with your experience.
Hi, I was diagosed in December 24, on 40mgs prednisolone, then in Jan 25, pred dropped to 30mgs and 50mgs Aza was added. Aza was increased to 100mgs inn Feb 25 and I was rold the initial low dose was to see how I tolerated it before it went to a higher dose. 100mgs was on the basis of 1mg per kg of weight (I'm under 100 kgs). Pred was reduced at 5mgs month until last month when it hit 10mgs. Hepatologist said this was my long term maintenance level but I'm having awful side effects from the pred so I've continued the taper myself (I've told the hep what I'm doing and that as my liver levels reduced quickly from ALT 1,553 to 17 in 4 months. And, I don't drink / smoke and have healthy diet etc. that I think I'm a good candidate for coming off the pred - I only have F1 fibrosis and a bit of fatty liver). I've seen recommendations that the Aza maintenance dose should be between 1-2 mgs per kgs body weight.
Thank you for sharing your info. All of this is so confusing!
I think it gets confusing because it's such an individualised disease that treatment plans often differ between individuals. The bit I find unfair is that even if you do all the right things, because of the unpredictable nature of AIH, it can still go wrong. Having said that, the stats I've seen suggest only 3% liver trasplants are due to AIH so only a very few people with the disease experience extreme liver problems. The majority of people, once the right medication regime has been worked out, have long and normal lives. The first few months can be difficult as your doctors work out which meds, and in what dose, are going to work best for you.