Patient's Query
Hello doctor,
I have been diagnosed with catastrophic antiphospholipid syndrome before three years and had a brain stroke in the same month due to blood clots. Since then I have not encountered any blood clot and have been on Acitrom 5 mg, Ecosprin 75 mg and Azathioprine 100 mg. Three weeks back neurologist had replaced Azathioprine with HCQ 300. My ANA test was done before changing. ANA result was negative.
Now for the last two days, I am experiencing pain near the heart line. The pain lasts for around one minute. Pain is such that it starts from deep inside and it pulls the skin/organs inwards. I have experienced such pain three to four times since two days.
My query is, is this due to a change in medication? Whether HCQ be stopped and Azathioprine be restarted? What is the use of Azoran in APS and are these both drugs somewhat similar? Should I continue with HCQ and if not is Azoran safe in the long run? I am taking Azoran for more than 2.5 years.
Kindly advise..
Hello,
Welcome to icliniq.com.
What treatment did you get during Catastrophic antiphospholipid syndrome? Was your APLA, LA test positive? Azoran is an immunomodulatory drug and has some role in APLA syndrome.
HCQS is a good drug for APLA as it has an anti-inflammatory plus anticoagulant effect, but your symptoms started after three weeks of HCQS. Please try to consult your physician, as he has examined you and he knows the complete details. So he can guide whether Azoran should be restarted or not?
According to my opinion in your case, I think you should restart Azoran and stop HCQS.
I hope this helps you.
Thank you.
Patient's Query
Thank you doctor,
Yes APLA, LA was positive. Actually I went to rheumatologist last month and they advised to replace Azoran with HCQ. Is Azoran a safe drug in long run? My neurologist suggested to taper Azoran to 50 mg in the morning and replace evening dosage of 50 mg with HCQ 300. So technically, I am taking both. So should I continue having both?
Kindly advise.
Hi,
Welcome to icliniq.com.
Yes, Azoran is very much safe. We are using that drug since 1960s. It is a very good immunomodulator and no long term side effects except we need to stop it if WBC (white blood cells) count and platelets goes down and liver enzymes rise. So no question of safety here.
Second point is you developed some chest discomfort and pain after starting (three weeks) HCQS, so it might be due to HCQS, stop it for a few days and watch, if it gets relieved then we need to rethink about restart of HCQS.
Take some antacids (liquid for acidity - Mucaine gel) for midline chest pain and do one ECG if possible.
I hope this helps you.
Thank you.
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Answered byDr. Prakashkumar P Bhatt
Medically reviewed byDr. Vinodhini J.
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