Advice needed about Imuran side-effects

[Gra]

I'm posting this because I'm worried about going on to Imuran, I was laying in bed for hours last night, losing sleep and getting stressed worrying about it.

I have been on a tapering dose (currently down to 1/2 of a 25 mg tablet per day) of prednisolone for 5 weeks since my diagnosis with Crohns disease in early May of this year.

That along with working hard on my adjusting my diet has put in a position now where I am having little pain or other symptoms.

However My GE tells me that my latest blood tests say it is not reducing the inflammation in my gut enough, he wants me to continue taking the prednisolone for now, and also start taking Imuran

Two things that I'm worried about, the first is the need to avoid people with colds (and I presume flu) as well as chickenpox. The second is the need to avoid exposure to sun.

The first is because I commute to work, taking a bus and then train, and of course during peak hour the trains are absolutely jam-packed with people and it is extremely commonplace to find that you are standing almost next to somebody who is coughing and spluttering and spraying their germs all over me. And then once I get to work, my I am in a building housing about 2000 public servants, 19 floors high, where the air-conditioning circulates everybody's bug's around to everybody else. I cannot se how can avoid being exposed to these things

Chickenpox is a proposition I dread, AFAIK I have never had it, they say it can be really bad in older adults (I am 64) and I imagine that having a reduced immune system would only make it much worse.

The second reason that I am concerned is the need to avoid sun exposure when on Imuran. I have been suffering from depression since 2007, my recent Crohns disease diagnosis has re-fueled it again. The onset of winter also always fuels my depression, and of course acts to further lower my immune system. One of the very few things that help me to combat depression is getting outside when there is a little bit of sunshine and soaking up the warmth of the sun on my skin. Going on to Imuran will rob me of this precious little bit of relief from my depression.

What I want to know is this, is Imuran the only next step after prednisolone, or are there other alternatives for further treatment that don’t have these side effects?

Thanks,
Gra

 

[toml99]

I'm 5 1/2 months into Imuran, and I'm glad I'm taking it. I had (and have) many of the same concerns you have, but it has really helped me. If this stops working for me, the next step is Remicade, which has more side effects.

For colds, flu, etc. that you can catch in public -- First of all, you have a natural immunity for certain strains of the common cold, so you will be less apt to "catch" a cold than someone who is younger. That said, your best defense is (a) turn your head away from someone who is coughing or sneezing, and (b) wash your hands frequently. (Note the alcohol-based hand sanitizers only work on bacteria, not on viruses -- hand washing is going to be essential). So far I haven't had too much of a problem with colds.

Sun exposure is really no big deal. I just returned from a week at the beach. Use a sunblock with SPF 50 and enjoy yourself. Be sure to also use a lip sunblock. If the weather is cool or cold and you have on long sleeves, so much the better. Bottom line, I wouldn't sweat this part of the Imuran.

I'm not well versed on chickenpox. You might want to talk to your doctor about this.

Good luck, and I hope you feel better on the Imuran.

 

[carrollco]

I was on Humira and Imuran for awhile. I had to go off Imuran because my kidneys and liver didn't like it. Now I'm just on Humira. I haven't had any issues with catching colds though they do advise you to get a flu shot which I did. The only thing I have to add is that you need to make sure you get your blood tested while on Imuran. I adjusted really well and when I graduated to every three months is when my kidneys and liver had issues. I'm 57 and since we're older we need to be more careful.

 

[Johnnysmom]

My son is on 6mp which is very similar to Imuran. My son has been very healthy since starting it and also gets lots of sun. We are careful to apply sunblock but we would do that anyway. Two weeks in Florida for spring break and he was fine. It has worked very well for him. Good luck.

 

[Irene3]

I was extremely sensitive to the sun on imuran. But if you have regular blood tests, and don't feel that way when your in the sun, then it could be great for your crohns. I'm on 6mp instead now, and I only notice my skin feels overly warm, in full sun after a while, without sun screen(which I need to get into a habit of using even on cloudy days).
Your question about the side effects.... All imunosuppressives have the minimal side effect, of become more susceptible to colds and flu. Like someone said, if you go on remicade or humira, you have a lot more side effects. Best of luck with it, and if your side effects are bad, just speak to your gi, and he may suggest 6mp instead. xo

 

[Gra]

I love the forum too

Thanks to all who have replied so far. This is the sort of thing I need to hear.

Gra

 

[jonathanzn]

E,my question is sunlight is also important to crohns because of Vitamin D3. So how can I make the balance of D3 and side effect of imuran?

 

[Catherine]

Did your dr mention having vaccine for chickenpox before starting aza. This vaccine is given to children in year 7, may worth considering. My daughter is taking aza and her gi still recommends some limited sun exposure.

 

[Begotten]

I'm on a very high dose of Aza/Imuran(currently just gone up to 400mg per day) and I was actually unlucky enough to catch chicken pox last year. Felt pretty awful until i got prescribed some anti-viral drugs and then I felt fine minus the itching which I'm sure is just standard chicken pox.

 

[David]

If the sun is what helps you with your depression, absolutely positively get your vitamin D levels tested immediately. Vitamin D deficiency is common, especially in people with Crohn's Disease and you can supplement vitamin D easily and not have to go in the sun much. Please do this! And while you're at it, get your vitamin B12 levels tested. It's another common deficiency in people with Crohn's Disease that can cause the feeling of depression.

 

[CLynn]

Gra, this is my 2nd time on the generic Imuran, Azathioprine, and I would say, try not to worry so much about the side effects. They are scary, I know, I was freaked out the first time, 15 years ago. I have always worked for the public, at a bank. Everyone comes in sick here too, believe me. And my kids catch colds, etc. But I did fine, and (knock on wood) am doing fine this time too. We just avoid what we can and wash our hands frequently. Honestly, it does more for my flares than prednisone ever has, and the prednisone had some pretty nasty side effects too. Hugs!

 

[Robert747]

Hello,

I am on 150mg of Aza and have recently developed Shingles (I am 53) - so I have quickly found out quite a bit about the chicken pox / shingles virus. Once you have had chicken pox the shingles virus is with you and and can develop if your immune system is lowered. People cannot 'catch' shingles from me - but if you have not had chicken pox - keep away! However most people do have chicken pox as a child - sometimes in a very mild form. So in a large family it can often be possible, many years later, that the parents simply cannot remember if the child had chicken pox - that was certainly the case with me.

While I have shingles I am off the Aza (low white blood - apparently!). I have had no real side effects apart from shingles - but then I guess that is quite enough.