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Imuran and Moderate Crohns


I was diagnosed with Crohn's on the 19th of October that is "moderately active." My question is, I was immediately put on asacol for about a week, then after the small bowel series changed to pentasa and Imuran. My question is should I be put on imuran this soon? From what I have read it is supposed to be a treatment for when something like pentasa doesn't work. The fact that it opens me up to various sicknesses, cancer, and other side effects scares me and they sound worse than the crohn's I am currently dealing with. I was bleeding bad before the asacol, but that seems to have stopped now with the pentasa and my biggest complaint is back pain. Should I just be taking pentasa alone, or is pentasa and imuran a better combination? Your thoughts are appreciated.


Senior Member
Hey Chris.. my laymans understanding is that pentasa, or any of the other like 5 ASA meds (asacol, salofalk, etc) are just anti-inflammatories. They treat the inflammation, but they don't address the underlying causes. for that, the choices are limited. Prednisone usually works, but it's long term side effects means it's only a short term deal. Long term meds, like imuran.. aka azathioprine, are brought in. Sure, there are potential issues, but with regular bloodwork to keep track of these, these drugs have been used long term for lots of things.. like for suppressing the immune system of people who've had organ transplants. It's this history of documented use that leads a lot of dr's to prescribe it to quell the immune response aspect of the various IBDs that are out there. My GI put me on it, but my body had other ideas. I experienced the same thoughts and fears as you are. now that it's off the table as far as my treatment goes, the remaining options I'm facing are even less appealing. Grass is always greener, right? I wasn't on it long enuff to develop either a love or hate relationship with it. You'll probably get some better informed feedback from other forum users.

Anyway, glad to see you asking questions. bear in mind that the answers you get here are from fellow sufferers, not from medically trained doctors. We have a first hand knowledge base, but if we knew all the answers, we'd be cured, right? You should pose these same questions to your doctors, OK

all the best.. keep posting...


ele mental leprechaun
Hi Chris,

If you dont manage your crohn's effectively it can contribute to cancer depending on where you have it and personally I would rather take the imuran (which I have been on for at least 6mths now) and manage my crohns and decrease my risks. On the infections aspect I havent had any big probs overall and the only big issue was nausea on commencing it and during any increases in dose but remedied that by taking it at night rather than morning.

As Kev says they do regular bloods and yes I am having a hiccup at the mo as my liver tests are a little out but they are decreasing my imuran in relation to that and I should sort out. I also have other options so am not worried.

Docs will go for whatever level of meds they feel you need in relation to the severity of your Crohns and they go by how you are too so the more info you give them the better they are able to care for you...

To be honest my quality of life has vastly improved since diagnosis last xmas and that is down to my GP my GI the meds and diet changes. So I will go for whatever they think is best as long as they keep me fully informed and can justify why.

Thats just my opinion though. Others may feel differently. Thats whats so good about here as you get both sides of the argument as it were from folk that have been there and it helps you get your head round things more so you can ask your docs more questions too!!
What time of day do you take your imuran. I have been taking it with food around dinner time, but it seems some take it right before bed. Has this method been more effective for anyone?

On a similar note, I had a pentasa dosing question. What kind of dose is everyone taking? How many times a day. My doc said its ok to take it 3 times a day instead of 4, just wanted to see if anyone else is. I'm currently on 125mg imuran and 4g pentasa. thanks!


Senior Member
That's a good question about pentasa (5ASA). I was taking my 4g daily in 4 doses of 2 500mg pills. Problem is, I was getting really bad headaches. One of the docs at the GI clinic suggested I switch to 3 x 500 mg twice a day, and 2 x 500 mg at bedtime. I also checked the manufacturer of my particular type of 5ASA (Salofalk made by Dr Falk) Their website recommended eating first, then taking pill ONE hour later. Doing that, both my headaches went away, and the pain I associate with eating/taking my meds decreased. So, it was a big win/win situation for me from both sides.