Imuran Questions

[niroowns]

Hi All,

I have been reading this sub-forum for the last several months in anticipation of starting Imuran this past summer, so first and foremost - thanks everyone for their feedback and sharing their knowledge. Hopefully, some of you can help me out with some questions I am having...

I have left sided UC and started Imuran as follows:

Imuran 25mg started on 6/27/12
Imuran 25mg/50mg alternating on 7/8/12
Imuran 50mg started on 7/14/12
Imuran 75mg started on 7/24/12
Imuran 100mg started on 7/28/12

Since I weigh 120 lbs, my doctor thinks the 100mg should suffice as the pre-blood work came back as me being a Normal responder when testing the TPMT enzyme.

I have been getting blood drawn every 2 weeks since July and have been trying to monitor my WBC to see if the Imuran is taking effect, but it has been almost impossible due to my concurrent use of steroids. I was on 60mg at one point, but am down to 40mg. From my understanding, steroids cause your neutrophil counts to go up (neutropenia) so I can't tell if my counts are going down due to the pred use.

So I am wondering, is there any other way besides expensive metabolite testing to see how I am doing or responding to the Imuran? Also, how long did it take most of you to start seeing effects to your IBD after starting Imuran? According to my doctor, it will take 2 months after I started my optimal dose (100mg), so I am looking at the end of September. I am not sure if I have enough patience to last that long! :ylol:

 

[michaelearnest]

The only thing I am on right now is the Imuran, 50mg per day. I do blood tests every 3 months and it has been working fine for me.

 

[CLynn]

The doctor ordered simple cbc blood tests for me, which at the first of the flare showed my white count way up, but within 2 months, going down, progressively each time. I was only on prednisone till the testing came back for imuran (or in my case, azathioprine). My white count just kept lowering on the cbc then gained a bit, but still on the low side.

 

[Aussie]

You're right about prednisone causing your white call count to go up.

You can look at the size of your red blood cells (mean cell volume or MCV), if that is slowly increasing after starting Imuran, that is a good quick guide that you're responding to the drug. Keep in mind there are a few other things that can also increase the size, so it's just a guide.

 

[niroowns]

Thanks for the responses.

The 6 week mark finally showed a drop of the WBC to 9ish from 12 even while on prednisone, so this is good news. Hopefully, the trend keeps going down to below 6, but stays above 4.

Just had a dr's appointment yesterday and we also took metabolite levels, I am pretty sure I am not at the proper level needed. Might be adding in allopurinol to help me get there.

 

[Mica]

Hi everyone! I'm newly diagnosed with Crohn's. Probably had it or the last 9 years but I went into remission by itself for 7 years and had symptoms for over. 1 yr and 1/2 and just got diagnosed a couple of weeks ago. My GI wants to put me in Prednisone for 8 was along with Imran and humira. She told me that Imran only has I do believe a 15% chance of putting me in remission where as Humira has a 40%-50% of remission.

Has anyone had success on Imran?

Right now I've decided to try the SCD diet to see if maybe I can go into remission naturally cause the drugs scary the living daylights out if me!

 

[niroowns]

So, the metabolite results came back last week....all is actually good according to the doctor.

6-TGN is @ 253 (range is 230-400)
6-MMPN is @ 2452 (range is < 5700)

So, the prognosis? More time....he doesn't want to add in allupurinol if I don't need it. I don't blame him. He said most patients take 3-4 months for the Imuran to kick in AND take effect, so I am basically half way there. Getting so tired of the pred....