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Question about Imuran

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Crohn's Disease
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Posted 10/3/2013 7:33 PM (GMT 0)
In July, my WBCs dropped to 6.9, so my GI upped the dose to 175 mg. The last CBC test which was 2 days ago showed that the WBCs became 6.6; which means that there is a decrease of 0.3 in 3 months. When I told my GI that he said this is not necessary; the most important thing is that you are responding to the med. Also, he refused to up the dose and kept it at 175 mg as this is the appropriate dose in relation to my weight. He also reduced Entocort to 6 mg. I insisted that I still have severe d and cramps but he said that these should resolve by time and that I should experiment w Imodium and Questran as I caused myself severe C.
I was just wondering what's the course of action of Imuran? The GP once told me I have to reach a WBC of 4. So, if I'm going down w a rate of 0.3/3 months, this means I'll reach the count of 4 after a year shakehead .
Could anyone kindly feed me in? Thank you.
Posted 10/3/2013 10:43 PM (GMT 0)
A normal WBC is in the range of roughly 4 -10 (x 10 to the 9 cells/L.)
As long as you are within this range then the drug is likely doing its job. Trying to get to the lower end of the range is not really the aim, particularly as a low WBC can be dangerous. You are in the middle of the accepted range which is fine.

The WBC is a count of all the different types of white blood cells in the blood. There are five major types of these (and sometimes one type can be high and another low). So the WBC is a general marker of any kind of inflammatory response.

See how you go dropping the Entocort to 6mg. It isn't used as a long term med (for many reasons), and 6mg may well be effective enough for you at this point.

Good luck experimenting with the Imodium and Questran. Keep it low and simple, by trying one at a time in low doses and increasing carefully.

Be gentle on yourself.
Posted 10/4/2013 12:14 PM (GMT 0)
Ambling, thank you very much. So that does that mean that I should not necessarily go down to a blood count of 4? Great so I'm trying to take Imuran religiously and hope one day I might go into remission. I'm still experimenting w both Imodium and Questran and don't think it's something easy; d is still persistent.
Take care :)
Posted 10/4/2013 2:25 PM (GMT 0)
Also, Imuran can take up to 6 months to be fully effective. In addition there are risks of liver toxicity w/too high a dose of Imuran. The ideal dose is to reach effectiveness w/o hepatotoxicity.

Entocort is usually used to support the build up to effectiveness of the Imuran that first 6 months. The Entocort dosage is gradually tapered off by the end of the 6 months.
Posted 10/4/2013 3:12 PM (GMT 0)
CrohnieToo, thank you very much. Yes, I'm exactly at the end of the 6 month. Hope it puts me into remission as I have never experienced it before.
Take care :)
Posted 10/5/2013 1:46 AM (GMT 0)
Prometheus has a test, the Prometheus TM test, that indicates the effective dosage range and likely hepatoxicity range for the dosage you are currently on at the time of the test. There are those who do well and need a higher or lower than recommended weight based dosage.

Good luck and God bless, I sure hope you are able to achieve remission!!
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