Azathioprine ( Imuran)

Huh? Why do you want to come off azathioprine? I'd stay on it if it isn't doing you any harm. 5-ASAs are virtually useless for Crohn's and the biologics are no joke to be on. My GI wanted me to go on azathioprine after surgery, but I basically told him 'no way Jose' and 'get on your bike, Mike' (this may not be strictly verbatim). Don't get me wrong: I wasn't really rude, but I was just so over all the Crohn's meds. My GI understood where I was coming from and didn't try to push it. Basically, if my CRP remains <10 and other inflammatory markers remain normal, I'm staying med-free. If CRP goes over 10, I'll go on 6MP or azathioprine.

Anyway, to answer your question (at long last). I'm not sure exactly, but it takes months to get into your system, so I would think it would take months to get out of it. However, it's safe to stop cold turkey: no need to wean off it.

Also, the next obvious choice is 6MP. There really is nothing between 6MP/Imuran and the biologics, except for methotrexate. Could look into methotrexate, though that's a rather toxic drug which is used as a chemotherapy agent at higher doses. I wouldn't fancy taking it if I was in remission, tbh.

I have no idea, tbh. I couldn't find anything on google that seemed terribly relevant.

Meanwhile, here's the British Society of Gastroenterology's recommendations: shorted the otherwise very long cached link: tinyurl.com/pd2f87m

Creatinine is monitored, but there is zero advice on what to do if creatinine levels are raised. I can't find anything relating azathioprine and creatinine anywhere, not even old forum posts. (Just to add, I'm not including self-reported symptom checker sites like ehealthme.com. They are not a reliable guide to symptoms or their causes, imo.)

But that said, I suspect you are probably right about azathioprine being the cause. Did the renal doctor think being an ileostomate had anything to do with it? You know, in that ileostomates lose more water and salt, which in turn can place more stress on the kidneys. Anyway, sorry I can't be of more help. My honest suggestion would be to suggest coming off the azathioprine and then going onto... nothing. I can understand if you wouldn't be comfortable doing that, but for me, the longer I stay off bone marrow/liver/pancreas-bashing meds, the better.

You could always get off it for a few weeks and retest your labs and if they go back to normal, you know it is was the Imuran ans if not, you could restart it.

Good luck!

I just got back from the doctor telling me my latest blood work shows the Imuran also attacked my liver in addition to my pancreas. My levels are over 840. I've been off of it for a few weeks now. He said he it was going to take some time for everything to go back to normal. Not exactly my favorite drug.