More Imuran or Back to Endocort?

Hi everyone.  I  really need opinions on which option I should ask my GI for--more imuran or back to endocort. I have been competely off edocort since mid july after beginning my taper the end of June.  I was taking 3mg two times a day.  My SED rate is back up to 41 (not near the highest it has ever been) and my "D" and pain is worsening.  This has been happening over the last few weeks. I am wondering if it would be better for me to try to stay off the endocot and ask about uping my imuran.  I know from reading this board and other sources that the "norm" is 100-150 mg. I am really torn about this.  I am even thinking about just waiting it out a few more mo's to see if it gets any worse.  If it was not time for my kids to go back to school and my college kids to come back for the fall semester I probably would. Thank you all in advance.

If it were me, I'd go up to 9 mg/day of Entocort before increasing my dose of Imuran, but of course, you should consult your doctor.

Are you still on only 50mg of Imuran? If so, that's probably too low to do any good. For most people the effective dose ends up being fairly close to your weight (for example, 150 pound person would be on 150 mgs of Imuran).

Anyway, instead of thinking which one, why not do both? Ask to start back on the Entocort for short term, and also increase your Imuran dose to an effective level at the same time. After a couple months, the Entocort should have helped get you through, and the Imuran should have had enough time to kick in, and then you can taper off the Entocort again.

That would be my strategy in your situation.

To echo other replies, 50mg of Imuran is a really low dose. There is a blood test available to show whether or not you are in the therapeutic range for Imuran to work (it's from Prometheus labs, but it's pretty expensive -- I couldn't have afforded it if I weren't insured). I had been on 100mg for years, slightly underdosed according to weight calculations. My new gastro ran the test, and sure enough, I was underdosed (I'm now on 125mg).

Entocort never did all that much for me, but I would be a little leery of taking steroids long-term, even if their systemic absorption is supposed to be minimal. For long-term maintenance, I'd go with the Imuran. As someone else suggested, you could do both -- go on the entocort and raise your imuran dose...once you're stable, taper off the entocort and stay on the Imuran. Honestly, for me, Imuran has had the fewest side effects of any med I've taken (and I've been on a lot of them).