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Ulcerative Colitis
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Posted 5/7/2015 2:43 PM (GMT 0)
My doc prescribed me to Imiran 50mg a day. He hasn't ordered any blood tests or tests of any type. Just a follow up appointment in 3 weeks. What do y'all think of this? I'm having a horrible flare. On 30 mg of Prednisone for the last two weeks which hasn't helped at all as far as I can tell. He said Imuran will help the steroids. Any tips on what not to eat?
Posted 5/7/2015 2:52 PM (GMT 0)
You'll probably get blood drawn at your follow up appointment. If 30mg of pred isn't working, you might need to up it. But the Imuran might help too. As far as what not to eat, you can find numerous forums on here about food, but it's all individual. Food has no effect on some people, while others can't eat anything. Some people have problems with alcohol, others can drink as much as they want. The best tip I can suggest is to keep your own food diary and write down what you ate and how you react to it. You're going to get better results doing that I think than asking people on here because everyone is different. For me if I'm flaring I know I can't have corn, popcorn, spicy foods, or coffee. But it's different for everyone.
Posted 5/7/2015 4:21 PM (GMT 0)
Yeah I imagine he will order bloodwork in three weeks. 50mg is a pretty low dose. I'm a little fuzzy on the Imuran helping the steroids. I don't think they technically help the steroids but the combination might help your UC. Imuran can take months to kick in.
Posted 5/7/2015 5:31 PM (GMT 0)
Before I was put on azathioprine (generic Imuran) I had to get a lot of blood tests to make sure I didn't have any liver problems (like hepatitis) and there was also a special blood test to check for something but I can't remember what it was.

Imuran won't help the steroids, but will become your new maintenance medication. It will take 2-4 months to fully kick in. 50 mg is pretty low, but maybe he wants to start you low and then build up. The dose is based on weight and is roughly about what you weigh -- if you weigh 125 pounds your max dose would probably be 125-150 mg.

30 mg of pred is kinda low for kick starting remission when in a flare. Most times I see 40 mg as the starting does and sometimes even higher than that. My suggestion would be to ask him to go up 40 mg for 5-7 days and see if that helps, and then taper down. Last time I was on pred, dr told me to stay on 40 mg for 2 weeks unless I started seeing improvement sooner and then start the taper. I saw improvement within 7 days so started tapering after that
Posted 5/7/2015 7:59 PM (GMT 0)
I was given weekly blood tests to monitor my CBC and liver function when I started 6mp (a similar medication to Imuran, just metabolized slightly different in the body). I think it's very odd you aren't being monitored. I'd call your gastroenterologist office and ask about it, perhaps it was an oversight.

Imuran's purpose is to lower your white blood cell count (they cause inflammation in the body) but it cannot get too low, the cbc test checks for that. The liver function bloodtest looks for liver proteins that indicate Imuran is causing toxicity within the liver. Should that be picked up in your test, then they either cease Imuran or lower the dosage. It's important because toxicity can permanently damage your liver. Both are very rare side effects, but important to verify you aren't encountering them. It's irresponsible not to monitor your blood when starting this medication.
Posted 5/7/2015 9:34 PM (GMT 0)
With IBD, diet is pretty much trial and error since it varies from patient to patient what they can or can't tolerate diet wise...fiber does help with diarrhea or constipation so you might want to look into either a supplement form or via food, if you struggle eating fiberous foods then using a supplement daily would likely be of benefit, just make sure you drink lots of water while on fiber supplements (you should drink lots of water regardless really) and especially when you take your fiber supplement in pill form.
Posted 5/8/2015 1:17 AM (GMT 0)
he should do a blood test before putting you on it in order to make sure you can metabolize it. You may want to call back and ask to have one done, otherwise you may react badly to it.

I've been taking it for over a year and it seems to be working (or at least my combo of meds are).

I started out with a horrible flare, 9 days in the hospital and about 1.5 months of diarreah/pain/blood. My cure was 60 mg of prednisone once a day in the morning. then 3 asacol HD in the morning. At night i'd take 3 more asacol HD and then put in a canasa suppository (14 days worth). Then i think it was 2 weeks later i started weaning off prednisone every week by about 5 mgs until i was off. When i was down to about 20mg i started imuran (azathioprine). I take 2 of those at night. i went into a remission and have been taking 3 asacol in the morning and 3 at night with the Imuran at night and went about 15 months before i saw a little blood. They had cut my asacol in half in march so i am back up to the 6 total a day and using canasa for 14 days. After just 2 days of canasa and upping the asacol again i have not had any more blood.

Everyone is different but this treatment plan worked for me. My doctor has been really wonderful and knowledgable so i really trust him a lot. I think asking for a blood test before is in your best interest. my doctor said that getting one before is more important than follow up blood tests because in the past they didn't have the capability to test people before hand, only after. If the option is out there it should be something available to you to be safe and educated when making your decision to take a new medication.

Good Luck
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