Imuran: How long does it take to work?

Hey there.

I've been having a mild flare up since Nov 1. My doctor put me on Imuran 150mg (also taking Lialda) but it hasn't kicked in yet. It's been about 2.5 months now and symptoms of flare are almost exactly the same as when it started. I've read on the internet that Imuran does take time to start working but that when it does, it can be a miracle for those who can tolerate it. So far, zero side effects, so that's good.

I'm wondering if anyone out there is taking Imuran and how long it took for symptoms to start disappearing? I'm getting a little impatient

Note: I realize many docs prescribe Predn in conjunction w/Imuran. I had just come off Predn at the end of Oct and was feeling better then flare started again the first week off Predn and on Imuran. Hope that's not too confusing.

Thanks.

2.5 months is a pretty long time, I would expect to have seen some result by now. There is a blood test you can take that tells you where you are in the range of therapy with imuran/6mp. If you're low, they can increase the dose if you're tolerating it well. If you're high on the range, and you're not having results, it may not be working as intended, but that seems like it's pretty rare. Usually if you're in the correct range, it is working as it should, and giving it some more time will likely provide the expected benefit. Have you been getting regular blood work? I wonder if they are running the thiopurine metabolites test. Usually you wouldn't taper off the pred until you felt like you were having some benefit from the imuran.

To clarify, the above two posts are referring to the same thing. Ask for a Thiopurine Metabolites blood test. Here's a link to labcorp's page, although most labs will do this test:

/www.labcorp.com/test-menu/35596/thiopurine-metabolites

The test enables your doctor to tell if you have reached ideal therapeutic (healing) levels within your body with Imuran. There's a rough dosage guideline of 2.0 to 2.5milligrams of imuran to every kilogram of patient body weight. However, everyone is different and some might need more/less depending on the test. Your doctor can add more mgs per day. If you're already in the ideal range, yet still experiencing UC symptoms then you can discuss adding more meds to get the desired result.

Thiopurine Metabolites is a different diagnostic test for Imuran than you are currently taking. It needs to be ordered separately. It's specific to ascertain proper dosing.

Your regular bloodwork while on Imuran would be (1) a Complete Bloodcell Count (CBC) and (2) a Liver/Hepatic Function Panel (LFP). When we flare our Whiteblood Cell count skyrockets. Essentially, they are watching your WhiteBloodcell Count (WBC) as imuran intentionally lowers your WBC count (the less WBC you have, the less inflammation WBC can cause within your large intestine, and the better your UC symptoms get) but WBC needs to stay within a safe range so you can fight off everyday germs. Also HFP makes sure you are not having a bad reaction to the imuran (your liver proteins would skyrocket in that eventuality). These are good precautions and essential routine tests to have while you/I are on on Imuran (they are reduced to every 3-months after a while).

Post Edited (iPoop) : 1/17/2018 12:58:21 PM (GMT-7)

Samura,

My understanding is that UC is caused by a "flawed" immune system.

As it relates to inflammation, organs like your colon become inflamed when your system is trying to fight off unhealthy cells, typically caused by bacteria, infections, etc. Everyone has this done, that's why everyone gets diarrhea at times when they are ill or something doesn't sit right.

Our problem, again if this is the belief you have, is that the immune system is improperly inflaming your colon, rectum, etc. when it shouldnt be. Hence the constant diarrhea, urgency, etc.

There's also people who think the immune system isnt the problem and instead the colon or whatever area in your body is inflamed does have some type of bacteria or cells there that cause the colon to be inflamed. I'm not sure how these unhealthy cells/bacteria could escape the eyes of medical professionals for all these years, but it is still a worthwhile hypothesis.

your doctor tells you eat foods to strengthen your immune system because of the medication. for certain medications, the medication is fighting off your immune system to reduce your inflammation, this reduction in immune system strength can make you more prone to diseases that a similar, healthy version of you would otherwise be able to fight off.

It's confusing. and no clear answer in the medical world certainly adds to that. I think even if they find the root cause of these diseases, that still doesnt necessarily get us back to a perfect treatment method.