I know how you feel -- when my husband needed to start imuran due to being sick for over a year and other meds not helping I was very nervous after reading everything about it.
He was started on the imuran along with 40 mg of prednisone to help jump start it. That was mid May last year during a hospital admission after a terrible flare. He had a very slow taper off the prednisone as 3-4 attempts off the prednisone previously did not go well.
6 weeks after starting the imuran he went from being a recluse with uncontrollable urgency and frequency to a situation of being able to go out a few hours here and there without being panic stricken.
His Dr had the promethius testing done 3 months after being on the imuran not prior to. Her feeling was she wanted to see how he was metabolising it etc. He was put on 75 mg to start which was a low dose as she was being very conservative to start. (It is a very expensive test...approx $850 which our insurance ended up covering after some dialogue back and forth.)
5 months later a 5 day appt with the Mayo clinic due to a referral that was in process by his regular local GI and the Dr there doubled his dose to 150 mg which he not only tolerates but put him in a semi-remission. He has to have a blood draw every month for 3 levels to be checked and the Dr authorizes another month of meds. This will be done for one year. When he goes back in Nov. we will see what the new arrangement will be.
His monthly levels have been great - the Dr. is somewhat pleased with his progress. My husband is basically pleased. He has his life back esentially. It is not perfect by any means but he has control where before the frequency and urgency was such that he needed to know every moment where a bathroom was and how close it was. Depending, if we are eating out sometimes he has to use the rest room like it or not. He hardly ever used a rest room outside but he has gotten over that now.
The Mayo clinic Dr knew how concerned I was by all the imuran related questions I was asking him. He indicated to me that imuran if monitored properly is a safe drug and very helpful to attain a remission and for me not to be so nervous about it.
I can verify and say without it for a year and 1/2 from the onset and trying various things this was what made the difference for him. He suffered for most of that year 1/2. It has been a little more than a year now since that hospital admission and life is so much better in comparison.
As you read this forum and what works for one may not work for another. You certainly have to be comfortable with your doctor and the choices. It is such a trial and error thing. My husband was at rock bottom and was not in a position to refuse as he was looking for something -- anything to reverse what he was going through.
Good luck with your decision and hope it helps you quickly.