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How often for Metabolite Testing for Imuran??

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Ulcerative Colitis
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Posted 9/17/2009 8:50 PM (GMT 0)
I have to start on Imuran.  I need to get the blood work done by Prometheus Lab and my insurance won't pay for it.  It will be $270.  They told me if I pay within 31 days it will be 35% off and cost about $175.50.  I just want to know if it is a test that is done on a regular basis.  Does anybody get this done while on Imuran??  I really need to start the meds.
Posted 9/17/2009 9:31 PM (GMT 0)
The intial test is to test whether or not you have the proper enzymes to break this med down with no toxicity. After the initial test, they do the Metabolites test to see how well your body is responding to the dose you are on. The first test is usually the more expensive of the two. My insurance (which is a HMO) covered the majority of the first Prometheus and I just had to pay $65. The metabolites test, I don't have to pay anything because it is considered a preventative/maintenance test.

When I first started 6mp, I had the metabolites test about once every 3 months to see at what thereupedic level I was at.
Posted 9/17/2009 9:43 PM (GMT 0)
My insurance won't pay for any of it because it is out of network. I will have to pay for it because I need the Imuran. The Remicade is not working and I am getting worried.
Posted 9/17/2009 11:04 PM (GMT 0)
     Wow...I never had the metabolytes test and I have been on 6MP for seven years!!!  Doctor never mentioned a word about it.  What exactly is the name of the test....is it Metabolyte....or is it known by another name?  He does send me for monthly blood tests but they are usually CBC's.  He is sending me for a liver panel because my bilirubin was elevated last month.  Does a regular lab do the test or does it have to be sent somewhere?  Now I am worried sad
Posted 9/18/2009 2:43 AM (GMT 0)
The only lab is Prometheus Lab in San Francisco. You can look it up and they list all the tests. He won't even let me start the pills without getting this first. Almost makes me scared to take the pill. Third dose of Remicade has done nothing so I guess it is worth a try. Will be paying for the blood work. Only the lab at the hospital can draw the sample. It has to be done with a kit they told me. Doctor will give me the kit, they will draw the blood and it is sent to the Prometheus Lab.
Posted 9/18/2009 4:38 PM (GMT 0)
Christine, some docs have a different protocol when it comes to being on immune suppressor. You had some issues with 6mp right? Your doctor should've done the Metabolites test to see if you were even at the thereupedic level before trying to increase your dose to 100mgs. The trouble that you had could've been avoided (maybe). When I was at 50mgs, the doc did a Metabolites test and I was just below the low end of the thereupedic level. So my doc increased my dose to 100mgs for only 2 days a week and the rest of the days are still at 50mgs. He then sent in the Metabolites test and found that this increased to just slightly above the low end of the thereupedic level. However, I can't go any higher because I have had one or two blood tests that showed slight liver toxicity. I was monitored closely after that but then my levels stabilized again.

I go to a regular lab to have mine drawn. It is then sent to California where the Prometheus labs are located. Results usually take about 3-5 days.

If you are concerned about this, ask your doc about it the next time you see him. Because if you not properly processing this med, then it may not even be worth it to be on it considering all that you've been thru.
Posted 9/18/2009 7:09 PM (GMT 0)
     Thanks Sherry.  I see him next Friday.  On Thursday I am going over to the Univ of PA hospital to see a Dr. Liechenstein who is supposed to be an expert on treating UC.  I am now in remission and have waited over two months to get in to see this guy.  My GI is sending me there.
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