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stopped imuran, now flare

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Ulcerative Colitis
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Posted 7/28/2020 9:51 AM (GMT -5)
Well, I made a mistake. I have been taking 50mg of Imuran for about 10 years give or take.
My family doctor had mentioned to me in the past to try getting off the drug but my GI says I should stay on if life is good.
I saw my family dr again in April and with his counsel again he suggested going to 25mg then getting off all together if I had no symptoms. Well being a scary med, and dealing with minor side effects (such as skin issues) over the years, I though ok, why not try. So I did, and 2 weeks ago I stopped.
Bam - Flare up. First one this severe in years. My body aches, loose stools, zero energy.
As someone that prides themselves on health and fitness, this has gotten me severely depressed and worried. I am supposed to be on a trip this coming week which includes many miles of hiking but my current energy is zero.
Trying to do things like yoga and keep my body moving and stress down.
I re-started 50mg of Imuran 2 days ago.
My question is, has anyone ever stopped Imuran before? Did you flare and if so, if you re-started did that help the flare? How long until I build up a dose that is effective again.
Appreciate everyone's thoughts and hope you're all doing well.
Posted 7/29/2020 8:43 AM (GMT -5)
I would recommend contacting your gasteroenterologist asap and reporting this flare. Your gasteroenterologist will run some labs to see how much Inflammation and verify it isn't an infection like CDIFF.

Stopping imuran had a roughly 6-8 week before it has any affect on you, similarly restarting has no affect until 6-8 weeks later. Why? Imuran slows the rate in which new White blood cells (WBCs) can be produced in your body, effectively dropping the maximum WBCs you can have at any one time. Imuran doesn't effect any WBCs that are currently in your circulatory system. The average clearance period is 6-8 weeks where your body dumps old WBCs and releases new ones into your blood. Thus that interval.

So if you ceased imuran 2 weeks ago, then this flare is coincidence or could be an infection. Your cessation will have an affect later on though. You might need to be on a corticosteroid like budesonide or Prednisone as a bridge until you recover. As simply restarting imuran might not be enough.
Posted 7/29/2020 12:13 PM (GMT -5)
Thank you ipoop. I'm definitely going to do that as soon as I return if symptoms haven't subsided, or of course should they get worse and i can't go.
Timing is everything and this of course is quite frustrating, which I don't need to explain to any of you.
I've strictened everything up and am hoping for the best. But agreed, won't wait too long.
Posted 7/29/2020 5:05 PM (GMT -5)
Did you take it with allopurinol? Because then it is possible to flare quickly after stopping. Otherwise indeed it should take months to be out of your system.
Ps re read your post. So you went to 25mg in April? Then indeed it could be a flare triggered by reducing the dose.
Posted 7/29/2020 11:04 PM (GMT -5)
Hi, no I did not take with allopurinol.
I did go to 25mg in April and after reading ipoops reply also thought possibly that was it.
I just started 50mg again and will see if this improves any or not. If not of course I'll have to see my GI but hoping it doesn't come to that. More meds.
Frustrating tho as I was really hoping I may have been able to reduce or eliminate imuran but... guess maybe not in the cards just yet?
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