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Does flaring on Imuran mean its no good?

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Ulcerative Colitis
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Posted 7/23/2019 9:40 AM (GMT -5)
Hi, currently taking 200mg daily of azathioprine for treating my ulcerative colitis (pancolitis). 6 months so far.

Been having a lot of gas/cramps for last month or so and last couple of weeks seeing some mucus, only going between 1-2 times a day. BM’s constantly changing between constipation and loose.

I’ve now started seeing blood for the past 7 days, red, covering BM.

My question is, does this mean Imuran isn’t working or are occasional flares with blood and mucus that may require pred. normal from time to time?

Worried I may be moved onto the next step or drugs.

Recent blood work said calprotectin 100 and negative for c diff on stool test.


Thanks,
1wish
Posted 7/23/2019 9:50 AM (GMT -5)
Everyone flares eventually, could be the run-of-the-mill flare that a course of prednisone cures, or it could be disease progression that requires stronger medications henceforth. More often then not, it is the former, and less commonly the later. Hope for the best case, but begin wrapping your mind around the worst case just in case you need it.
Posted 7/23/2019 10:04 AM (GMT -5)
Thanks for the quick reply iPoop, I appreciate the feedback and positive vibes.
Unfortunately I always end up thinking the worse first anyway, I think in part due to my anxiety.

Hopefully it wont require new meds.

1Wish
Posted 7/24/2019 9:40 AM (GMT -5)
200mg, that's a pretty big dose. I've been on 100mg for 10+ years. Originally I was on 75mg, and I went quickly back into my irresolvable-flare problem, then the doctor bumped me up to 100mg and I had a good long remission. However I had at least one flareup a year on 100mg Aza plus 2400mg mesalamine, up to about 4 years ago when I switched to a less stressful job, and I haven't had a flare since.

But you shouldn't expect to never have a flare again just because you're on Azathioprine.

Being on Azathioprine means you should expect your flares to end sooner and occur less frequently.
Posted 7/24/2019 11:32 AM (GMT -5)
Azathioprine is dosed 2.0 to 2.5mgs per kilogram of body weight. So, it really depends on patient weight. At my current weight (165-pounds or 75-kilograms), I'd be prescribed between 150 to 187mgs of Imuran/azathioprine a day if I took that med.

I'm taking 6MP, which is roughly 1/2 the dosage of aza/imuran. Seems right, 75-mgs of 6mp is 1/2 of 150
Posted 7/24/2019 1:38 PM (GMT -5)
Thanks @UCinGV. Good to realize that flares will happen even on meds but should be less intense. Something I wasn't aware of really. I guess I just assumed it wouldn’t happen.

Cheers @iPoop, yeah I weigh around 83kg so makes sense my dose is 200mg like you mention. I wouldn’t mind it being less though as my WBC keeps dropping. Eager to see next set of results.

1Wish
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