Imuran and GI issues?

[ArlaMo]

Dr. Langford had me start taking Imuran two weeks ago as a maintenance med - 50mg to start, then 100mg after a week and today I took the full dose of 150mg. I could not keep anything down this morning! :sad: Ugh - this is hard because I've been feeling pretty good lately.

What's your experience? Will it get better?

I was on ctx for 11 months and although I was nauseous for the first 6-8 weeks, I never threw up. I barely made it home from the lab this morning to run to the bathroom.

[elephant]

Let her know, you may need to decrease the drug or switch.

[drz]

I didn't have any nausea when I started azathioprine (Imuran) but my increases were a lot more gradual. If you think it is the drug causing it, maybe the doctor will support you backing up the dosage to 100 again and see if problems go away. Then maybe go up to 125 for awhile before resuming the 150 mg. That is what i think my doctor would have done for me if the drug was causing the vomiting so see what they think and recommend for you.

[Sangye]

Do you have to take the daily dose all at once? I was never on imuran so I don't know. With ctx I had to split it up into 3 doses or I'd get horrible stomach pain.

[drz]

I think you can take it all at once but I don't. I set my pills up once a week and so when the increase was ordered from 100 to 150 it was easier for me to just add the 50 to the evening dosage since i had taken the morning dosage already and just kept doing it that way. Now i take 100 in AM and 75 in PM and doctors said it was fine to do it that way so I just continued. It also keep my pills amount a little more even since many pills I take twice a day. I think it helps balance out the load on my liver too but not sure it makes any real difference.


Do you have to take the daily dose all at once? I was never on imuran so I don't know. With ctx I had to split it up into 3 doses or I'd get horrible stomach pain.

[Rose]

Imuran 100mg daily was the drug of choice for me to maintain remission following cyclophosphamide IV treatment. I was fine for 5 weeks or so but then started experiencing nausea, stomach pain and vomiting. At first I did not relate it to Imuran as I took the Imuran after breakfast and these symptoms only occured about 3 to 4 hours later at first lasting an hour or so but by the 4th day the symptoms were very severe and lasting about 3 to 4 hours. This is when I contacted the doctor. i stopped the imuran and the relief was immediate. i restarted a week later and intended to split the dose to morning and evening but n ver got to take the evening dose as the severe symtoms returned. I believe the splitting of the dose does help a lot of people to tolerate Imuran but I am sure in my case that I had an allergic reaction to it. I have since discovered that Imuran is not tolerated by some people because of a faulty enzyme. Apparently there is a test available to check for this and some doctors will only commence treatment with Imuran after testing.

[Palmyra]

Hi AriMo,
My daughter also experienced GI problems with imuran, and her physician's nurse caught it pretty quickly. She would have similar symptoms, most pronounced after eating. In her case Imuran had caused pancreatisis, and it was not a pretty road to resolution. I hope that is not the case for you, and that you are able to find a way to tolerate the drug. It seems to be a great maintenance drug.

[Sangye]

You can still have a bad reaction to imuran even if the enzyme test says it's alright for you. They should always do the enzyme test prior to putting someone on imuran.

[drz]

You can still have a bad reaction to imuran even if the enzyme test says it's alright for you. They should always do the enzyme test prior to putting someone on imuran.

I think they usually start you out with a small dosage too to double check if you can tolerate the drug and then slowly increase it to reduce risk of reaction. They told me it was rare that anyone lack the enzyme but still did the test. it took awhile though to get the results since they had to send it to some special place like they do for ANCA tests too.

[ArlaMo]

I had the enzyme test done before I started and results were fine. I did fine on the 50mg and fine on the 100mg, just a tiny bit nauseous. But that 150mg yesterday hit me hard. I'm almost afraid to take it today. I'm going to try splitting the dosage and see how that goes.

[pberggren1]

Isn't there an enzyme test that should be done for mtx as well?

[Sangye]

No, only imuran has a test.

[RudiK]

I was on 100mg CTX (50mg twice a day) for five months, and switched to 150 mg Imuran (50mg three times a day) two weeks ago. So far no problems. I'm also still on 7.5 mg Preds daily.
Rudi K.

[pberggren1]

No, only imuran has a test.

okay, I thought mtx did too cause I was sure that I had my doc do a test for something that he sent to Mayo back in 2004, but I could be mistaken. I have never been wrong, but mistaken a few time......lol:wink1:

[ArlaMo]

Doc took me off the Imuran for a few days - even backing off to 100mg, I was having pretty severe GI issues. We going to try one more time - start again at 50 and stop at 100, but if problems persist, he said Cellcept is the next option.

[elephant]

It appears most of these meds can cause havoc on our GI system. Hope you start to feel better soon!

[drz]

Doc took me off the Imuran for a few days - even backing off to 100mg, I was having pretty severe GI issues. We going to try one more time - start again at 50 and stop at 100, but if problems persist, he said Cellcept is the next option.

Sounds like a good plan and hope it works out for you. Good luck!

[Sangye]

I hope you're feeling better by now, ArlaMo!

[ArlaMo]

Well, the re-introduction of Imuran lasted all of 90 minutes and that was at 50mg. Let's just way I weigh 5lbs less (clothed!) than I did this morning (sans clothes.) Meeting with the doc later this week to discuss alternatives.