Crohn's patient: Imuran vs. Pentasa

May 9, 2009 2:27 PM

Hi there. My boyfriend is struggling with his Crohn's and has recently been switched from Pentasa (5-aminosalicylic acid (mesalamine)) to Imuran (azathioprine). He's wondering how long it has taken for Imuran to kick in for other Crohn's patients.

He was switched from Pentasa to Imuran because of his fatigue and because the GI found scar tissue and inflammation in his Ilium--indicating the Pentasa wasn't working.

He's been on Imuran for three weeks now, and has been suffering from diarrhea (only 2-3 BMs per day), abdominal cramps and pain, fatigue, loss of appetite and possibly a small amount of rectal bleeding. These symptoms aren't too severe--he is still able to go about his day, albeit with discomfort. After the bleeding about a week and a half ago, he got in touch with his GI, who didn't feel the severity of the symptoms warranted moving up to the next possible treatment, which would be cortico-steroids and told him to hold out on the Imuran for a few more weeks.

Basically my question is--does it take a while for Imuran to start working? What's been your experience with it?

While he has been calling his GI, it's a bit of an effort to get time with him, so he's debating whether to keep hounding the guy for answers now, or give the drug a couple more weeks to kick in.

posted by stray to Health & Fitness (1 answer total)

I have UC, but it took about 4-5 weeks for me to feel normal again after I started Imuran. However, during that time I was on Lialda and Canasa (both 5ASA) in addition to the Imuran. I eventually dropped the Canasa but still take Lialda. During that month, my symptoms got gradually better. I too had doubts about when or if it would work, but I waited it out because I wanted to make sure it didn't work before moving on to TNF inhibitors, like Remicade or Humira.

If you want to talk to more Crohn's patients, I've found the HealingWell.com forums to be quite good.
posted by mathlete at 2:46 PM on May 9, 2009