Using Imuran
Yes, I m taking the generic form of Imuran. The name is azathioprine.
My doctor added Imuran about 6 months after I started IVIG. I started at 50mg per day for a month. then 100 mg per day for a month. then 150 mg a day for about 9 months when I raised it to 175 mg per day.
Other forum members have cautioned using Imuran. Hmmm, let me think. No, I’ll look it up on line. Searching this forum is time consuming and tedious when you don’t know the exact words used.
Maybe it was this “…associated with abnormal AZA metabolism, is linked to the thiopurine methyltransferase (TPMT) genetic polymorphism. …”
Yes, there is a blood test for the condition “[I]…Thiopurines are a class of drugs that suppress the immune system. Examples include azathioprine, mercaptopurine, and thioguanine. These medications are used to treat diseases such as acute lymphoblastic leukemia, inflammatory bowel disease, and autoimmune disorders. They may also be prescribed to patients who have had organ transplants to help delay or prevent organ rejection. This test detects the activity level of the enzyme thiopurine S-methyltransferase (TPMT) in a person’s red blood cells. The activity level of TPMT is associated with the ability to effectively metabolize thiopurines. …[/I]”
In my case, I believe the testing was done by way of the slow titration to full, that is full ivig suppression dose, not full kidney transplant dose. The starting Imuran dosage for preventing rejection of a kidney transplant is 3 to 5 mg per kg once a day. In my case that would would be 3-5 times 80 or a daily dose of 240-400. so, you see, even 175 is well below that.
Keep the significantly lower dose in mind when you read about Imuran side effects.
It is expected to take 6 months to one year for the full effect to be noticed. Then, if I’m lucky, my IVIG can be weaned to zero.
Your doctor should order CBC (complete blood count) to monitor your blood counts (white, red, lymphocytes, etc) and CMP (comprehensive metabolic panel) to monitor your liver enzymes. When the doctor orders the tests, I recommend you inquire about levels he is looking for. That way, you can also look for them.
good luck