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How To Wean Off Imuran Slowly Without Any Side Effects?

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Posted on Thu, 19 Mar 2015
Question: Guidance for getting off of 150 mg Immuran a day (after several years)
doctor
Answered by Dr. Baranidharan Kuselan (2 hours later)
Brief Answer:
Why are you on imuran?

Detailed Answer:
Hi there,
Thanks for using HCM.

I would like to have some more information.

1. Why are you on imuran?
2. What symptoms you have?
3. Are you on any other medications?

With kind regards,
Dr.Barani
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Baranidharan Kuselan (40 minutes later)
I have Primary Sjorgren's and was put on Imuran (after a trial period in which my rheumatologist explored other medication possibilities) because i developed a so-called, I suppose, Sjorgren's lung and was diagnosed with interstitial lung disease and some asthma. I have had bacterial pneumonia at least twice in the past couple years (yes, I have had the pneumonia vaccine). I have cough (off and on) and sometimes shortness of breath. I also have osteoporosis, osteoarthritis, and secondary pulmonary hypertension when the asthma kicks in. For a while I was on oxygen 24/7, but I responded so well to diet, exercise, and Imuran I was able to go off of it entirely and my normal oxygenation rate stays right around 94. I found Furhman and very much believe in his diet but am afraid of taking the big step of going off Imuran although his books say his diet can do it. My pulmonologist and rheumatologist will discuss this same question and my pulmonologist has shared with me the desire to lower or get me off the Imuran but he realizes/knows the possible hazards of it not being the principle reason for my improvement. I have lost over 100 lbs and held it for three years and have moved from a sedentary lifestyle to one with regular exercise (walking and recumbent bicycle.) I decided to reach out to your community and think about this question, as well, to the best of my ability. I am also rereading Furhman. Thank you for exploring this with me. Oh, I do have a heart stenosis which I have had for some 60 years but it causes me no known issues and has been checked out frequently.
Medications for hypertension (under control): Losartan, Lovazza; I was on Furosemide for edema but have recently discontinued it. Because of the Furosemide I was on potassium (Klor-Con). I take a baby aspirin, a multi-vitamin, and calcium and vitamin D. I also take CYMBALTA for arthritic pain primarily.
doctor
Answered by Dr. Baranidharan Kuselan (23 hours later)
Brief Answer:
Plan to stop imuran given below

Detailed Answer:
Hi,
Thanks for the additional information.
I believe your symptoms are kept under control by Imuran 150 mg you take per day.
I fear that there might be a flare up of your symptoms if you stop imuran.

Fuhrman diet is essentially a micronutrient rich diet.
I have read many patient stories where they have said after a few weeks of Fuhrman diet they got good relief of symptoms.
But unfortunately there are no randomised controlled trials which says Fuhrman's diet alone without medications can provide relief.

So I would advise you to start of Fuhrman's diet plan along with the full dose of Imuran you are taking now.
After 4 weeks decrease the dose of imuran to 100 mg (from 150 mg), and see whether you remain symptom free. If there is no flare with this reduced dose and Fuhrman diet plan, continue with this dose for 4 more weeks.
Try to reduce the dose further and assess your symptoms. If there is no flare up decrease the dose of imuran further to 50 mg and continue with Fuhrman diet.

With this time interval try to stop imuran after a few weeks.

But discuss with your doctor before tapering imuran. And always watch for flare up of symptoms.

I hope that answers your question.
Let me know if you have any more questions.

With kind regards,
Dr.Barani


Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Yogesh D
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Answered by
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Dr. Baranidharan Kuselan

Pain Medicine & Palliative Care Specialist

Practicing since :1996

Answered : 417 Questions

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How To Wean Off Imuran Slowly Without Any Side Effects?

Brief Answer: Why are you on imuran? Detailed Answer: Hi there, Thanks for using HCM. I would like to have some more information. 1. Why are you on imuran? 2. What symptoms you have? 3. Are you on any other medications? With kind regards, Dr.Barani