Imuran: Immunosuppressive Therapy for Autoimmune Conditions
Imuran
| Product dosage: 50mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 60 | 1.17 $ | 70.20 $ (0%) | 🛒 Add to cart |
| 90 | 1.09 $ | 105.30 $ 98.28 $ (7%) | 🛒 Add to cart |
| 120 | 1.05 $ | 140.40 $ 126.36 $ (10%) | 🛒 Add to cart |
| 180 | 1.02 $ | 210.60 $ 183.69 $ (13%) | 🛒 Add to cart |
| 270 | 0.99 $ | 315.90 $ 267.93 $ (15%) | 🛒 Add to cart |
| 360 | 0.98 $
Best per pill | 421.20 $ 353.34 $ (16%) | 🛒 Add to cart |
Synonyms | |||
Imuran (azathioprine) is a cornerstone immunosuppressive medication used to manage a range of autoimmune disorders and prevent organ transplant rejection. By selectively modulating the immune system, it helps control the underlying inflammatory processes responsible for tissue damage. This guide provides a comprehensive, expert-level overview of its use, benefits, and essential safety information for healthcare professionals and informed patients.
Features
- Active ingredient: Azathioprine
- Available in 25 mg, 50 mg, and 75 mg oral tablets
- Prodrug metabolized to active mercaptopurine
- Requires monitoring of complete blood counts and liver function tests
- Generic versions are widely available
Benefits
- Effectively reduces autoimmune activity, leading to disease remission or significant symptom reduction.
- Decreases the risk of organ rejection in transplant recipients, improving long-term graft survival.
- Allows for reduction in corticosteroid dosage, minimizing steroid-related side effects.
- Can induce long-term maintenance of remission in chronic conditions like inflammatory bowel disease.
- Offers a well-established safety profile with decades of clinical use and research.
- Provides flexible dosing that can be tailored to individual patient response and tolerance.
Common use
Imuran is primarily indicated for the prophylaxis of organ transplant rejection, typically in combination with other immunosuppressive agents. In autoimmune diseases, it is used for its steroid-sparing effects and to maintain remission in conditions such as rheumatoid arthritis, systemic lupus erythematosus, inflammatory bowel disease (Crohn’s disease and ulcerative colitis), autoimmune hepatitis, and certain dermatological conditions like pemphigus vulgaris. Its use is generally reserved for cases where first-line therapies have proven insufficient or when steroid toxicity becomes a concern.
Dosage and direction
Dosage must be individualized based on the patient’s condition, renal function, and tolerance. For transplant rejection prophylaxis: Initial dose is usually 3-5 mg/kg daily, beginning at the time of transplant. Maintenance doses are often 1-3 mg/kg daily. For autoimmune diseases: Initial dose is typically 1 mg/kg daily given as a single dose or in two divided doses. Dose may be increased by 0.5 mg/kg daily at 4-week intervals if necessary, to a maximum of 2.5 mg/kg daily. Should be taken with food to minimize gastrointestinal upset. Regular monitoring of blood counts is essential, particularly during the initial treatment period and after dosage changes.
Precautions
Complete blood counts should be monitored weekly during the first month, twice monthly for the second and third months, then monthly or more frequently if dosage alterations or other therapy changes are necessary. Liver function tests should be monitored periodically. Patients should be advised to report any signs of infection, unusual bruising or bleeding, or jaundice immediately. Use with caution in patients with impaired renal function, as dosage reduction may be necessary. Due to immunosuppression, patients may have reduced response to vaccinations and increased susceptibility to infections. Sun exposure should be limited due to increased risk of skin cancer.
Contraindications
Hypersensitivity to azathioprine or any component of the formulation. Patients with rheumatoid arthritis who have been treated with alkylating agents (cyclophosphamide, chlorambucil, melphalan, or others) may have a prohibitive risk of neoplasia if treated with Imuran. Should not be used in patients with clinically active pancreatitis. Not recommended during pregnancy unless potential benefits justify potential risks to the fetus. Generally contraindicated in patients with known TPMT (thiopurine methyltransferase) deficiency or very low activity.
Possible side effect
Common side effects include nausea, vomiting, diarrhea, loss of appetite, and mild hair loss. More serious side effects requiring medical attention include: signs of bone marrow suppression (unusual tiredness, fever, sore throat, mouth sores, easy bruising/bleeding), hepatotoxicity (yellowing eyes/skin, dark urine, abdominal pain), pancreatitis (severe abdominal pain, nausea/vomiting), and increased susceptibility to infections. Long-term use is associated with increased risk of neoplasia, particularly non-Hodgkin’s lymphoma and skin cancers. Other potential effects include rash, muscle pain, and drug fever.
Drug interaction
Allopurinol inhibits xanthine oxidase, dramatically increasing azathioprine toxicity - dose reduction to ¼ to ⅓ of the usual dose is necessary when used concomitantly. May potentiate effects of other bone marrow suppressants. Live vaccines should generally be avoided. Angiotensin-converting enzyme inhibitors may cause severe leukopenia. Warfarin effect may be reduced. Co-trimoxazole may increase bone marrow suppression. Ribavirin may increase the risk of pancytopenia.
Missed dose
If a dose is missed, it should be taken as soon as remembered unless it is almost time for the next dose. In that case, skip the missed dose and resume the regular dosing schedule. Do not double the dose to make up for a missed one. Patients should be advised to maintain a consistent dosing schedule and to contact their healthcare provider if multiple doses are missed.
Overdose
Symptoms may include nausea, vomiting, diarrhea, and hematological toxicity such as leukopenia, thrombocytopenia, and anemia. May also show signs of liver toxicity. There is no specific antidote. Treatment is supportive and should include gastric lavage if ingestion was recent, followed by intensive supportive measures and blood count monitoring. Hemodialysis is not likely to be effective due to high protein binding.
Storage
Store at room temperature (20-25°C or 68-77°F) in a dry place protected from light. Keep in the original container with the lid tightly closed. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging. Do not transfer tablets to other containers as moisture protection may be compromised.
Disclaimer
This information is provided for educational purposes only and does not constitute medical advice. Treatment decisions should be made by qualified healthcare professionals based on individual patient circumstances. Always follow the prescribing information provided with the medication and consult with a healthcare provider for personalized medical advice. The manufacturer’s prescribing information should be consulted for complete details.
Reviews
Clinical studies and decades of use demonstrate Imuran’s efficacy in maintaining transplant graft survival and controlling autoimmune disease activity. Many rheumatologists and gastroenterologists report satisfactory long-term outcomes with appropriate monitoring. Patients often experience significant improvement in quality of life when the medication effectively controls their condition. However, the requirement for regular monitoring and potential side effects are noted considerations in treatment decisions. Most experts emphasize that benefits generally outweigh risks when used appropriately in indicated conditions with proper supervision.