Imuran

Azathioprine, the active ingredient in Imuran, is an immunosuppressant (antimetabolite) presented as a tablet for oral use. It is used to prevent organ transplant rejection and to manage autoimmune conditions such as rheumatoid arthritis, inflammatory bowel disease, and systemic lupus erythematosus.

GNH USA supplies Imuran as a licensed, GDP‑compliant international pharmaceutical supplier serving hospitals, transplant centres, oncology centres, pharmacies and clinics worldwide.

Azathioprine is employed in several immune‑mediated conditions to suppress abnormal immune activity.

- Organ transplant rejection: helps prevent graft rejection by inhibiting immune cell proliferation. - Rheumatoid arthritis: reduces joint inflammation and disease progression. - Inflammatory bowel disease (Crohn's disease, ulcerative colitis): maintains remission and decreases intestinal inflammation. - Systemic lupus erythematosus: controls disease activity and flares.

Azathioprine may cause a range of adverse reactions, varying from mild to severe.

Common Side Effects: - Nausea: mild gastrointestinal upset. - Vomiting: occasional episodes. - Diarrhea: loose stools. - Decreased white blood cell count: mild leukopenia. - Elevated liver enzymes: mild transaminase rise.

Serious or Rare Side Effects: - Severe bone marrow suppression: pancytopenia. - Hepatotoxicity: significant liver injury. - Increased infection risk: opportunistic infections. - Pancreatitis: abdominal pain with elevated enzymes. - Malignancy: rare increased risk of lymphomas or skin cancers.

When prescribing azathioprine, several safety considerations should be observed.

- Baseline testing: obtain complete blood count and liver function tests before initiation. - Monitoring: perform regular CBC and LFTs to detect hematologic or hepatic toxicity. - Infection risk: assess for active infections and vaccinate appropriately before treatment. - Pregnancy: avoid use unless benefits outweigh risks; category D. - Drug interactions: review concomitant medications that affect thiopurine metabolism. - Store at ambient temperature: keep tablets in original container, protect from moisture and light.

Azathioprine interacts with several agents that can alter its efficacy or safety.

Major Interactions (Avoid): - Allopurinol or febuxostat: can cause severe bone marrow suppression. - Thiopurine methyltransferase (TPMT) inhibitors: increase risk of toxicity. - Live vaccines: may lead to uncontrolled infection.

Moderate Interactions (Monitor Closely): - Warfarin: azathioprine may enhance anticoagulant effect. - Mycophenolate mofetil: additive immunosuppression increasing infection risk. - Ribavirin: potential for enhanced hematologic toxicity.