Imuran Mitis

Azathioprine, the active ingredient in Imuran Mitis, is an immunosuppressant presented as an oral formulation for oral use. It is used to suppress the immune response in conditions such as organ transplantation, rheumatoid arthritis, inflammatory bowel disease, and systemic lupus erythematosus.

GNH USA supplies Imuran Mitis 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 reduce abnormal immune activity. - Organ transplantation: helps prevent graft rejection by suppressing T‑cell activation. - Rheumatoid arthritis: reduces joint inflammation and slows disease progression. - Inflammatory bowel disease (Crohn's disease, ulcerative colitis): diminishes intestinal inflammation and maintains remission. - Systemic lupus erythematosus: controls systemic autoimmune activity and reduces flare severity.

Azathioprine may cause a range of adverse reactions, varying from mild to potentially life‑threatening.

Common Side Effects: - Nausea or vomiting: gastrointestinal discomfort that may occur early in therapy. - Loss of appetite: reduced desire to eat, sometimes with weight loss. - Fatigue or weakness: general feeling of tiredness. - Mild liver enzyme elevation: transient increase in ALT/AST.

Serious or Rare Side Effects: - Severe bone marrow suppression: pancytopenia or aplastic anemia. - Hepatotoxicity: significant liver injury or hepatitis. - Increased risk of infections: opportunistic or severe bacterial infections. - Possible malignancies: rare development of lymphomas or skin cancers.

Before initiating azathioprine therapy, several precautions should be observed to ensure patient safety. - Baseline laboratory testing: obtain complete blood count and liver function tests prior to treatment. - Monitor blood counts regularly: check CBC every 1–2 weeks initially, then monthly. - Assess liver function: repeat LFTs periodically to detect hepatotoxicity. - Screen for TPMT activity: consider testing for thiopurine methyltransferase deficiency to adjust dose. - Avoid use in active infection: postpone initiation if patient has uncontrolled infection. - Store at ambient temperature: keep tablets in original container, protect from moisture and heat below 25°C.

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

Major Interactions (Avoid): - Allopurinol or febuxostat: potentiate azathioprine toxicity, may require dose reduction. - Live vaccines: increased risk of infection, should be avoided during therapy. - Antithymocyte globulin: additive immunosuppression, heightening infection risk.

Moderate Interactions (Monitor Closely): - Warfarin: azathioprine may enhance anticoagulant effect, monitor INR. - Ribavirin: combined use can increase bone marrow suppression. - Mycophenolate mofetil: overlapping immunosuppressive effects, monitor blood counts.