Imurel

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

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

Azathioprine is employed in the management of immune‑mediated conditions and to prevent graft rejection.

Prevention of organ transplant rejection: reduces the risk of acute and chronic rejection by suppressing lymphocyte activity. Rheumatoid arthritis: alleviates joint inflammation and slows disease progression. Inflammatory bowel disease (Crohn's disease, ulcerative colitis): helps achieve and maintain remission by dampening intestinal immune response.

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

Common Side Effects: - Nausea or vomiting - Loss of appetite - Mild leukopenia or anemia - Rash or pruritus - Fatigue or headache - Elevated liver enzymes

Serious or Rare Side Effects: - Severe bone‑marrow suppression leading to pancytopenia - Life‑threatening infections - Hepatotoxicity or cholestatic jaundice - Pancreatitis - Increased risk of malignancies such as lymphoma - Severe hypersensitivity reactions

Before initiating therapy, several precautions should be observed.

Monitor blood counts: regular CBC to detect leukopenia or anemia. Assess liver function: periodic LFTs to identify hepatotoxicity. Screen for infections: evaluate and treat active infections prior to use. Avoid use in patients with known hypersensitivity to azathioprine. Pregnancy considerations: discuss potential risks with the prescriber. Store at ambient temperature: keep below 25 °C, protect from moisture and light in the original container.

Azathioprine interacts with several medicines; some require avoidance while others need careful monitoring.

Major Interactions (Avoid): - Allopurinol: can markedly increase azathioprine toxicity. - Warfarin: may enhance anticoagulant effect and increase bleeding risk. - Live vaccines: heightened risk of infection due to immunosuppression.

Moderate Interactions (Monitor Closely): - ACE inhibitors: may affect renal function when combined. - Sulfonamides: additive bone‑marrow suppression potential. - Rituximab: may increase overall immunosuppressive burden.