Imurel

Azathioprine, the active ingredient in Imurel, is an immunosuppressant presented as an oral dosage form for oral use. It is used to prevent organ transplant rejection and to manage certain autoimmune diseases such as rheumatoid arthritis and inflammatory bowel disease.

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

Azathioprine is employed in conditions where immune suppression is required to control disease activity.

- Organ transplantation: reduces the risk of graft rejection by suppressing immune response. - Rheumatoid arthritis: helps control joint inflammation and slows disease progression. - Inflammatory bowel disease (Crohn's disease, ulcerative colitis): aids in achieving remission and reducing flare‑ups.

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

Common Side Effects: - Nausea or vomiting. - Decreased appetite. - Mild leukopenia or anemia. - Skin rash or itching. - Headache or fatigue.

Serious or Rare Side Effects: - Severe bone‑marrow suppression (pancytopenia). - Hepatotoxicity (elevated liver enzymes, hepatitis). - Pancreatitis. - Increased susceptibility to infections. - Malignancies such as lymphoma. - Severe hypersensitivity reactions (e.g., Stevens‑Johnson syndrome).

Before initiating azathioprine therapy, several safety considerations are recommended.

- Monitor blood counts: perform regular complete blood count tests to detect bone‑marrow suppression. - Assess liver function: conduct periodic liver enzyme tests. - Screen for infections: evaluate for active infections before and during treatment. - Avoid in known hypersensitivity: discontinue if severe allergic reactions occur. - Use caution in pregnancy: discuss potential risks with a healthcare professional. - Store at room temperature: keep in the original container, protect from moisture and light.

Azathioprine can interact with other medicines, altering its efficacy or safety.

Major Interactions (Avoid): - Allopurinol or febuxostat: may increase azathioprine toxicity. - Warfarin: heightened anticoagulant effect, increasing bleeding risk. - Live vaccines: risk of uncontrolled infection due to immunosuppression.

Moderate Interactions (Monitor Closely): - ACE inhibitors or ARBs: may enhance renal effects. - NSAIDs: can increase risk of bone‑marrow suppression. - Sulfonamide antibiotics: may augment myelosuppression. - Antifungal agents (e.g., fluconazole): may raise azathioprine plasma levels.