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Azathioprine is manufactured by Glaxo SmithKline Inc. This medicine is an immunosuppressive agent used to prevent rejection after a kidney transplant. It may also be used to treat rheumatoid arthritis and other conditions as determined by your doctor.
Why is Imuran prescribed?
Imuran is given after organ transplant surgery to help prevent rejection of organs (kidney, heart, or liver) by holding down the body's immune system. It is also used to avoid long-term rejection in people previously treated with other immunosuppressant drugs, such as Imuran. Neoral is a newer formulation of Imuran's active ingredient, cyclosporine. In addition to prevention of organ rejection, it is prescribed for certain severe cases of rheumatoid arthritis and psoriasis. Some doctors also prescribe Imuran to treat alopecia areata (localized areas of hair loss), aplastic anemia (shortage of red and white blood cells and platelets), Crohn's disease (chronic inflammation of the digestive tract), and nephropathy (kidney disease). Imuran is sometimes used in the treatment of severe skin disorders, including psoriasis and dermatomyositis (inflammation of the skin and muscles causing weakness and rash). The drug is also used in procedures involving bone marrow, the pancreas, and the lungs.
Imuran is always given with prednisone or a similar steroid. It is available in capsules and liquid, or as an injection.
Where can I order Imuran From? Can I buy Imuran at Canadian Prices?
Yes, if you are from the U.S. then you can buy Imuran at Canadian prices. Currently we will only accept an order for Imuran from U.S. and Canadian residents. Both U.S. and Canadian residents require a prescription to purchase Imuran and when you order Imuran it will be delivered with express shipping.
Most important fact about Imuran
If you take Imuran orally over a period of time, your doctor will monitor your blood levels of cyclosporine to make sure your body is receiving the correct amount of Imuran. The reason for this repeated testing is that the absorption of this drug in the body is erratic. Constant monitoring is necessary to prevent toxicity due to overdosing or to prevent possible organ rejection due to underdosing. It is important to note that Imuran may need to be taken by mouth for an indefinite period following surgery.
How should you take Imuran?
Take the Imuran capsule or oral liquid at the same time every day. You may take the medication either with a meal or between meals, but be consistent. To make Imuran oral liquid more palatable, you may mix it with room-temperature milk, chocolate milk, or orange juice. Try to use the same beverage as often as possible. Neoral oral solution may be mixed with room-temperature orange or apple juice. It does not taste good in milk. Use a container made of glass, not plastic. Never let the mixture stand; drink it as soon as you prepare it. To make sure you get your full dose, rinse the glass with a little more liquid and drink that too. You should maintain good dental hygiene and see your dentist frequently for cleaning to prevent tenderness, bleeding, and gum enlargement. After you use the dosage syringe to transfer the oral solution to a glass, dry the outside of the syringe with a clean towel and put it away. Do not rinse or wash it. If you do have to clean it, make sure it is thoroughly dry before you use it again. You may notice an odor when you open the capsule container; this is nothing to worry about and will soon dissipate. Neoral should start to work on rheumatoid arthritis in 4 to 8 weeks, and on psoriasis in 2 weeks. Psoriasis is usually controlled within 12 to 16 weeks; you should not take the drug for more than a year. --If you miss a dose...If fewer than 12 hours have passed, take it as soon as you remember. If it is almost time for the next dose, skip the one you missed and go back to your regular schedule. Do not take 2 doses at once. --Storage instructions...
Store both the capsules and the oral solution below 86 degrees F; do not store the liquid in the refrigerator. Keep the liquid from freezing. Imuran liquid, once opened, must be used within 2 months.
What side effects may occur with Imuran?
Side effects cannot be anticipated. If any appear or change in intensity, inform your doctor immediately. Only your doctor can determine if it is safe for you to continue taking Imuran. The principal side effects of Imuran are high blood pressure, hirsutism (unusual growth of hair), kidney damage, excessive growth of the gums, and tremor.
Other common side effects may include:
Abdominal discomfort, acne, breathing difficulty, convulsions, coughing, cramps, diarrhea, flu-like symptoms, flushing, headache, liver damage, lymph system tumor, muscle, bone, or joint pain, nasal inflammation, nausea, numbness or tingling, sinus inflammation, vomiting, wheezing
Less common side effects may include:
Abdominal distention, allergic reactions, anemia, appetite loss or increase, bleeding gums, blood disorders, brittle fingernails, confusion, conjunctivitis (pinkeye), dizziness, fever, fluid retention, frequent urination, hearing loss, hiccups, high blood sugar, indigestion, infection, insomnia, nervousness, peptic ulcer, rash and other skin disorders, ringing in the ears, stomach inflammation, vertigo
Rare side effects may include:
Anxiety, blood in the urine, breast development in males, chest pain, constipation, depression, hair breaking, heart attack, itching, joint pain, lymph disorders, mouth sores, night sweats, sluggishness, stomach and upper intestinal bleeding, swallowing difficulty, tingling, visual disturbance, weakness, weight loss
Why should Imuran not be prescribed?
Do not take these products if you have ever had an allergic reaction to them. Avoid Imuran by injection if you have ever had an allergic reaction to an injection of the drug or you are especially sensitive to castor oil.
Avoid taking Neoral for arthritis or psoriasis if you have a kidney condition, high blood pressure, or cancer. While taking the drug, you should avoid most other psoriasis treatment, including ultraviolet light, coal tar, methotrexate, and radiation.
Possible food and drug interactions when taking Imuran
Avoid getting immunizations while you are taking Imuran. The drug may make vaccinations less effective or increase your risk of contracting an illness from a live vaccine. If taking Neoral for psoriasis, remember to avoid other psoriasis treatments. Avoid grapefruit and grapefruit juice while taking this drug. Also avoid the antidepressant herb St. John's Wort. This over-the-counter herbal remedy reduces the effect of Imuran and Neoral, and can lead to organ rejection.
If Imuran is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Imuran with the following:
Allopurinol (Zyloprim)
Amiodarone (Cordarone)
Amphotericin B (Fungizone, Abelcet)
Bromocriptine (Parlodel)
Calcium-blocking heart and blood pressure medications such as Calan, Cardene, Procardia, and Cardizem
Carbamazepine (Tegretol)
Cimetidine (Tagamet)
Clarithromycin (Biaxin)
Colchicine
Danazol (Danocrine)
Diclofenac (Voltaren, Cataflam)
Digoxin (Lanoxin, Lanoxicaps)
Erythromycin (E.E.S., Erythrocin, others)
Fluconazole (Diflucan)
Gentamicin (Garamycin)
Indinavir (Crixivan)
Itraconazole (Sporanox)
Ketoconazole (Nizoral)
Lovastatin (Mevacor)
Melphalan (Alkeran)
Methotrexate
Methylprednisolone (Depo-Medrol, Medrol, Solu-Medrol)
Metoclopramide (Reglan)
Nafcillin (Unipen)
Nelfinavir
Nonsteroidal anti-inflammatory drugs such as Clinoril and Naprasyn
Octreotide (Sandostatin)
Orlistat (Xenical)
Phenobarbital
Phenytoin (Dilantin)
Potassium-sparing diuretics (Dyrenium, Midamor, Aldactone)
Prednisolone (Delta-Cortef, Prelone)
Quinupristin (Synercid)
Ranitidine (Zantac)
Rifampin (Rifadin, Rifamate, Rimactane)
Ritonavir (Norvir)
Saquinavir (Fortovase)
Ticlopidine (Ticlid)
Tacrolimus (Prograf)
Tobramycin (Nebcin)
Trimethoprim/sulfamethoxazole (Bactrim, Septra)
Vancomycin (Vancocin)
Special information if you are pregnant or breastfeeding while taking Imuran
The effects of Imuran in pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, inform your doctor immediately. Imuran should be used during pregnancy only if the benefit justifies the potential risk to the unborn child. Since Imuran appears in breast milk, it should not be used during breastfeeding. If you are a new mother, you may need to choose between taking Imuran and breastfeeding your baby.
Recommended Imuran dosage
ADULTS Transplant Rejection
Your doctor will tailor your dosage of Imuran in accordance with your body's response. Expect a single dose of 15 milligrams per 2.2 pounds of body weight 4 to 12 hours before a transplant and 1 dose daily for 1 to 2 weeks after the operation. After that, the doctor may keep you on a daily dose of 5 to 10 milligrams per 2.2 pounds of body weight. The dosage of Neoral depends on the type of transplant and the other drugs you are taking. It is always taken twice a day. Psoriasis or Rheumatoid Arthritis The starting dosage is 2.5 milligrams of Neoral per 2.2 pounds of body weight divided into 2 doses per day. Your doctor may gradually increase the daily dose to a maximum of 4 milligrams per 2.2 pounds.
CHILDREN Dosage is generally the same for children as for adults, though somewhat higher doses are sometimes needed. Both drugs have been used to prevent transplant rejection in small children. Neoral has not been tested for arthritis or psoriasis in children under 18.
Imuran Overdosage
Although no specific information is available, an overdose of Imuran would be expected to cause liver and kidney problems. Any medication taken in excess can have serious consequences. If you suspect an overdose of Imuran, seek medical attention immediately.
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