1 What is Imuran?

Generic: Azathioprine

Imuran is an immunosuppressive agent that used to allow the body to accept a transplanted kidney.

Azathioprine acts by weakening the body’s natural defense to prevent it from rejecting the transplanted kidney.

This medicine is also used to treat patients with rheumatoid arthritis.

2 What to know before using

Your doctor will inform you of what you need to know before using Imuran.

Tell to your doctor if you are allergic to Azathioprine or to any other medications.

You should also inform your healthcare providers if you are allergic to foods, dyes, or animals.

Safety and effectiveness of this medication have not been established for children.

Pregnancy Category D – Do not use Azathioprine injection while you are pregnant as it can cause risk to the unborn baby.

There are no adequate studies whether Azathioprine can pass through breast milk or if it could cause harmful effects to the infant. Discuss with your doctor if you are breastfeeding a baby.

Using this medicine with Febuxostat is not recommended and you may not be required to receive this medication. Otherwise, alternative medicine may be prescribed for your other medications.

Taking this medicine with any of the following medicines is usually not recommended, but with exception in some cases. Dosage or frequency of one or both of your medicines may be changed if both medicines are prescribed together.

  • Adenovirus Vaccine Type 4, Live
  • Adenovirus Vaccine Type 7, Live
  • Alacepril
  • Alfalfa
  • Allopurinol
  • Bacillus of Calmette and Guerin Vaccine, Live
  • Benazepril
  • Black Cohosh
  • Captopril
  • Cilazapril
  • Doxorubicin
  • Doxorubicin Hydrochloride Liposome
  • Enalaprilat
  • Enalapril Maleate
  • Fosinopril
  • Influenza Virus Vaccine, Live
  • Lisinopril
  • Measles Virus Vaccine, Live
  • Mercaptopurine
  • Moexipril
  • Mumps Virus Vaccine, Live
  • Mycophenolic Acid
  • Olsalazine
  • Oxypurinol
  • Pentopril
  • Perindopril
  • Poliovirus Vaccine, Live
  • Quinapril
  • Ramipril
  • Ribavirin
  • Rotavirus Vaccine, Live
  • Rubella Virus Vaccine, Live
  • Smallpox Vaccine
  • Spirapril
  • Sulfamethoxazole
  • Sulfasalazine
  • Trandolapril
  • Trimethoprim
  • Typhoid Vaccine
  • Varicella Virus Vaccine
  • Yellow Fever Vaccine
  • Zofenopril

Taking this medicine with any of the following medication may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. Dosage or frequency of one or both of your medicines may be changed if both medicines are prescribed together.

  • Acenocoumarol
  • Cyclosporine
  • Phenprocoumon
  • Warfarin

Some medical conditions can interact with this medication.

Tell your doctor if you have any of the following conditions:

3 Proper usage

To use Imuran properly, you must follow all instructions given by your doctor.

Azathioprine injection is injected through the vein by a nurse or other trained health care professionals in a hospital or clinic.

Small doses will be given administered until your condition improves. Your doctor will then switch you to an oral medicine that works the same way.

Talk to your doctor if you have any concerns about this.

4 Precautions to take

Before using Imuran, there are some precautions you must take.

Your doctor will be checking you regularly for the effectiveness of the medication. Blood tests may be ordered as well for undesirable effects.

This medication may cause fetal abnormalities. Contraceptives may be used to keep you or your partner from getting pregnant. Tell your doctor immediately if you think you have become pregnant while using this medication.

You should not use this medicine with mercaptopurine (Purinethol®). Using these medicines together could cause serious undesirable effects.

If you are going to use this medication for arthritis, tell your doctor if you received chlorambucil, cyclophosphamide, or melphalan in the past to treat your arthritis. Using Azathioprine injection after these medicines may increase your risk for undesirable effects.

Azathioprine injection may increase your risk of getting certain types of cancer, especially of the skin, lymph system, or blood.

Talk to your doctor if you have concerns about this risk.

Avoid extensive sun exposure and using of sun lamps or tanning beds when you are using this medication. When you are planning to go outdoors, use sunscreen or sunblock lotions with SPF of at least 15.

Do not receive any vaccinations without your doctor’s approval while you are under azathioprine treatment or after using this medication to prevent the risk of getting an infection. Azathioprine may lower your body's resistance and the vaccine may not work as well or you might get the infection the vaccine is meant to prevent. Furthermore, avoid people who have received live virus vaccines to prevent the chance of getting the virus.

Azathioprine injection can lower your body’s resistance temporarily as well as your platelet count.

To reduce the risk of bleeding and infection, these certain precautions should be followed:

  • Avoid coming into close contact with sick people.
  • Consult with your doctor immediately if you notice any unusual bleeding or bruising, black, tarry stools, blood in the urine or stools, or pinpoint red spots on your skin.
  • Be cautious when using a regular toothbrush, dental floss, or toothpick.
  • Use protective equipment such as mask for added protection.
  • Avoid activities that might cause injuries.

If you notice any unusual bleeding or bruising, black, tarry stools, blood in the urine or stools, or pinpoint red spots on your skin, check with your doctor right away.

Check with your doctor immediately if you have more than one of these symptoms while you are using this medicine:

These could be symptoms of a serious reaction to the medicine in your intestine.

Do not take other medicines unless they have been discussed with your doctor.

5 Potential side effects

As with many medications, there are several potential side effects associated with Imuran.

If any of the following side effects occur, check with your doctor right away:

  • Black, tarry stools
  • Bleeding gums
  • Blood in the urine or stools
  • Chest pain
  • Cough or hoarseness
  • Fever or chills
  • Lower back or side pain
  • Painful or difficult urination
  • Pinpoint red spots on the skin
  • Shortness of breath
  • Sore throat
  • Sores, ulcers, or white spots on the lips or in the mouth
  • Swollen glands
  • Unusual bleeding or bruising
  • Unusual tiredness or weakness
  • Abdominal or stomach pain or tenderness
  • Clay-colored stools
  • Dark urine
  • Decreased appetite
  • Fast heartbeat
  • Fever (sudden)
  • Headaches
  • Itching
  • Loss of appetite
  • Muscle or joint pain
  • Nausea, vomiting, and diarrhea (severe)
  • Redness or blisters on the skin
  • Swelling of the feet or lower legs
  • Unusual feeling of discomfort or illness (sudden)
  • Yellow eyes or skin
  • Abdominal or stomach cramps
  • Diarrhea
  • Difficulty with breathing
  • Difficulty with moving
  • Fat in the stool
  • General feeling of illness
  • Pale skin
  • Sores on the skin
  • Sudden loss of weight
  • Troubled breathing with movement
  • Weight loss

Less serious side effects:

  • Nausea or vomiting (mild)
  • Swollen joints
  • Hair loss or thinning of the hair

Not all side effects are listed above.

If you notice any other effects, check with your healthcare professionals.