Imuran

Imuran is an FDA-approved medication for treating rheumatoid arthritis and preventing graft versus host reaction after kidney transplantation. However, the drug has several side effects and is not considered the first choice in both instances. Healthcare providers may prescribe Imuran for indications other than those approved by the FDA, referred to as off-label uses.

What is Imuran and How Does it Work?

Imuran, the brand name of azathioprine, is a prescription medication belonging to the class of meds known as disease-modifying anti-rheumatic drugs (DMARDS) or immunosuppressive agents, implying the drug weakens the body’s natural defense or immunity. Typically, azathioprine slows the production of new immune cells leading to reduced immune activity and alleviating the symptoms of diseases such as rheumatoid arthritis, characterized by overactive immunity.

Uses of Imuran

• Preventing rejection after organ transplant

Imuran lowers the body’s immune system, preventing it from attacking the transplanted organ, which the immune system perceives as a foreign material. Suppressing the immune system is necessary for preventing rejection or graft vs. host disease. Thus, the drug helps the body to accept the transplanted organ. Imuran prevents rejection in many organ transplants, including kidney, heart, and liver.

• Rheumatoid arthritis

Rheumatoid arthritis (RA) is an autoimmune disorder in which the immune cells attack particular organs, primarily the joints, leading to inflammation and pain. Imuran reduces the swelling, pain, and inflammation associated with arthritis by calming the natural defense response. Due to the side effects, azathioprine is only used to treat RA unresponsive to conventional therapy.

Besides the FDA-approved uses, the doctor can prescribe Imuran for other conditions (off-label indications), including;

• inflammatory bowel disease (ulcerative colitis or Crohn’s disease)
• systemic lupus erythematosus
• autoimmune musculoskeletal disorders, including dermatomyositis  and polymyositis
• polyarteritis nodosa
• blood disorders such as autoimmune hemolytic anemia and thrombocytopenic purpura

Generally, Imuran suppresses the immune system and can be used to minimize symptoms of any condition characterized by immune system hyperactivity.

How to Use Imuran (Azathioprine)

Imuran is available as an oral tablet and as an injectable drug. Medication usage depends on the form administered and the condition being treated.

When used to prevent transplant rejection, Imuran is started as an intravenous injection, given through the vein on the day of surgery. The amount administered dose depends on the body weight, usually 3-5 mg per kg. After the transplant, azathioprine is given as tablets. On the other hand, those taking azathioprine for rheumatoid arthritis are usually started on oral tablets.

Take this medication by mouth exactly as directed by the doctor, typically once or twice daily. Taking azathioprine tablets with food is vital in minimizing stomach upset.

Do not take azathioprine for more extended periods or in higher doses than prescribed, as this will not alleviate the systems faster but might worsen the side effects. Dosing is usually determined by the condition being treated, response to therapy, and body weight.

Regular use of this medication is necessary for obtaining the optimum benefit. Try taking this medicine at the same time each day (setting the alarm can help). It might take up to 2 months of regular use before experiencing the benefits of Imuran, especially during the treatment of arthritis. Therefore, do not use a higher dose than prescribed if the symptoms do not reduce after a few weeks of treatment unless directed by the doctor. Inform the provider if the condition does not improve after three months of using azathioprine correctly.

If a dose is missed, do not take a double amount to compensate for the missed dose. Instead, return to the regular schedule. For instance, if you take the drug once daily and miss a dose, skip the missed dose and continue with the usual drug routine.

Store Imuran at room temperature and away from direct sunlight. Keep the medication out of reach of children.

Note: Pregnant women or those who may become pregnant should not handle Imuran because of the potential effects on the unborn baby, as the drug can be absorbed through the skin or lungs.

Imuran Dosage

The dosage of this medication depends on the condition and patient body weight, among other factors.

• preventing rejection in organ transplant

The initial recommended dose is 3-5 mg per kilogram of body weight given as an injection on the day of surgery. A maintenance dose of 1-3 mg per kg, taken by mouth daily, is then given.

• treating rheumatoid arthritis

The start dose is usually 1 mg per kg (the equivalent of 50-100 mg) taken by mouth once or twice daily. Depending on the response to treatment, the doctor may increase the dose after 6-8 weeks by 0.5 mg per kilogram of body weight. Additional increments can be made at intervals of 4 weeks until a maximum daily dose of 2.5 mg per kg.

Possible Side Effects of Imuran

Like other medications, Imuran can produce unwanted responses known as side effects when taken in the recommended doses. However, not everyone taking this medication experiences the listed side effects.

Most unwanted effects resolve on their own or can be managed by simple interventions. If you are concerned about the risks of Imuran, talk to the doctor before starting this medication.

Contact the healthcare provider if the following side effects become bothersome or worsen during treatment with azathioprine;

• nausea
• vomiting
• hair loss
• fever
• tiredness
• muscle pain

Other side effects of Imuran are rare but can lead to severe problems if not managed promptly. Therefore, stop the medication and call the doctor immediately if the following occurs:

• Severe allergic reaction marked by hives, swelling of the face or throat, and problems breathing
• Dizziness or fainting, especially when standing up from a sitting position
• Signs of infection such as fever, chills, stiff neck, headache, and weight loss
• Bleeding problems such as easy bruising, passing blood in urine, or bleeding gums
• Kidney disease

Users of Imuran can experience side effects other than those listed in the medication guide. Talk to the doctor if unusual symptoms develop when taking this medication.

Precautions and Warnings

Before taking Imuran, talk to the doctor about any significant medical history and overall health status, including pregnancy and lactation, as they might affect the usage of this medication.

• Azathioprine increases the risk of particular skin cancers such as hepatosplenic T-cell lymphoma. Limit exposure to sunlight or ultraviolet radiation by wearing protective clothing or applying sunscreen to reduce the risk of these cancers when taking azathioprine
• This medication reduces the number of platelets and white blood cells, leading to an increased risk of bleeding and infections. Regular monitoring through lab tests is necessary to detect such effects and avoid the consequences.
• Do not use Imuran during pregnancy unless the benefits outweigh the risks, as it can harm the baby. The drug can also pass into breast milk and should not be used by lactating mothers.

Drug Interactions

Imuran can interact with other medications, affecting how it works or worsening the side effects. Before starting azathioprine, tell the doctor about all the current drugs you might be using. Depending on the potential effects, the doctor might recommend stopping the medications, changing their dosages or leaving everything as it is.

Drugs that can interact with Imuran include;

• 5-ASA medications (mesalamine and sulfasalazine)
• Allopurinol
• Febuxostat
• Adalimumab
• Cyclophosphamide
• ACE inhibitors like enalapril
• Baricitinib

Alternatives to Imuran

• CellCept (mycofenolate mofetil)
• Cyclosporine
• Arave (leflunomide)
• Methotrexate

Buying Imuran from a Trusted Online Store

Kiwi Drug offers affordable access to all medications to people on all continents. Subject to industry regulations, Kiwi uses professional pharmacists to ensure the clients receive the best services and maintain optimum quality of life. You can buy Imuran from Kiwi Drug after an online doctor reviews your medical profile and writes a prescription through the online doctor service. But the process is even more straightforward if you have a prescription. To purchase the medicine, follow the steps below:

• Sign up and add the drug to the cart
• Click the “Checkout Now” button
• Answer the questions presented on the next page
• Enter payment details and wait for your order to arrive