IMURAN Injection
Azathioprine
25mg/ml
The Wellcome Foundation Limited
| Pack size | 2ml Vial |
|---|---|
| Dispensing mode | POM |
| Source | UK |
| Agent | AL BAKER TRADING EST. |
| Retail Price | 37.50 AED |
Indications
IMURAN Injection is used for:
Rheumatoid arthritis, Prevention of rejection in organ and tissue transplantation, Auto-immune diseases, Renal homotransplantation
Adult Dose
Rheumatoid Arthritis
1 mg/kg/day PO initially in single daily dose or divided q12hr; may be increased by 0.5 mg/kg/day after 6-8 weeks, then by 0.5 mg/kg/day every 4 weeks; not to exceed 2.5 mg/kg/day
Maintenance: Reduce daily dose by 0.5 mg/kg every 4 weeks until lowest effective dosage is reached
Kidney Transplantation
Prevention of transplant rejection
3-5 mg/kg/day PO initially on day of transplant or 3 days before transplant (rare)
Maintenance: 1-3 mg/kg/day PO
Auto-immune diseases 1-3 mg/kg/day.
Hepatic Impairment Reduce dose.
Child Dose
Juvenile Idiopathic Arthritis
1 mg/kg/day PO initially in single daily dose or divided q12hr; may be increased by 0.5 mg/kg/day after 6-8 weeks, then by 0.5 mg/kg/day every 4 weeks; not to exceed 2.5 mg/kg/day
Maintenance: Reduce daily dose by 0.5 mg/kg every 4 weeks until lowest effective dosage is reached
Renal Dose
Reduce dose.
Administration
May be taken with or without food. Preferably taken w/ or after meals to reduce GI discomfort.
Contra Indications
Hypersensitivity; previous treatment with alkylating agents; pregnancy, lactation.
Precautions
Increased risk of serious infections and neoplasia in chronic immunosuppression; leucopenia, thrombocytopenia, renal or hepatic impairment. Increased risk of haematologic toxicity in patients with thiopurine methyltransferase deficiency. Monitor CBC (including platelet count) wkly during 1st mth, twice mthly for 2nd and 3rd mth, then mthly; monitor more frequently if there are dosage adjustments. Monitor LFT periodically; discontinue treatment if jaundice occurs. Reduce dose promptly or withdraw drug temporary if there is rapid decrease/persistently low WBC or signs of bone marrow depression. Dose reduction may be necessary in patients with reduced TPMT (thiopurine methyltransferase) activity.
Lactation: Drug excreted at low levels in breast milk; use not recommended
Pregnancy-Lactation
Pregnancy category: D
Lactation: Drug excreted at low levels in breast milk; use not recommended
Interactions
Increased risk of haematotoxicity with aminosalicylates, drugs that affect myelopoesis e.g. co-trimoxazole or trimethoprim. Increased risk of infections with intra-uterine devices and live vaccines. Increased risk of leucopenia with ACE inhibitors. Concurrent use may reduce the anticoagulant effect of vitamin K antagonists e.g. warfarin. Increased risk of myelosuppressive effects when used with drugs that inhibit TPMT (thiopurine methyltransferase) or xanthine oxidase e.g. olsalazine, allopurinol.
Potentially Fatal: Increased risk of serious haematotoxicity or hepatotoxicity with leflunomide. Increased risk of bone marrow suppression with mycophenolate mofetil. Increased risk of infections and malignancies with efalizumab.
Adverse Effects
Side effects of Azathioprine :
>10%
Leukopenia (28-50%), Infection (20%)
<1%
Lymphoma
Frequency Not Defined
Fever, chills; bone marrow depression, thrombocytopenia or anaemia; anorexia, nausea, diarrhoea; arthralgias; secondary infections; hepatotoxicity, rash, alopoecia.
Potentially Fatal: Myelosuppression, mutagenicity and carcinogenicity; veno-occlussive liver disease.
Mechanism of Action
Azathioprine is an imidazolyl derivative of mercaptopurine, which inhibits DNA, RNA and protein synthesis and antagonises purine synthesis. It also inhibits mitosis and interferes with cellular metabolism of susceptible organisms. Azathioprine inj should be converted to oral therapy as soon as the drug can be tolerated.
Note
IMURAN 25mg/ml Injection manufactured by The Wellcome Foundation Limited. Its generic name is Azathioprine. IMURAN is availble in United Arab Emirates.
Farmaco UAE drug index information on IMURAN Injection is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.