Imuran (Azathioprine)

Azathioprine (Imuran) works by decreasing the effects of certain cells in the body’s immune system to decrease tissue inflammation. Imuran can be used to prevent kidney transplant rejection, severe rheumatoid arthritis, Crohn’s disease and ulcerative colitis.

How should it be used?

Imuran come in a tablet and liquid form.

Tablet form

  • Take this medicine once a day.
  • Take with food to reduce stomach upset.
  • Take the medicine around the same time each day.
  • Do not increase or stop taking this medicine, without your doctor’s approval.
  • If you cannot swallow pills, a liquid formula is available.

Imuran works slowly in your body so the full benefit of this medicine may not be felt for 4 months or longer. During this time you doctor may also prescribe a corticosteriod for the treatment of ulcerative colitis or Crohn’s.

Imuran can cause a decrease in the number of blood cells in your bone marrow. Your doctor will order tests before, during, and after your treatment to see if this medicine affects your blood cells.

Special Precautions / Instructions

Talk to your doctor about the risks of taking this medication.

Before taking Imuran, tell your doctor:

  • About all the medications (including over-the-counter), vitamins, herbal products, and supplements you are taking including the following:
    • allopurinol (Zyloprim)
    • angiotensin-converting enzyme (ACE) inhibitors such as benazepril (Lotensin)
    • captopril (Capoten)
    • enalapril (Lexxel, Vasotec)
    • fosinopril (Monopril), lisinopril (Prinivil, Zestril)
    • moexipril (Univasc)
    • perindopril (Aceon)
    • quinapril (Accupril)
    • ramipril (Altace)
    • trandolapril (Mavik, Tarka)
    • anticoagulants (‘blood thinners’) such as warfarin (Coumadin)
    • antimalarials such as chloroquine (Aralen)
    • hydroxychloroquine (Plaquenil)
    • mefloquine (Lariam)
    • primaquine
    • proguanil (Malarone)
    • pyrimethamine (Daraprim)
    • and quinine
    • cancer chemotherapy medications
    • co-trimoxazole (Bactrim, Septra, Sulfatrim)
    • cyclosporine (Neoral, Sandimmune)
    • gold compounds such as auranofin (Ridaura) and aurothioglucose (Aurolate,
    • Solganal)
    • methotrexate (Rheumatrex)
    • penicillamine (Cuprimine, Depen)
    • sirolimus (Rapamune)
    • tacrolimus (Prograf)
  • Any type of infection.
  • Have, or had, kidney, liver, or pancreas disease.
  • Are pregnant, plan to become pregnant, or are breast-feeding. Use birth control to be sure you or your partner will not become pregnant while you are taking this medication. Do not breast-feed while you are taking this medication.
  • Having surgery, including dental surgery.
  • Have, or had, cancer.
  • Take, or have taken, alkylating agents such as chlorambucil (Leukeran), cyclophosphamide (Cytoxan), or melphalan (Alkeran) for cancer.

Call the doctor immediately if you experience any of the following: unusual bleeding or bruising; excessive tiredness; pale skin; headache; confusion; dizziness; fast heartbeat; difficulty sleeping; weakness; shortness of breath; sore throat, fever, chills, other signs of infection, and any changes in your skin or any lumps or masses anywhere in your body.

Side Effects

Imuran may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

  • Nausea
  • Vomiting
  • Diarrhea
  • Muscle aches

Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately.

  • Mouth sores
  • Cough
  • Lack of energy
  • Loss of appetite
  • Pain in the upper right part of the stomach
  • Yellowing of the skin or eyes
  • Flu-like symptoms
  • Rash
  • Blurred vision
  • Stomach pain

Storage Conditions

Store medication in the original container, closed, at room temperature, and away from heat, moisture (not in the bathroom), and direct light. Keep this medication, and all medications, out of reach of children.

Emergency / Overdose

Call the national poison control center 1-800-222-1222 or 9-1-1 in the event of an overdose. If the person is not breathing or has collapsed, contact local emergency services, usually at 9-1-1.

Additional Information

Additional information may be found at: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000602