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azathioprine-50mg

PRODUCT DETAILS

Composition : Azathioprine
Strength availability : 50mg
Tab Count : 100 Tablets
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Imuran tablet belongs to immunosuppressant medication, that means it decrease the body's defense system or immune response.
Imuran is an inactive form which is metabolized to its active component 6-mercaptopurine (6-MP), a purine antagonist which prvents DNA synthesis and lymphocyte proliferation.
Imuran is a prescription drug provided under the supervision of medical practioners.

INDICATION

Imuran is a drug used for the treatment of addition for the prevention of rejection in kidney homotransplantations.
Imuran is a drug used for the treatment for the management of active rheumatoid arthritis to reduces signs and symptoms.

DOSAGE

For oral dosage form – for kidney transplant rejection :
In adults the prescribed dose is based on body weight and should be driven by doctor
Commonly starting dose is 3 to 5 mg/kg/day initially on day of transplant given as a single dose on once a day. The first dose is initiate either 1 to 3 days before the transplant or on the day of the transplant. The doctor may adjust your dose as needed.
Usage of the drug in children and dose should be discussed by doctor.
For rheumatoid arthritis :
In adults the dose is depends on body weight and should be driven by doctor.
Normally starting dose is 1 mg/kg/day IV/PO initially on day of transplant of body weight per day administer as a single dose once a day or split into two doses. Inform the doctor may adjust your dose as necessary. Still the dose is generally not ≥2.5 mg/ kg of body weight per day.
In children the drug usage and dose should be discussed by doctor.
Overdose :
If overdose occurs, then please seek emergency department. Avoid the overdose, have the drug properly

MECHANISM

Azathioprine consist of purine analogue with cytotoxic and immunosuppressive activity. Azathioprine is a inactive form which is altered by hepatic xanthine oxidase to its active metabolite 6-mercaptopurine.
Then 6-MP is metabolized by hypoxanthine-guanine phosphoribosyl transferase into 6-thioguanosine-5'-phosphate and 6-thioinosine
monophosphate both prohibit nucleotide conversions and de novo purine development. This causes to prevention of DNA, RNA, and protein combination. As a result, cell multiplication may be blocked, specifically in lymphocytes and leukocytes.

ADME

Well absorbed, and maximum plasma radioactivity is 1-2 hours.
plasm protein binding is 30%.
Mostly azathioprine alters to the main metabolites 6-mercaptopurine and 6-thioinosinic acid via a non-enzymatic process and glutathione transferases. Stimulating of 6-mercaptopurine happen via hypoxanthine-guanine phosphoribosyl transferase (HGPRT) and a set of multi-enzymatic processes included kinases to form 6-thioguanine nucleotides (6-TGNs) as important metabolites.
Fastly eliminated from blood and in urine after 8 hours has no azathioprine or mercaptopurine is detectable.

PRECAUTION

• While on treatment with Imuran tablet Long-term use increases risk of neoplasia
• While on treatment with Imuran will Increased risk of infection and hepatotoxicity; check hepatic function periodically; hepatic sinusoidal obstruction syndrome resulted; stop the therapy if suspected
• When using Imuran tablet is a Chronic immunosuppression with this purine antimetabolite raises neoplasia risk, mutagenic risk, and hematologic toxicities
• Using of drug Imuran tablet, resulted with malignancies contain posttransplant lymphoma and hepatosplenic T-cell lymphoma (HSTCL) in patients with inflammatory bowel disease.

DRUG INTERACTION

Co administration with captopril will show pharmacodynamic synergism and use with caution and will have risk of neutropenia.
Imuran co administration with zidovudine will either raise the toxicity of the other by pharmacodynamic synergism and will have risk of myelosuppression. Use with caution
Imuran co administration with adalimumab will have high immunosuppressive effects and risk of infections occurs. Avoid usage both combinations.
Imuran co administration with allopurinol will have high levels of azathioprine by reducing metabolism and increased risk of bone marrow toxicity.
Imuran co administration with cyclosporine both increase immunosuppressive effects. Avoid the using

CONTRAINDICATION

• Hypersensitivity
• Pregnancy while treatment for rheumatoid arthritis

MISSED DOSE

If dose is missed to take, then have immediately before next dose reaches or swap the dose and follow normal timing
Please Consult with the doctor

STORAGE

• Store the drug at 20℃-25℃
• Keep the drug in dry place and from light.

SIDE EFFECTS

Serious side effects :
Lymphoma
Fever
Hepatotoxicity
Macrocytic Anemia
Myalgia
Nausea or vomiting
Rash
Skin cancer
Steatorrhea
Abdominal pain
Alopecia
Arthralgia
Bacterial, fungal, protozoal, viral infections
Bone marrow suppression
Diarrhoea
Sweet syndrome (acute febrile neutrophilic dermatosis)
Thrombocytopenia
Leukopenia (28-50%)
Infection (20%)

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