Azathioprine 50mg (Azathioprine)

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Brand nameImuranActive substanceAzathioprineStrength50mgCategoryNephrologyPackaging10 tablets

Description of Imuran 50mg (Azathioprine 50mg)

Imuran 50mg (Azathioprine 50mg) tablet belongs to immunosuppressant medication, that means it decrease the body's defense system or immune response

Imuran 50mg (Azathioprine 50mg) 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 50mg (Azathioprine 50mg) is a prescription medicine provided under the supervision of medical practioners.

Medical use /Indication of Imuran 50mg (Azathioprine 50mg)

Imuran 50mg (Azathioprine 50mg) is a medicine used for the treatment of addition for the prevention of rejection in kidney homotransplantations.

Imuran 50mg (Azathioprine 50mg) is a medicine used for the treatmentfor the management of active rheumatoid arthritis to reduces signs and symptoms.

Mechanism of Action Imuran 50mg (Azathioprine 50mg)

Azathioprine consist of purine analogue with cytotoxic and immunosuppressive activity. Azathioprine is a inactive formwhich 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 monophosphateboth prohibit nucleotide conversions and de novo purine development. This causes toprevention of DNA, RNA, and protein combination.

As a result, cell multiplication may be blocked, specifically in lymphocytes and leukocytes.

ADME of Imuran 50mg (Azathioprine 50mg)

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.

Side effects of Imuran 50mg (Azathioprine 50mg)

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%)

Precautions of Imuran 50mg (Azathioprine 50mg)

  • While on treatment with Imuran 50mg (Azathioprine 50mg)tablet Long-term use increases risk of neoplasia
  • While on treatment with Imuran 50mg (Azathioprine 50mg)will Increased risk of infection and hepatotoxicity; checkhepatic function periodically; hepatic sinusoidal obstruction syndrome resulted; stop the therapy if suspected
  • When using Imuran 50mg (Azathioprine 50mg) tablet is a Chronic immunosuppression with this purine antimetabolite raises neoplasia risk, mutagenic risk, and hematologic toxicities
  • Using of medicine Imuran 50mg (Azathioprine 50mg)tablet, resulted with malignancies contain posttransplant lymphoma and hepatosplenic T-cell lymphoma (HSTCL) in patients with inflammatory bowel disease

Drug interaction of Imuran 50mg (Azathioprine 50mg)

Co administration with captopril will show pharmacodynamic synergism and use with caution and will have risk of neutropenia.

Imuran 50mg (Azathioprine 50mg) 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 50mg (Azathioprine 50mg) co administration with adalimumab will have high immunosuppressive effects and risk of infections occurs. Avoid usage both combinations.

Imuran 50mg (Azathioprine 50mg) co administration with allopurinol will have high levels of azathioprine by reducing metabolism and increased risk of bone marrow toxicity.

Imuran 50mg (Azathioprine 50mg) co administration with cyclosporine both increase immunosuppressive effects. Avoid the using with Azathioprine

Contraindication of Imuran 50mg (Azathioprine 50mg)

  • Hypersensitivity
  • • Pregnancy while treatment for rheumatoid arthritis

Pregnancy of Imuran 50mg (Azathioprine 50mg)

Pregnancy category is D
Avoid Imuran 50mg (Azathioprine 50mg) treatment during pregnancy because it will cause fetal harm

Lactation of Imuran 50mg (Azathioprine 50mg)

Some of evidence reveal the breastfeeding during Imuran 50mg (Azathioprine 50mg) treatment is safe but proper discussion with doctor before using Imuran 50mg (Azathioprine 50mg) tablet

Dosage of Imuran 50mg (Azathioprine 50mg)

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 medicine 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 medicine usage and dose should be discussed by doctor.

Over dosage of Imuran 50mg (Azathioprine 50mg)

If overdose occurs, then please seek emergency department. Avoid the overdose, have the medicine properly

Storage of Imuran 50mg (Azathioprine 50mg)

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

Missed dose of Imuran 50mg (Azathioprine 50mg)

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

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