Info

Brand Name

Imuran®

Company

Glaxo Wellcome Inc.

Class

• Immunosuppressive antimetabolite (6-mercaptopurine)

Mechanism of Action

• Interferes with DNA and RNA synthesis, thereby inhibiting differentiation and proliferation of both T and B lymphocytes

Indication

• Adjunct for the prevention of rejection in renal hom transplantation

Clinical Experience

• 35-55% 5-year patient survival in over 16,000 transplantations

Contraindication

• Hypersensitivity to azathioprine

Warnings

• Increased risk of neoplasia

• Severe myelosuppression

• Serious infection

• Pregnancy Category D

Special Precautions

• Gastrointestinal hypersensitivity reaction

• Periodic blood counts may be needed

Adverse Reactions

• Hepatotoxicity (NA)

• Agents affecting myelopoiesis

• Angiotensin converting enzyme inhibitors

Formulations

• 50 mg scored tablets

• 20 mL vial containing 100 mg azathioprine

Dosage

• 3 mg/kg/d to 5 mg/kg/d single dose given at time of transplantation

• Dose usually adjusted depending on WBCs

• Lower doses should be considered in presence of renal dysfunction

Editors' Notes:

Combined administration of azathioprine and allopurinol may result in severe pancytopenia. The dose of Azathioprine should be reduced by two-thirds when given with allopurinol. Azathioprine rarely causes liver dysfunction, frequently manifested by an isolated rise in ALT and bilirubin. With the introduction of mycophenolate mofetil, azathioprine may be relegated to a second-line antimetabolite for the prevention of graft rejection.

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