Imuran
Imuran: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. In case of impaired renal function
- 11. For violations of liver function
- 12. Drug interactions
- 13. Analogs
- 14. Terms and conditions of storage
- 15. Terms of dispensing from pharmacies
- 16. Reviews
- 17. Price in pharmacies
Latin name: Imuran
ATX code: L04AX01
Active ingredient: azathioprine (azathioprine)
Manufacturer: Glaxo Wellcome (Great Britain)
Description and photo updated: 20.11.2018
Imuran is a drug with antitumor, cytostatic, immunosuppressive effects.
Release form and composition
Dosage form of release - coated tablets (in a cardboard box 4 blisters of 25 pcs.).
Composition of 1 tablet:
- active substance: azathioprine - 50 mg;
- auxiliary components: stearic acid, pregelatinized starch, corn starch, lactose monohydrate, magnesium stearate;
- shell: macrogol 400, hypromellose.
Pharmacological properties
Pharmacodynamics
Azathioprine promotes inhibition of the growth and development of immunocompetent cells (plasma cells, lymphocytes), affects the cooperative immune response (T- and B-lymphocytes, macrophages), inhibits the migration of stem cells. In large doses (10 mg / kg) inhibits the proliferation of granulocytes, causes leukopenia, inhibits bone marrow function.
Pharmacokinetics
Azathioprine has a very variable absorption.
Bioavailability is 20%, since it is rapidly converted into 6-mercaptopurine (bioavailability of the latter is 60%).
The maximum concentration of the substance is reached in 2 hours. Creates high concentrations in the tissues of the intestines, liver; the level in the spleen, lungs, kidneys, muscles is equal to plasma. The half-life is 5 hours.
Indications for use
- chronic active hepatitis;
- chronic idiopathic thrombocytopenic purpura;
- organ transplant;
- severe rheumatoid arthritis;
- dermatomyositis;
- systemic lupus erythematosus;
- pemphigus vulgaris;
- hemolytic anemia;
- nodular periarteritis.
Contraindications
Absolute:
- pregnancy and lactation;
- individual intolerance to the components of the drug, including 6-mercaptopurine.
Relative (Imuran is prescribed under medical supervision):
- renal failure;
- liver failure.
Instructions for the use of Imuran: method and dosage
Imuran is taken orally.
For organ transplantation on the first day of therapy, the drug is prescribed in a daily dose of up to 5 mg / kg. The maintenance dose ranges from 1-4 mg / kg per day and depends on hematological tolerance and clinical indications. Even in the case of low doses, maintenance therapy should be carried out indefinitely, since there is a possibility of graft rejection.
When used in the relapsing form of multiple sclerosis, Imuran is prescribed at 2-3 mg / kg per day. To achieve a therapeutic effect, a course of more than one year may be required. After 2 years of therapy, it is not always possible to control the progression of the disease.
If Imuran is used for other indications, the initial dose is 1–3 mg / kg per day. It depends on the clinical effect (it may not be obtained within weeks and months from the start of admission) and changes in the blood formula. After achieving a therapeutic effect, the maintenance dose should be reduced to the minimum level at which the effect is maintained. If no improvement is observed within 3 months, Imuran is canceled. In inflammatory bowel diseases, therapy should be carried out for at least 12 months, and the therapeutic effect can be achieved in 3-4 months. The maintenance dose is in the same range as the treatment dose. It is determined by the illness and the patient's individual response.
Elderly patients, as well as with renal / hepatic insufficiency, Imuran is prescribed in minimal doses. Particular attention should be paid to the control of hematological parameters.
Side effects
Possible side reactions: myelodepression (thrombocytopenia, leukopenia, anemia), megaloblastic erythropoiesis and macrocytosis, development of secondary infections, anorexia, vomiting / nausea, drug fever, skin rash, myalgia, arthralgia, cholestatic hepatitis.
In transplant recipients, erosive and ulcerative lesions and bleeding from the gastrointestinal tract, pancreatitis, intestinal perforation and necrosis may be observed; in rare cases - meningeal reactions, acute renal failure, acute pulmonary diseases, hemolytic anemia.
Overdose
There is no information.
special instructions
For the first 8 weeks of taking azathioprine, a weekly CBC is required.
When combined with oxy-, allo-, thiopurinol, the dose should be reduced by 4 times.
Application during pregnancy and lactation
According to the instructions, Imuran is not prescribed during pregnancy / lactation.
With impaired renal function
Therapy for renal failure should be carried out under medical supervision.
For violations of liver function
Therapy for liver failure should be carried out under medical supervision.
Drug interactions
Possible interactions:
- depolarizing muscle relaxants: enhancing the effect;
- non-depolarizing muscle relaxants: weakening the effect;
- oxypurinol, allopurinol, thiopurinol: potentiation of the action of Imuran.
Analogs
The analogue of Imuran is Azathioprine.
Terms and conditions of storage
Store in a place protected from light at temperatures up to 25 ° C. Keep out of the reach of children.
The shelf life is 5 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Imuran
Reviews about Imuran are few, since the drug is not available in pharmacies.
Price for Imuran in pharmacies
The price of Imuran is unknown. The approximate price for an analogue - Azathioprine (50 tablets of 50 mg) - 217-293 rubles.
Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
