Imuran - instructions for use, reviews, analogs and formulations (tablets 50 mg) of the drug for the treatment of organ rejection, rheumatoid arthritis, systemic lupus erythematosus, hemolytic anemia in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Imuran. Presented are the opinions of visitors to the site - consumers of this medication, as well as the opinions of doctors of specialists on the use of Imuran in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Imuran in the presence of existing structural analogues.Use to treat organ and transplant rejection, rheumatoid arthritis, systemic lupus erythematosus, hemolytic anemia in adults, children, as well as during pregnancy and lactation. Composition of the preparation.

Imuran - shows a pronounced antitumor, cytostatic, immunosuppressive effect. It blocks cell division as a result of competition with natural purine bases of DNA and RNA. It inhibits the growth and development of immunocompetent cells (lymphocytes, plasma cells), affects the cooperative immune response (T-lymphocytes-macrophages-B-lymphocytes), inhibits the migration of stem cells. In large doses (10 mg per kilogram) depresses the function of the bone marrow, suppresses the proliferation of granulocytes, causes leukopenia.

Composition

Azathioprine + auxiliary substances.

Pharmacokinetics

Has a very variable absorption. Bioavailability is 20%, because it rapidly turns into 6-mercaptopurine (bioavailability of the latter is 60%). The maximum concentration is fixed after 2 hours. Creates high concentrations in the tissues of the liver, intestines; the level in the kidneys, lungs, spleen, muscles is equal to that in plasma. Half-life is 5 hours.

Indications

• organ transplantation;
• severe rheumatoid arthritis;
• systemic lupus erythematosus;
• dermatomyositis;
• chronic active hepatitis;
• pemphigus vulgaris;
• nodular periarteritis;
• relapsing form of multiple sclerosis;
• hemolytic anemia;
• chronic idiopathic thrombocytopenic purpura.

Forms of release

The coated tablets are 50 mg.

Instructions for use and dosing regimen

Inside. Adults and children.

Application for organ transplantation: up to 5 mg per kilogram per day on the first day of therapy; maintenance dose - 1-4 mg per kilogram, depending on clinical indications and hematological tolerance. Even in the case of low doses, supporting therapy with Imuran should be performed indefinitely, since there is a risk of graft rejection.

Application in the relapsing form of multiple sclerosis: 2-3 mg per kilogram per day; to achieve the effect, the duration of treatment for more than 1 year may be required. It is not always possible to control the progression of the disease after 2 years of therapy.

Application for other diseases: an initial dose of 1-3 mg per kilogram per day and should be selected in this dose range depending on the clinical effect (which may not be obtained within weeks and months from the start of treatment) and changes in the blood formula. If the therapeutic effect is obtained, then it is necessary to reduce the maintenance dose to the minimum level at which the effect is preserved. If the clinical effect is not achieved within 3 months, then Imuran should be canceled. However, in inflammatory bowel diseases, treatment should be performed for at least 12 months, and the therapeutic effect can be achieved in 3-4 months. The maintenance dose may range from less than 1 to 3 mg per kilogram per day and is determined by the disease, as well as by the individual response of the patient.

Side effect

• myelodepression (oppression of bone marrow hematopoiesis) - leukopenia, thrombocytopenia, anemia;
• megaloblastic erythropoiesis and macrocytosis (megoblastic anemia);
• nausea, vomiting;
• anorexia;
• skin rash;
• arthralgia (pain in the joints);
• myalgia (pain in the muscles);
• drug fever;
• Cholestatic hepatitis (bile stasis and excessive concentration of its constituents);
• development of secondary infections.

In transplant recipients:

• erosive and ulcerative lesions and bleeding from the gastrointestinal tract;
• pancreatitis;
• necrosis and intestinal perforation;
• acute renal insufficiency;
• hemolytic anemia;
• acute lung diseases;
• meningeal reactions.

Contraindications

• hypersensitivity (including to 6-mercaptopurine).

Application in pregnancy and lactation

Imuran in pregnancy is contraindicated. During the treatment period, women of childbearing age should use reliable methods of contraception.

Use in children

The drug can be used to treat children, except for the treatment of multiple sclerosis, in which the use of Imuran is not recommended.

Application in elderly patients

The experience of using Imuran in elderly patients is limited. Although according to available data, the occurrence of side effects in the elderly does not exceed that of other patients taking Imuran, they should use the minimum dosages of the recommended dose range. Particular attention should be paid to monitoring hematological parameters, reducing the maintenance dose to the minimum allowable to maintain the therapeutic effect.

special instructions

The first 8 weeks of therapy require a weekly full blood test. Use with caution in renal and hepatic insufficiency. When combined with allo-, hydroxy-, thiopurinol, the dose should be reduced 4-fold.

Drug Interactions

Potentiates the effects of immunosuppressants, cytostatics. Azathioprine inhibits the anticoagulant effect of warfarin. Allopurinol slows the metabolism of azathioprine, promotes its accumulation and enhance the toxic effect, while the application need reduced dose of azathioprine (up to one-fourth of the average dose).

If concomitant use of azathioprine with Co-trimoxazole may increase myelotoxic action of azathioprine, with ACE inhibitors - increase the risk of anemia and severe leukopenia with other immunosuppressants (corticosteroids, cyclosporine, anti-of CD3-antibody) - increases the risk of infection and the appearance of tumors.

When vaccination with live virus vaccines at the same time taking azathioprine may increase the replication of the virus, inactivated vaccines - inhibition of antibody production. With caution use azathioprine simultaneously with Sulfasalazine or mesalazine.

Analogues of medicinal preparation Imuran

Structural analogs for the active substance:

• Azathioprine.

Analogues for the pharmacological group (immunosuppressants):

• Abaggio;
• Advagraf;
• Actemra;
• Antiliphosphine;
• Arava;
• Arresto;
• Artamine;
• Atgam;
• Benlist;
• Bianodine;
• Hydroxychloroquine;
• Gilenia;
• The festival;
• Grafalon;
• Delagil;
• Zenapax;
• Ilaris;
• Immard;
• The Imnovid;
• Infliximab;
• Consuprene;
• Xolar;
• Kuprenil;
• Leflish;
• Leflunomide;
• Lefomide;
• MabThera;
• Misept;
• Mayforth;
• The methodical;
• Mycophenolate;
• Modena;
• Necklair;
• Nulojiks
• Orgosporin;
• Orensia;
• Othello;
• Pantograph;
• Panimun;
• Plaquenil;
• Priluxide;
• Prograph;
• Raleph;
• Rapamun;
• Raptiva;
• Redditus;
• Redesp;
• Remicade;
• Restasis;
• Rituximab;
• Sandimmun;
• CellCent;
• Sertikan;
• Simponi;
• Simulect;
• Soliris;
• Stelara;
• Suprema;
• Tacrolimus;
• Tacrose;
• Tauredon;
• Teriflunomide;
• Tizabry;
• Timoglobulin;
• Timodepressin;
• Femoriks;
• Fingolimod;
• Flammages;
• Humirah;
• Cycloral;
• Cyclosporin;
• Ecological;
• Elafra;
• Enbrel;
• Antivio;
• Yaqurinus.

Response of a rheumatologist

Imuran is an effective remedy for many autoimmune diseases. I assign it to patients with severe forms of rheumatoid arthritis.Treatment with Imuran helps to relieve the patient's condition - pain, swelling, numbness of the joints, pain sensation in the chest and muscle weakness disappear. The course of treatment with the drug is long, the dose and duration of therapy depend on how the organism reacts to the drug in each specific case. Treatment should be carried out under strict medical supervision.

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