Product image of Imuran (Azathioprine) supplied by GNH India

Imuran

Active Ingredient:
Azathioprine
Origin:
EU

Imuran (Azathioprine)

Azathioprine, the active ingredient in Imuran, is an immunosuppressant presented as a unknown strength/unknown form for oral use. It is used to prevent organ transplant rejection and to manage rheumatoid arthritis and inflammatory bowel disease in adult patients.

GNH India supplies Imuran as a licensed, GDP‑compliant international pharmaceutical supplier serving hospitals, transplant centres, oncology centres, pharmacies and clinics worldwide.

Manufacturer / TM Owner

Aspen Pharma Trading Limited

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Indications & Clinical Uses

  • Azathioprine is employed across several immune‑mediated conditions where suppression of the immune response is required.
  • Organ transplantation rejection prophylaxis: helps prevent acute and chronic rejection episodes after solid‑organ transplant.
  • Rheumatoid arthritis: reduces joint inflammation and slows disease progression.
  • Inflammatory bowel disease: controls symptoms and induces remission in Crohn's disease and ulcerative colitis.

How It Works

  • Azathioprine is a prodrug that is converted intracellularly to 6‑mercaptopurine, which inhibits purine nucleotide synthesis. This blockade reduces DNA replication in rapidly dividing lymphocytes, leading to decreased proliferation of T and B cells and overall suppression of the immune response.

Side Effects

Azathioprine may cause a range of adverse reactions, from mild to severe.

Common Side Effects

  • Nausea or vomiting
  • Decreased white blood cell count (leukopenia)
  • Elevated liver enzymes
  • Fatigue or weakness
  • Mild rash or itching
  • Diarrhea

Serious or Rare Side Effects

  • Severe bone marrow suppression (pancytopenia)
  • Hepatotoxicity or liver failure
  • Increased risk of opportunistic infections
  • Potential development of malignancies such as lymphoma
  • Severe hypersensitivity reactions (e.g., Stevens‑Johnson syndrome)

Precautions & Warnings

  • Patients should be monitored regularly for hematologic and hepatic parameters, and dose adjustments may be required based on laboratory results.
  • Baseline laboratory testing: obtain complete blood count and liver function tests before initiating therapy.
  • Regular monitoring: repeat CBC and LFTs every 1–2 weeks during dose titration, then monthly.
  • Infection vigilance: advise patients to report signs of infection promptly.
  • Vaccination guidance: avoid live vaccines while on therapy.
  • Pregnancy and lactation: discuss risks with a healthcare professional before use.
  • Store at ambient temperature: keep in original container, protect from moisture and heat.

Avoid Interactions

Azathioprine interacts with several drug classes that can alter its efficacy or increase toxicity.

Major Interactions (Avoid)

  • Allopurinol or febuxostat: may cause severe bone marrow suppression.
  • Thiopurine methyltransferase (TPMT) inhibitors: increase risk of myelosuppression.
  • Live vaccines: heightened risk of infection.

Moderate Interactions (Monitor Closely)

  • Warfarin: may enhance anticoagulant effect, monitor INR.
  • Antacids containing magnesium or aluminum: may reduce absorption.
  • Ribavirin: potential additive hematologic toxicity.

Frequently Asked Questions

Imuran (azathioprine) is prescribed to prevent organ transplant rejection, to manage rheumatoid arthritis, and to treat inflammatory bowel diseases such as Crohn's disease and ulcerative colitis by suppressing the immune system.

Azathioprine is converted to 6‑mercaptopurine, which interferes with purine synthesis. This limits DNA replication in rapidly dividing immune cells, reducing the proliferation of T and B lymphocytes and thereby dampening the immune response.

The appropriate dose of Imuran is individualized by the prescribing clinician based on the specific indication, patient weight, renal and hepatic function, and laboratory monitoring results.

Safety of azathioprine during pregnancy or lactation should be evaluated by a healthcare professional. The potential benefits must be weighed against possible risks to the fetus or infant, and the prescriber will decide if continuation is appropriate.

To place an order, submit an enquiry on the Imuran product page at gnhindia.com, specifying the required quantity. GNH India works with hospitals, pharmacies, and procurement teams worldwide, verifies trade or institutional credentials, and then provides pricing, availability, shipping details and any necessary import documentation.

Compared with agents such as mycophenolate mofetil or cyclosporine, azathioprine offers a different metabolic pathway and may have a more favorable side‑effect profile for some patients, but individual response and tolerability vary, making physician selection essential.

Imuran should be stored at ambient temperature, below 25 °C, in its original packaging to protect it from moisture and light. Keep the product out of reach of children.

Imuran is taken orally, usually in tablet form, with or without food as directed by the prescriber. Swallow the tablet whole with a glass of water; do not crush or chew unless specifically instructed.

The most serious risks include severe bone‑marrow suppression (pancytopenia), hepatotoxicity, increased susceptibility to infections, and a potential heightened risk of certain malignancies such as lymphoma. Regular laboratory monitoring helps detect these complications early.

Imuran is contraindicated in patients with known hypersensitivity to azathioprine or its metabolites, those with severe bone‑marrow failure, active infections, or significant liver disease. It should also be used with caution in individuals with TPMT deficiency.

Published by

GNH India Pharmaceuticals Limited

Licensed pharmaceutical supplier

Last updated:

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