Imuran (Azathioprine)

Azathioprine is a purine analog that is converted intracellularly to 6‑mercaptopurine and then to thio‑inosine monophosphate, which interferes with de novo purine synthesis. This disruption inhibits DNA replication in rapidly dividing cells, particularly T‑ and B‑lymphocytes, reducing their proliferation and overall immune response.

The dosage of Imuran is individualized by the prescribing clinician based on the specific indication, patient weight, renal and hepatic function, and tolerance. Physicians typically start with a low dose and adjust gradually while monitoring blood counts and liver enzymes to achieve the desired immunosuppressive effect.

Imuran is classified as pregnancy category D, indicating evidence of risk to the fetus, and it should be used only if the potential benefit justifies the risk. It is excreted in breast milk, so breastfeeding is generally not recommended while receiving azathioprine therapy.

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 (including any cold‑chain requirements) and necessary import documentation.

Compared with calcineurin inhibitors such as cyclosporine or tacrolimus, azathioprine has a slower onset of action but is often preferred for long‑term maintenance because of its oral formulation and lower nephrotoxicity. Unlike mycophenolate, azathioprine may be less costly but requires monitoring for bone‑marrow suppression and liver toxicity.

Imuran tablets should be stored at ambient temperature, below 25 °C, in the original container to protect them from moisture and light. Keep the medication out of reach of children and do not use if the packaging is damaged or the tablets appear discoloured.

Imuran is taken orally, usually with food or a glass of water to reduce gastrointestinal irritation. The tablet should be swallowed whole; it should not be crushed, chewed, or split unless specifically instructed by a healthcare professional. Dosing intervals are determined by the prescriber and may be once daily or divided doses.

The most serious adverse events include severe bone‑marrow suppression leading to pancytopenia, hepatotoxicity that can progress to liver failure, opportunistic infections due to profound immunosuppression, and an increased long‑term risk of certain malignancies such as lymphoma. Prompt monitoring of blood counts and liver function tests is essential to detect these complications early.

Imuran is contraindicated in patients with known hypersensitivity to azathioprine or any of its components, in those with severe hepatic impairment, and in individuals who are pregnant unless the therapeutic benefit outweighs the fetal risk. It should also be avoided in patients with active, uncontrolled infections and in those lacking adequate thiopurine methyltransferase (TPMT) activity without dose adjustment.