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 an oral tablet for oral use. It is employed to reduce immune system activity in patients undergoing organ transplantation, as well as in autoimmune conditions such as rheumatoid arthritis, inflammatory bowel disease, and systemic lupus erythematosus.

GNH India supplies Imuran as a licensed, GDP‑compliant international pharmaceutical supplier serving hospitals, transplant centres, pharmacies and clinics worldwide. The company adheres to stringent quality standards and provides reliable sourcing for regulated markets.

Manufacturer / TM Owner

Aspen Pharma Trading Limited

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Indications & Clinical Uses

Azathioprine is used to modulate immune activity in several chronic inflammatory and transplant‑related conditions.

  • Organ transplantation: helps prevent graft rejection by suppressing T‑cell activation.
  • Rheumatoid arthritis: reduces joint inflammation and slows disease progression.
  • Inflammatory bowel disease: maintains remission in Crohn’s disease and ulcerative colitis.
  • Systemic lupus erythematosus: diminishes auto‑antibody production and organ involvement.

How It Works

  • Azathioprine is a purine analog that is converted intracellularly to 6‑mercaptopurine metabolites. These metabolites inhibit de novo purine synthesis, leading to reduced DNA replication in rapidly dividing cells, particularly activated T and B lymphocytes. By limiting clonal expansion, the drug also reduces cytokine release and auto‑antibody formation, providing immunosuppression.

Side Effects

Azathioprine may cause a range of adverse reactions, varying from mild to potentially serious.

Common Side Effects

  • Nausea: mild gastrointestinal upset.
  • Vomiting: occasional episodes.
  • Diarrhea: loose stools.
  • Decreased white blood cell count: mild leukopenia.
  • Elevated liver enzymes: mild transaminase rise.

Serious or Rare Side Effects

  • Severe bone marrow suppression: pancytopenia.
  • Hepatotoxicity: significant liver injury.
  • Increased infection risk: opportunistic infections.
  • Malignancy: heightened risk of lymphomas and skin cancers.
  • Pancreatitis: acute inflammation of the pancreas.

Precautions & Warnings

Before initiating azathioprine therapy, several safety considerations should be reviewed.

  • Baseline testing: obtain complete blood count and liver function tests.
  • Monitoring: perform regular CBC and LFTs to detect hematologic or hepatic toxicity.
  • TPMT activity: assess thiopurine methyltransferase levels to identify patients at risk of severe myelosuppression.
  • Pregnancy: avoid use unless benefits outweigh risks; classified as pregnancy category D.
  • Infection risk: screen for latent infections such as tuberculosis and hepatitis before treatment.
  • Store at ambient temperature: keep tablets in original container, protect from moisture and heat below 25 °C.

Avoid Interactions

Azathioprine interacts with several medicines that can alter its efficacy or safety profile.

Major Interactions (Avoid)

  • Allopurinol: may increase azathioprine toxicity; dose reduction required.
  • Febuxostat: similar risk of enhanced myelosuppression.
  • Mycophenolate mofetil: additive immunosuppression increasing infection risk.

Moderate Interactions (Monitor Closely)

  • Warfarin: azathioprine can potentiate anticoagulant effect; monitor INR.
  • ACE inhibitors: may worsen renal function when combined.
  • Live vaccines: increased risk of infection; avoid administration during therapy.

Frequently Asked Questions

Imuran, whose active ingredient is azathioprine, is prescribed to prevent organ transplant rejection and to treat autoimmune disorders such as rheumatoid arthritis, inflammatory bowel disease (including Crohn’s disease and ulcerative colitis) and systemic lupus erythematosus. It works by suppressing the immune system’s over‑activity in these conditions.

Azathioprine is a purine analog that is metabolized inside cells to 6‑mercaptopurine. These metabolites block the synthesis of new DNA, which limits the proliferation of activated T and B lymphocytes. By reducing the number of these immune cells, azathioprine dampens the adaptive immune response and decreases inflammation.

The dose of Imuran is individualized by the prescribing clinician based on the specific indication, patient weight, renal and hepatic function, and TPMT enzyme activity. Only a qualified healthcare professional should determine the appropriate dosing regimen.

Azathioprine is classified as pregnancy category D, indicating evidence of risk to the fetus. It should only be used during pregnancy when the potential benefit justifies the risk. Limited data suggest that short‑term exposure during breastfeeding may be acceptable, but the decision must be made by the treating physician.

To request Imuran, submit an enquiry on the product page at gnhindia.com, specifying the required quantity. GNH India supplies 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 calcineurin inhibitors such as cyclosporine, azathioprine offers a different mechanism—purine synthesis inhibition—resulting in a distinct side‑effect profile. It is often used in combination regimens or when patients cannot tolerate alternatives, but clinicians weigh efficacy, toxicity, and drug‑interaction potential when selecting therapy.

Imuran tablets should be stored at ambient temperature, below 25 °C, in their original packaging. Protect them from moisture, direct sunlight, and excessive heat to maintain stability and potency.

Imuran is taken orally, usually with food or a glass of water to reduce gastrointestinal irritation. The exact timing and frequency are determined by the prescriber and may be adjusted based on laboratory monitoring.

Serious risks include severe bone‑marrow suppression leading to pancytopenia, hepatotoxicity, opportunistic infections, and an increased long‑term risk of certain cancers such as lymphoma and skin malignancies. Patients should be monitored regularly for blood counts and liver function.

Imuran is contraindicated in patients with known hypersensitivity to azathioprine or its metabolites, those with severe hepatic impairment, and individuals with a documented deficiency of thiopurine methyltransferase (TPMT) activity. Caution is also advised for pregnant women, nursing mothers, and patients with active infections.

Published by

GNH India Pharmaceuticals Limited

Licensed pharmaceutical supplier

Last updated:

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