Product image of Imurel (Azathioprine) supplied by GNH India

Imurel

Active Ingredient:
Azathioprine
Origin:
EU

Imurel (Azathioprine)

Azathioprine, the active ingredient in Imurel, is an immunosuppressant presented as an oral dosage form for oral use. It is used to prevent organ transplant rejection and to manage certain autoimmune diseases such as rheumatoid arthritis and inflammatory bowel disease.

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

Manufacturer / TM Owner

Aspen Pharma Trading Limited

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Indications & Clinical Uses

Azathioprine is employed in conditions where immune suppression is required to control disease activity.

  • Organ transplantation: reduces the risk of graft rejection by suppressing immune response.
  • Rheumatoid arthritis: helps control joint inflammation and slows disease progression.
  • Inflammatory bowel disease (Crohn's disease, ulcerative colitis): aids in achieving remission and reducing flare‑ups.

How It Works

  • Azathioprine is a pro‑drug that is converted intracellularly to 6‑mercaptopurine, which inhibits purine nucleotide synthesis. This blocks DNA replication, leading to reduced proliferation of lymphocytes and other immune cells, thereby dampening the immune response involved in transplant rejection and autoimmune inflammation.

Side Effects

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

Common Side Effects

  • Nausea or vomiting.
  • Decreased appetite.
  • Mild leukopenia or anemia.
  • Skin rash or itching.
  • Headache or fatigue.

Serious or Rare Side Effects

  • Severe bone‑marrow suppression (pancytopenia).
  • Hepatotoxicity (elevated liver enzymes, hepatitis).
  • Pancreatitis.
  • Increased susceptibility to infections.
  • Malignancies such as lymphoma.
  • Severe hypersensitivity reactions (e.g., Stevens‑Johnson syndrome).

Precautions & Warnings

Before initiating azathioprine therapy, several safety considerations are recommended.

  • Monitor blood counts: perform regular complete blood count tests to detect bone‑marrow suppression.
  • Assess liver function: conduct periodic liver enzyme tests.
  • Screen for infections: evaluate for active infections before and during treatment.
  • Avoid in known hypersensitivity: discontinue if severe allergic reactions occur.
  • Use caution in pregnancy: discuss potential risks with a healthcare professional.
  • Store at room temperature: keep in the original container, protect from moisture and light.

Avoid Interactions

Azathioprine can interact with other medicines, altering its efficacy or safety.

Major Interactions (Avoid)

  • Allopurinol or febuxostat: may increase azathioprine toxicity.
  • Warfarin: heightened anticoagulant effect, increasing bleeding risk.
  • Live vaccines: risk of uncontrolled infection due to immunosuppression.

Moderate Interactions (Monitor Closely)

  • ACE inhibitors or ARBs: may enhance renal effects.
  • NSAIDs: can increase risk of bone‑marrow suppression.
  • Sulfonamide antibiotics: may augment myelosuppression.
  • Antifungal agents (e.g., fluconazole): may raise azathioprine plasma levels.

Frequently Asked Questions

Imurel, containing azathioprine, is prescribed to prevent rejection after organ transplantation and to manage autoimmune disorders such as rheumatoid arthritis and inflammatory bowel disease, including Crohn's disease and ulcerative colitis.

Azathioprine is converted inside cells to 6‑mercaptopurine, which interferes with purine synthesis. This blocks DNA replication, limiting the proliferation of immune cells and thereby reducing the immune response that drives transplant rejection and autoimmune inflammation.

The dosage of Imurel is individualized. A qualified prescriber determines the appropriate dose based on the specific indication, patient weight, renal and hepatic function, and response to therapy.

The safety of azathioprine in pregnancy and lactation is not definitively established. Healthcare providers should weigh potential benefits against risks and discuss alternatives when treating women who are pregnant, planning pregnancy, or breastfeeding.

To place an order, submit an enquiry on the Imurel 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.

Azathioprine is a purine analogue that offers oral administration and a well‑characterised safety profile. Compared with newer agents such as mycophenolate mofetil, it may have a slower onset of action but is often chosen for its cost‑effectiveness and extensive clinical experience.

Imurel should be stored at room temperature, below 25 °C, in its original packaging. Keep the product away from moisture, direct sunlight and excessive heat to maintain stability.

Imurel is taken orally, usually with food or a glass of water, as directed by the prescribing clinician. The exact schedule (once daily, divided doses, etc.) is determined by the treating physician.

Serious risks include severe bone‑marrow suppression, liver toxicity, pancreatitis, opportunistic infections and an increased risk of certain cancers. Regular laboratory monitoring is essential to detect these complications early.

Imurel is contraindicated in patients with known hypersensitivity to azathioprine or its metabolites, those with severe bone‑marrow failure, active uncontrolled infections, or significant liver disease. It should also be used with caution in pregnant or lactating women.

Published by

GNH India Pharmaceuticals Limited

Licensed pharmaceutical supplier

Last updated:

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