Pharmacologic class: Purine antagonist
Therapeutic class: Immunosuppressant
Pregnancy risk category D
Use with Allopurinol
One of the pathways for inactivation of Azatioprina is inhibited by allopurinol. Patients receiving Azatioprina tablets and allopurinol concomitantly should have a dose reduction of Azatioprina tablets, to approximately ⅓ to ¼ the usual dose. It is recommended that a further dose reduction or alternative therapies be cons >CLINICAL PHARMACOLOGY, WARNINGS, PRECAUTIONS: Laboratory Tests and ADVERSE REACTIONS sections).
Use with Aminosalicylates
There is in vitro evidence that aminosalicylate derivatives (e.g., sulphasalazine, mesalazine, or olsalazine) inhibit the TPMT enzyme. Concomitant use of these agents with Azatioprina tablets should be done with caution.
Use with Other Agents Affecting Myelopoesis
Drugs which may affect leukocyte production, including co-trimoxazole, may lead to exaggerated leukopenia, especially in renal transplant recipients.
Use with Angiotensin-Converting Enzyme Inhibitors
The use of angiotensin-converting enzyme inhibitors to control hypertension in patients on Azatioprina has been reported to induce anemia and severe leukopenia.
Use with Warfarin
Azatioprina tablets may inhibit the anticoagulant effect of warfarin.
Use with ribavirin
The use of ribavirin for hepatitis C in patients receiving Azatioprina has been reported to induce severe pancytopenia and may increase the risk of Azatioprina-related myelotoxicity. Inosine monophosphate dehydrogenase (IMDH) is required for one of the metabolic pathways of Azatioprina. Ribavirin is known to inhibit IMDH, thereby leading to accumulation of an Azatioprina metabolite, 6-methylthioionosine monophosphate (6MTITP), which is associated with myelotoxicity (neutropenia, thrombocytopenia, and anemia). Patients receiving Azatioprina with ribavirin should have complete blood counts, including platelet counts, monitored weekly for the first month, twice monthly for the second and third months of treatment, then monthly or more frequently if dosage or other therapy changes are necessary.
Carcinogenesis, Mutagenesis, Impairment of Fertility
The use of IMURAN in nursing mothers is not recommended. Azatioprina or its metabolites are transferred at low levels, both transplacentally and in breast milk. 17,18,19 Because of the potential for tumorigenicity shown for Azatioprina, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
Princeton's WordNet (0.00 / 0 votes) Rate this definition:
Azatioprina, Imuran (noun)
an immunosuppressive drug (trade name Imuran) used to prevent rejection of a transplanted organ
Serious Side Effects of Azatioprina
Call your doctor immediately if you experience any of the symptoms listed in the Warning section or any of the following severe side effects:
How should this medicine be used?
Azatioprina comes as a tablet to take by mouth. It is usually taken once or twice a day after meals. Take Azatioprina at around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take Azatioprina exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
If you are taking Azatioprina to treat rheumatoid arthritis, your doctor may start you on a low dose and gradually increase your dose after 6-8 weeks and then not more than once every 4 weeks. Your doctor may gradually decrease your dose when your condition is controlled. If you are taking Azatioprina to prevent kidney transplant rejection, your doctor may start you on a high dose and decrease your dose gradually as your body adjusts to the transplant.
Azatioprina controls rheumatoid arthritis but does not cure it. It may take up to 12 weeks before you feel the full benefit of Azatioprina. Azatioprina prevents transplant rejection only as long as you are taking the medication. Continue to take Azatioprina even if you feel well. Do not stop taking Azatioprina without talking to your doctor.
Receiving live vaccines while taking Azatioprina may increase your risk of negative side effects from the vaccine. Examples of live vaccines include:
- nasal flu vaccine
- measles, mumps, rubella vaccine
- chickenpox (varicella) vaccine
Receiving an inactivated vaccine while taking Azatioprina may make the vaccine less effective.
Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
This drug comes with several warnings.
Information for Patients
Patients being started on Azatioprina tablets should be informed of the necessity of periodic blood counts while they are receiving the drug and should be encouraged to report any unusual bleeding or bruising to their physician. They should be informed of the danger of infection while receiving Azatioprina tablets and asked to report signs and symptoms of infection to their physician. Careful dosage instructions should be given to the patient, especially when Azatioprina tablets are being administered in the presence of impaired renal function or concomitantly with allopurinol (see Drug Interactions subsection and DOSAGE AND ADMINISTRATION). Patients should be advised of the potential risks of the use of Azatioprina tablets during pregnancy and during the nursing period. The increased risk of malignancy following therapy with Azatioprina tablets should be explained to the patient.