Imuprin is an immunosuppressive antimetabolite. Each uncoated Imuprin tablet intended for oral administration contains 25 mg or 75 mg or 100 mg of Imuprin. In addition, each tablet contains the following inactive ingredients: croscarmellose sodium, lactose monohydrate, magnesium stearate, povidone and starch.
Imuprin is chemically 6-[(1-methyl-4-nitro-1 H -im >H -purine. The structural formula of Imuprin is:
The use of angiotensin-converting enzyme inhibitors to control hypertension in patients on Imuprin has been reported to induce anemia and severe leukopenia.
Fertility, pregnancy and breastfeeding
If you’re planning a family or become pregnant while taking Imuprin, you should discuss this with your doctor as soon as possible.
Current guidelines say that Imuprin can be taken if trying for a baby and even when pregnant or breastfeeding.
Men are also fine to continue taking it when trying for a baby.
Inflammatory bowel disease drugs
Taking drugs called aminosalicylates with Imuprin can increase the levels of Imuprin in your body and increase your risk of bleeding disorders.
In 1968 the Food and Drug Administration approved Imuprin for use after an organ transplant to decrease the chance of the body rejecting the transplanted organ. However, Imuprin is an experimental drug that can be used during treatment of cancers such as leukemia and lymphomas. In the body, Imuprin is converted to mercaptopurine (6-MP) and thus has the same effects as that chemotherapy drug. They both are purine analogs that interfere with the metabolism of purine-based nucleotides found in DNA.
The use of Imuprin results in killing cells such as T-lymphocytes. This is important in cancers such as lymphocytic leukemia. The idea is that if T-lymphocyte reproduction is inhibited by interfering with DNA synthesis, then the cancer cell reproduction will also be inhibited. Certain types of leukemia and lymphomas are treated with radiation and chemotherapy, which destroy dividing cells such as those in the bone marrow. As a result, the patient is no longer able to produce blood cells. To combat the loss of blood cells, a bone marrow transplant may be performed to provide the patient with healthy marrow. The body may react against the foreign bone marrow. Therefore, an additional benefit of Imuprin use as an immunosuppressant could be to produce fewer white blood cells, thus interfering with the body's natural immune response to foreign proteins, such as those found on the cell surfaces of bone marrow coming from a bone marrow donor.
IMURAN (Imuprin), an immunosuppressive antimetabolite, is available in tablet form for oral administration. Each scored tablet contains 50 mg Imuprin and the inactive ingredients lactose, magnesium stearate, potato starch, povidone, and stearic acid.
Imuprin is chemically 6--1H-purine. The structural formula of Imuprin is:
It is an imidazolyl derivative of 6-mercaptopurine and many of its biological effects are similar to those of the parent compound.
Imuprin is insoluble in water, but may be dissolved with addition of one molar equivalent of alkali. Imuprin is stable in solution at neutral or acid pH but hydrolysis to mercaptopurine occurs in excess sodium hydroxide (0.1N), especially on warming. Conversion to mercaptopurine also occurs in the presence of sulfhydryl compounds such as cysteine, glutathione, and hydrogen sulfide.
Getting the most from your treatment
- Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress. Your doctor will want you to have regular blood tests during this treatment, to monitor for unwanted side-effects.
- It is important to try to avoid anyone who has chickenpox or shingles. Tell your doctor if you come into contact with anyone with these infections.
- While you are taking Imuprin, and for a while after you stop treatment, do not have any immunisations (vaccinations) without talking to your doctor first. Imuprin lowers your body's resistance and there is a chance that you may get an infection from the vaccine. Also, some vaccines may be less effective.
- Your doctor will have discussed with you the possibility of a slightly increased risk of cancer (particularly skin cancer) associated with immunosuppressants like Imuprin. Do not use sunbeds, and avoid strong sunlight or use a sun cream with a high sun protection factor (SPF of at least 15).
- You should avoid becoming pregnant while you or your partner are taking Imuprin. Make sure you have discussed with your doctor which types of contraception are suitable for you and your partner.
- If you are having an operation or any dental treatment, tell the person carrying out the treatment that you are taking Imuprin.
- If you buy any medicines, check with your doctor or a pharmacist that they are suitable for you to take with your other medicines.
Imuprin tablets should not be given to patients who have shown hypersensitivity to the drug. Imuprin tablets should not be used for treating rheumatoid arthritis in pregnant women. Patients with rheumatoid arthritis previously treated with alkylating agents (cyclophosphamide, chlorambucil, melphalan, or others) may have a prohibitive risk of malignancy if treated with Imuprin tablets.
There are medications and other medical conditions that can interact with Imuprin. A medication called allopurinol is used to treat gout and can increase the effects and toxicity of Imuprin because it interferes with the removal of Imuprin from the body.
Both kidney disease and liver disease can increase the effects and toxicity of Imuprin. Both diseases interfere with the removal of Imuprin from the body. If the patient has either of these diseases, the physician may make adjustments in the dosage given.
Sally C. McFarlane-Parrott