Imuran

Azathioprine finds use in Pakistan’s transplant centers like SIUT Karachi and rheumatology wards at Jinnah Hospital Lahore, where it’s key for stopping kidney graft rejection or calming severe rheumatoid arthritis flares when steroids alone won’t cut it. As an immunosuppressant, PMDC oversees its tight controls due to infection risks in our dense populations. Tablets or injectables come prescription-only, generics around PKR 100-300 for 50mg strips—sourced from local pharma like Getz—practical info from hospital protocols, not a signal to start without specialist oversight.

Ingredients

• Active Ingredient: Azathioprine (typically 50mg tablets).
• Excipients: Lactose, starch, stearic acid—check labels for allergies.

Drug Class

Immunosuppressant (Purine Analogue).

How It Functions

Azathioprine converts to 6-mercaptopurine, jamming DNA synthesis in fast-dividing immune cells, dialing down T- and B-cell activity to prevent rejection or autoimmunity. In Pakistan’s post-transplant follow-ups, docs monitor TPMT enzyme levels first to avoid toxicity in low-activity patients common here.

Common Applications

Local nephro and rheum guidelines include:

• Kidney transplant rejection prophylaxis.
• Severe rheumatoid arthritis unresponsive to basics.
• Sometimes IBD or lupus, per specialist call.

Dosage Form

Oral tablets once/twice daily; IV for acute rejection by hospital staff.

Potential Side Effects

Frequent: Nausea, vomiting, diarrhea.

Others: Hair loss, mouth sores, low blood counts.

Grave from reports: Infections (fever, cough), liver damage (jaundice), cancers (skin, lymphoma), bone marrow suppression (bruising, fatigue). ER for persistent fever or yellowing.

Key Warnings and Precautions

PMDC mandates:

• Infections: High risk—avoid crowds, vaccinate pre-start (no live ones).
• Blood: Weekly CBCs early; stop if counts drop.
• Liver: Baseline LFTs, monitor monthly.
• Pregnancy: Category D—teratogenic; contraception strict.
• TPMT Testing: Essential to dose right.
• Sun: Use protection—skin cancer up.

No alcohol; elderly or Asians may need tweaks.

When It’s Not Suitable (Contraindications)

Avoid if:

• Allergy to azathioprine or mercaptopurine.
• Active infection or low TPMT.
• Recent live vaccines or pregnancy.

Drug Interactions

Tell doc:

• Allopurinol/Febuxostat—slash dose 75%, toxicity risk.
• Sulfamethoxazole or warfarin—blood count dips.
• ACE inhibitors—marrow suppression.
• Vaccines—live ones contraindicated.

In Case of Overdose

Nausea, bleeding, infection surge—hospital for supportive, possible acetylcysteine for liver.

Missed Dose

Take soon unless near next; skip, no double—call doc for gaps.

Storage and Disposal

Room temp (15-30°C), dry, light-protected, kid-proof. Pharmacy return unused.

Quick Tips

• With food for stomach ease.
• Regular blood work non-negotiable.
• Report fevers or bruises ASAP.

Doctor Review

Nephrologists at SIUT or rheumatologists at PIMS Islamabad deploy azathioprine post-transplant with cyclosporine combos, dosing low for Pakistani metabolizers to sidestep myelosuppression, but infection prophylaxis and cancer screens are routine given TB and hep burdens here.

Laboratory Screening

Essential:

• TPMT genotype pre-start.
• CBC, LFTs weekly then monthly.
• Viral serologies.

This charts azathioprine’s niche in Pakistan’s immuno care—reference material, specialist required.

Disclaimer: This is product information only, not a prescription or diagnosis. Consult a qualified Pakistani doctor before using azathioprine to ensure it’s safe. Seek immediate care for severe symptoms like fever, bruising, or jaundice