Immunosuppressive drug, Purine antagonist, Autoimmune disease, Bone marrow suppressant
Brand Names
Imuran®
Drug Information
Pharmacology
Purine antagonist antimetabolite-immunosuppressive drug.
Less immunosuppressive with less side effects than cyclophosphamide.
Contraindications
General
- Contraindicated in patients with known sensitivity to this type of drug.
- Use with caution in cases with pre existing liver disease.
- Use with caution if at all in patients with pre existing bone marrow suppression.
- Contraindicated in pregnancy due to risk of teratogenicity.
Cat
- Generally contraindicated in cats due to the potential for causing bone marrow suppression.
Adverse Effects
General
- Acute hepatotoxicity, jaundice, GI upset, skin eruptions, poor hair growth and pancreatitis have also been reported.
- Animals are more susceptible to infection while on this drug.
- Doses should be slowly tapered once resolution of hemolytic anemia is achieved to minimize the risk for rebound hyperimmune response.
- Bone marrow suppression-usually leukopenia but also thrombocytopenia and anemia.
Cat
- Bone marrow suppression-usually leukopenia but also thrombocytopenia and anemia. Cats are more prone to this side effect and therefore it is not recommended in this species.
Interactions
General Interactions
- Astragalus may impair the immunosuppressive effects of AzaTHIOprine.
Category Interactions
Non-depolarizing neuromuscular blocker
- Neuromuscular blocking activity may be inhibited or reversed.
Drug Interactions
Allopurinol
- Allopurinol inhibits the hepatic metabolism of AzaTHIOprine. Reduced dosages are needed.
Allopurinol
- Toxic levels of AzaTHIOprine can result if used concurrently.
Mycophenolate
- Additive risk for bone marrow suppression – use together is not advised in humans.
Pancuronium bromide
- AzaTHIOprine may reverse effects.
Vecuronium bromide
- AzaTHIOprine may reverse effects.
Available Forms
Human
- Tablets- 50 mg; Imuran ® Injection- 100 mg per vial in 20 mL vial, Imuran® and generic.
Veterinary – General
- None
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