Imuran side effects

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

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Imuran is the trade name (GlaxoSmithKline) for azathioprine. Azathioprine is metabolized to 6-mercaptopurine which is a purine analogue that interferes with purine synthesis and therefore with DNA synthesis.

While used extensively for rheumatoid arthritis in the past, it is referred to less often since biologic drugs have proven to be so effective.

It is contraindicated in hypersensitive individuals, pregnant or nursing patients, and those individuals who are taking allopurinol.

Azathioprine raises the risk for malignancy, primarily leukemia and lymphoma.

It interacts with allopurinol. Accumulation of 6-mercaptopurine results leading to toxicity. Concurrent use with other immunosuppressants increases the risk of infection and long term risk of malignancy.

Replication of viruses from live vaccines may occur.

Common side-effects include fever, chills, vomiting, diarrhea, nausea, drop in platelet and white blood cell counts.

Less common side effects include herpes zoster, liver toxicity, pancreatitis, pneumonitis, hypersensitivity, mouth sores, rash, and clotting of the blood vessels leading to the liver.

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