Imuran is an immunosuppressant medication that is prescribed to treat auto-immune diseases. The active ingredient is azathioprine and it is manufactured by Excella GmbH & co.
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Imuran is an immunosuppressant, which is a group of medications that reduce the body’s immune system response. These treatments are often required when the body’s immune system starts to attack healthy tissues and cells, as if they are foreign invaders, causing inflammation and even deformities in the body. Imuran is prescribed to treat auto-immune diseases such as rheumatoid arthritis, Crohn’s disease, ulcerative colitis and lupus. It’s a regular treatment that can be used to stop the body from rejecting organ transplants.
Rheumatoid arthritis is a condition where the immune system attacks healthy tissues and cells, resulting in chronic pain in the affected areas. This distinguishes it from osteoarthritis, which is caused by the wear and tear of the joints. Symptoms include a warm sensation in the joints, followed by swelling and tenderness in the affected area. This usually begins in the smaller joints, such as the fingers and toes, and then spreads to the larger joints, such as the wrists, knees and elbows. The condition may also affect the heart, eyes, kidneys, nerve tissues, marrow of the bone, blood vessels, lungs and salivary glands. Symptoms may come and go as flare ups or be ever-present, which themselves can range from mild to severe. In some cases, the condition can lead to bone deformities.
Crohn’s disease is a serious condition that sometimes goes by the name IBD (inflammatory bowel disease). It is not entirely known what causes Crohn’s, but it is likely a combination of genetics, lifestyle and possibly a previous infection that stimulates the immune system’s response. Crohn’s causes inflammation of the digestive tract, sometimes in certain areas of the gut. This inflammation can spread deep into the bowel’s tissue and cause serious discomfort. In the most severe cases, the condition can be life-threatening, with malnutrition, fever, weight loss, fatigue, bloody stools, mouth sores, stomach cramps, inflammation of the eyes, joints and liver and diarrhoea all common symptoms.
Ulcerative colitis presents in many of the same ways as Crohn’s, with both conditions causing inflammation in the digestive tract and possessing similar symptoms. What distinguishes one condition from the other is that, while Crohn’s can occur anywhere from the mouth to the anus, ulcerative colitis only presents in the bowel. Crohn’s can also affect both diseased parts of the bowel and healthy areas, deep in body tissue.
Ulcerative colitis, by contrast, only affects superficial tissue and inflammation is protracted.
Lupus is an auto-immune disease where all organs and tissues can be affected by the body’s overactive immune response. It is a serious condition that could be life-threatening, affecting the brain, kidneys, liver, heart, lungs and nervous system. It can also affect the skin, joints and blood cells. As the condition mimics so many other ailments, it can be hard to diagnose, but the most telling symptom is a butterfly rash that presents on the face, spreading across the nose to both cheeks.
Lupus is very much a condition that is unique to the individual, with no two cases the same. Symptoms can be mild or severe, present suddenly or progress over time, and may come and go or be ever-present. It is genetic in nature, but certain triggers are likely to play a role, such as sunlight, medications or various infections.
Diagnosing auto-immune conditions is not always straightforward, as can be seen in the case of lupus. A doctor is likely to ask you about symptoms that are not visible and inspect those that are, such as rashes. If they think further analysis is required, urine tests or blood tests may be conducted, which can highlight any inflammation in the system and any antibodies present in the blood. From here, treatment can be targeted for your condition.
Imuran works by reducing the activity of the immune system, thereby reducing its effects on healthy tissues and cells that are being attacked by it. The active ingredient in Imuran, Azathioprine, works by reducing the production of white blood cells, part of the immune system’s response to what it sees as an invading entity in the body.
You should see a doctor if you believe you are experiencing symptoms of an auto-immune disease in order to get the condition properly diagnosed and treated. If you have any concerns about your health, we provide a seven day a week video consultation service where our registered clinicians can provide advice and access to specialists, as well as fit notes.
To obtain a prescription for Imuran you will have to undergo a full video consultation and provide your SCR (Summary Care Record) so we can ensure the best advice and treatment for you. The service is available between the hours of 9am and 5pm.
To get the most out of your treatment, you should follow the instructions as provided by your doctor. If instructions are not undertaken correctly, it can lead to an increased chance of side effects occurring and the possibility of health risks, some of which may be severe. You should also read the patient information leaflet enclosed with your medication thoroughly.
- Taken with water after food
- Dosage can start as high as 5mg per kilo of body weight
- Ongoing dosage is equivalent to between 1mg and 4mg per kilo of body weight
- Exact dosage will depend on the severity of symptoms
- Organ transplant dosages can reach as high as 4mg per kilo of body weight
- Immunosuppressant use up to 3mg
- Dosage will likely be reduced as treatment continues
- Age and condition of kidneys and liver will also affect the strength of treatment
- You should inform your doctor if you have missed a dose
- Never take twice the amount in order to make up for a missed dosage
- You should seek immediate medical attention if you have taken more than you should
While most side effects are unlikely, it is important to be aware of any potential risks with this treatment. In very rare cases, you might experience an allergic reaction, so should any of the following symptoms occur, it is important to seek immediate medical attention: Dizziness and tiredness, fever, vomiting, severe diarrhoea, chills, severe rashes, joint pain, changes in the colour of urine, weakness, low blood pressure and lumps under the skin.
Other possible serious side effects include unusual bleeding, severe bruising, extreme fatigue, blisters and contact with someone with chickenpox or shingles.
Very common (affects more than 1 in 10 users)
Infections, bone marrow function reduced and low white blood cell count.
Common (affects less than 1 in 10 users)
Increase in bleeding or bruising caused by low blood platelet levels
Uncommon (affects less than 1 in 100 users)
Shortness of breath, dizziness, low red blood cell count, headaches, paleness, stomach aches, vomiting, liver problems, pale stools, odd coloured urine and yellowing and itchiness of eyes and skin.
Rare (affects less than 1 in 1,000 users)
Weakness, bone marrow problems, bowel issues including diarrhoea and constipation, irreversible hair loss, liver damage, blood, lymph and skin cancers and sensitivity to sunlight.
Very rare (affects less than 1 in 10,000 users)
Imuran also increases the risk of skin cancers when exposed to sunlight. It is therefore recommended that you wear a high factor sunscreen or protective clothing when exposed to sunlight.
Conditions to look out for
Before starting treatment with Imuran you should inform your doctor of any conditions that you currently have or have experienced in the past, no matter how unrelated these may seem. It is only then that your prescriber is able to recommend treatment with confidence, reducing your risk of serious side effects.
Imuran is not suitable if you are allergic to any of the medication’s ingredients.
Your doctor may decide that an alternative treatment should be sought if you have any of the following conditions: kidney disease; liver disease; Lesch-Nyhan Syndrome; low levels of TPMT (thiopurine methyltransferase); if you have ever suffered from chickenpox or shingles; if you have inherited the NUDT15 gene mutation (which can lead to further hair loss and risk of infection); certain types of arthritis.
Taking it with other medications
If you are currently taking other medications, or have recently completed a treatment course, including herbal supplements, you should inform your doctor. These medications can increase the risk of both known side effects and new, potentially dangerous interactions.
The following medications may render Imuran unsuitable for use:
Other immunosuppressive therapies, taking vaccines, allopurinol (gout), warfarin (blood clots), penicillamine (rheumatoid arthritis), co-trimoxazole (infections), mesalazine or olsalazine (ulcerative colitis), captopril (heart problems), succinylcholine or tubocurarine, cimetidine (stomach ulcers or indigestion), balsalazide or sulfasalazine (ulcerative colitis and rheumatoid arthritis), indomethacin (anti-inflammatory painkiller) and furosemide (heart problems).
Pregnancy and breastfeeding
If you are pregnant, think you might be pregnant or are trying to become pregnant in the near future, you should avoid taking Imuran. Men should also avoid using Imuran in circumstances concerning conception.
Imuran should also be avoided if you are breastfeeding as trace amounts are found in the breast milk and can affect the baby.
Driving and using machinery
There are no known symptoms that are likely to impair your driving skills or prevent you from using heavy machinery.
Food, drink and alcohol
You can drink alcohol while using Imuran, but it may increase the likelihood of nausea. You should avoid excessive alcohol consumption however.
You should refrain from taking Imuran if you are trying to conceive. Circumstances regarding conception apply to both men and women.
I’m elderly, is it appropriate for me?
Yes, but your doctor may adjust the dosage to suit your needs.
How do I store Imuran?
Imuran should be kept in an environment that does not exceed 25C. It should also be kept out of direct light and the reach of children.
Can I buy it without a prescription?
No. It is not available over the counter, so you will need to consult a doctor, or obtain a repeat prescription, in order to buy Imuran online.
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