Imuran/Azathioprine IS USED FOR:

Preventing kidney transplant rejection along with other medicine. It may also be used to treat signs and symptoms of active rheumatoid arthritis. It may also be used for other conditions as determined by your doctor.

Azathioprine/Imuran is an antimetabolite. It works by decreasing the effects of certain cells in the body's immune system.

BEFORE USING Imuran/Azathioprine :

Some medical conditions may interact with Azathioprine/Imuran . Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you have kidney or liver problems, or gout
• if you are taking a disease-modifying antirheumatic drug (DMARD) (eg, methotrexate/Rheumatrex, adalimumab)
• if you have certain enzyme deficiencies (thiopurine methyltransferase [TPMT] or xanthine oxidase) or you have recently had a blood transfusion
• if you have a history of bone marrow problems, anemia, low white blood cell or platelet levels, or unusual bruising or bleeding
• if you have allergies to medicines, foods, or other substances
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you have an infection, a history of frequent or prolonged infections, or you have recently had a vaccination

Some MEDICINES MAY INTERACT with Azathioprine/Imuran . Tell your health care provider if you are taking any other medicines, especially any of the following:

• Mercaptopurine because severe toxic effects, including severe bone marrow suppression or death, may occur
• Alkylating agents (eg, cyclophosphamide/Cytoxan, chlorambucil/Leukeran, melphalan) because the risk of developing a tumor may be increased
• Anticoagulants (eg, warfarin/Coumadin) or hydantoins (eg, phenytoin/Dilantin) because their effectiveness may be decreased by Azathioprine/Imuran
• Allopurinol/Zyloprim, aminosalicylates (eg, mesalazine, olsalazine, sulfasalazine/Azulfidine), angiotensin-converting enzyme (ACE) inhibitors (eg, enalapril ), doxorubicin, or trimethoprim/sulfamethoxazole because they may increase the risk of Azathioprine/Imuran 's side effects

This may not be a complete list of all interactions that may occur. Ask your health care provider if Azathioprine/Imuran may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

HOW TO USE Imuran/Azathioprine :

Use Azathioprine/Imuran as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Take Azathioprine/Imuran by mouth with or without food. If stomach upset occurs, take with food to reduce stomach irritation.
• If you miss a dose of Azathioprine/Imuran , take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.
• Ask your doctor if you should follow any special guidelines for handling Azathioprine/Imuran .

Ask your health care provider any questions you may have about how to use Azathioprine/Imuran .

DO NOT USE Imuran/Azathioprine IF:

• you have rheumatoid arthritis and are pregnant
• you are taking mercaptopurine
• you have a tumor or an unusual growth
• you have rheumatoid arthritis and have used alkylating agents (eg, cyclophosphamide/Cytoxan, chlorambucil/Leukeran, melphalan) in the past
• you are allergic to any ingredient in Azathioprine/Imuran

Contact your doctor or health care provider right away if any of these apply to you.

POSSIBLE SIDE EFFECTS OF Imuran/Azathioprine :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Mild nausea or vomiting.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; itching; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain or tightness; dark urine; dizziness; fever, chills, or sore throat; increased or painful urination; muscle pain or aches; pale or fatty stools; severe or persistent nausea, vomiting, or diarrhea; shortness of breath; stomach pain; unusual bleeding or bruising; unusual growths or lumps; unusual weakness or fatigue; yellowing of the eyes or skin.

IMPORTANT SAFETY INFORMATION:

• Tell your doctor or dentist that you take Azathioprine/Imuran before you receive any medical or dental care, emergency care, or surgery.
• Azathioprine/Imuran may increase your risk of developing a tumor or other cancer. Contact your doctor at once if you notice any unusual growths or lumps. Discuss any questions or concerns with your doctor.
• Azathioprine/Imuran should be used with extreme caution in CHILDREN; safety and efficacy in children have not been confirmed.
• Contact your doctor at once if you develop severe nausea and vomiting. This may occur with or without diarrhea, rash, fever, muscle pain, or dizziness. If this reaction occurs, it usually happens within the first several weeks of therapy.
• Azathioprine/Imuran may lower the ability of your body to fight infection. Avoid contact with people who have colds or infections. Tell your doctor if you notice signs of infection like fever, sore throat, rash, or chills.
• Talk with your doctor before you receive any vaccine while you are taking Azathioprine/Imuran .
• An enzyme called TPMT helps to break Azathioprine/Imuran down in the body. Infrequently, some patients may have decreased TPMT enzyme activity. This may increase the risk of developing serious side effects (eg, severe bone marrow problems). Patients with decreased TPMT enzyme activity may need a lower dose of Azathioprine/Imuran . Discuss any questions or concerns with your doctor.
• Azathioprine/Imuran may reduce the number of clot-forming cells (platelets) in your blood. Avoid activities that may cause bruising or injury. Tell your doctor if you have unusual bruising or bleeding. Tell your doctor if you have dark, tarry, or bloody stools.
• Lab tests, including complete blood counts, liver function, and TPMT enzyme activity, may be performed while you use Azathioprine/Imuran . These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
• PREGNANCY and BREAST-FEEDING: Azathioprine/Imuran has been shown to cause harm to the fetus. Do not become pregnant while you are using it. If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using Azathioprine/Imuran while you are pregnant. Azathioprine/Imuran is found in breast milk. Do not breast-feed while taking Azathioprine/Imuran .

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.