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|Imuran

Imuran

Imuran 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.

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

Do NOT use Imuran if:

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

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

Before using Imuran :

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

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

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

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

This may not be a complete list of all interactions that may occur. Ask your health care provider if 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 :

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

• Take Imuran by mouth with or without food. If stomach upset occurs, take with food to reduce stomach irritation.
• Ask your doctor if you should follow any special guidelines for handling Imuran .
• If you miss a dose of 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 health care provider any questions you may have about how to use Imuran .

Important safety information:

• 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.
• 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.
• Tell your doctor or dentist that you take Imuran before you receive any medical or dental care, emergency care, or surgery.
• Talk with your doctor before you receive any vaccine while you are taking Imuran .
• 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.
• 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.
• An enzyme called TPMT helps to break 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 Imuran . Discuss any questions or concerns with your doctor.
• Lab tests, including complete blood counts, liver function, and TPMT enzyme activity, may be performed while you use Imuran . These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
• Imuran should be used with extreme caution in CHILDREN; safety and efficacy in children have not been confirmed.
• PREGNANCY and BREAST-FEEDING: 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 Imuran while you are pregnant. Imuran is found in breast milk. Do not breast-feed while taking Imuran .

Possible side effects of Imuran :

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.

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.

This is not a complete list of all side effects that may occur. If you have questions or need medical advice about side effects, contact your doctor or health care provider. You may report side effects to the FDA at 1-800-FDA-1088 (1-800-332-1088) or at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org/findyour.htm), or emergency room immediately. Symptoms may include severe or persistent diarrhea, nausea, or vomiting; unusual bruising or bleeding.

Store Imuran at room temperature, between 68 and 77 degrees F (15 and 25 degrees C), in a tightly closed container. Store away from heat, moisture, and light. Do not store in the bathroom. If you no longer need Imuran , ask your doctor how to properly dispose of it. Keep Imuran out of the reach of children and away from pets.

General information:

• If you have any questions about Imuran , please talk with your doctor, pharmacist, or other health care provider.
• Imuran is to be used only by the patient for whom it is prescribed. Do not share it with other people.
• If your symptoms do not improve or if they become worse, check with your doctor.

This information is a summary only. It does not contain all information about Imuran . If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.