In this article we will talk about a drug such as "Imuran", instructions for use, description and analogues will be considered.
Composition, release form
The active substance in the medication is azathioprine. "Imuran" in the form of tablets contains 50 mg of this component, is available in packaging in the amount of 100 pieces. The drug in ampoules for injection contains the equivalent of 50 mg of azathioprine (in the form of sodium salt, lyophilized by cooling), is available in individual packaging.
Drug action
For the medication "Imuran" instructions for use indicate that it has a cytostatic and immunosuppressive effect. When using the drug in increased doses, bone marrow activity is suppressed, granulocyte proliferation is suppressed, leukopenia, thrombocytopenia is manifested.
In what cases is appointed?
The drug is intended for use by patients who underwent organ transplantation. In addition, its use as a therapeutic agent is carried out in cases of chronic active hepatitis, severe rheumatoid arthritis, systemic lupus erythematosus, dermatomyositis, pemphigus vulgaris, periarteritis nodosa, acquired hemolytic anemia, idiopathic thrombocytopenic purpura, and gangrenous pyoderma. This confirms the instructions for use for the Imuran.
It is also prescribed in the presence of the following groups of diseases:
- Pathologies that are not treated with corticosteroids.
- Diseases that can be treated with corticosteroids, but in a dosage that can cause a serious side effect.
- If there are contraindications for the use of corticosteroids.
Dosage and application
Description of the drug "Imuran" we reviewed. Dosage and timing of administration are assigned individually. This is influenced by the nosological form and severity of the course of the disease, doses of other drugs used simultaneously with it, and hematological tolerance.
Transplantation in adults and children
As a rule, a large dose is prescribed - up to 5 mg / kg orally, then the drug is used in a maintenance daily dose of 1-4 mg / kg (it all depends on the patient's condition and hematological tolerance). If it is not possible to use the dose to maintain 1-2, 5 mg / kg / day is administered intravenously. The use of the drug for a sufficiently long time is allowed in the absence of contraindications. There are times when fairly small doses are required. The risk of transplant rejection is not excluded when the medication is discontinued, even in cases where the treatment lasted several years. This confirms the instructions for use for the medication "Imuran".
Side effects
The main distinguishing side effect when taking it is dose-dependent, usually a reversible weakening of bone marrow activity, which finds expression in such ailments as leukopenia, thrombocytopenia and anemia. Hematological toxicity of the drug can occur in the appearance of megaloblastic erythropoiesis and macrocytosis. Most often, such drug toxicity develops in the first time after the start of treatment, but this is not a regularity. There are cases when leukopenia and anemia develop much later, which indicates the need for constant hematological monitoring, despite prolonged stable treatment.
As for intolerance from the gastroenterological side with oral administration, it varies. It manifests itself, as a rule, in the form of symptoms: diarrhea, nausea, anorexia, and occasionally vomiting. Some cases of these side effects are due to intolerance to the prescribed dose. If you take a short break, you can resume taking the drug, but already in more reduced doses. It is advisable to use the drug with meals. This is indicated by the instruction for use of the drug "Imuran".
In addition to these side effects, more serious gastrointestinal complications may occur in the form of pancreatitis, ulcers, intestinal bleeding, necrosis and perforation of the intestine. The reason for their appearance may be treatment with steroid drugs at the same time with Imuran. Discontinuation of the drug is necessary when a dose-dependent, reversible toxic cholestatic liver lesion appears.
Allergic reactions, drug fever, skin rashes, myalgia and arthralgia, acute renal failure, hemolytic anemia, acute pulmonary diseases, and unexplained meningeal reactions can also be observed as side effects. This confirms the instructions for use for the Imuran. The price will be presented below.
Contraindications
Contraindication is hypersensitivity to the components of the drug. As for the use of the drug during pregnancy and lactation, it is necessary to pay attention to the possible teratogenicity of azathioprine. It is proved that the active component that is part of the drug, and its metabolites can penetrate the placenta. Short-term dysfunction of the immune system appears due to exposure to azathioprine in combination with prednisolone.
Precautionary measures
During treatment, the patient must be under strict medical supervision. "Imuran" is prescribed only in cases where there is the possibility of appropriate monitoring of the patient in order to identify toxic effects during therapy. The first 8 weeks of treatment with the drug every week, and sometimes more often, it is necessary to take a complete complete blood count, which includes platelet counts. Then the test frequency decreases. With good tolerance it is allowed to use it for a long time. There are cases when when the necessary dose is canceled, for example, with systemic lupus erythematosus, which is accompanied by nephritis, a serious relapse of the disease can develop. This confirms the instructions for use for the drug "Imuran".
In some diseases (rheumatoid arthritis and pathologies of the blood system), therapy is stopped, even in the absence of a negative effect. The end of the drug is not carried out immediately and under the strict supervision of the attending physician. The drug "Imuran" can cause negative reactions, which manifest themselves in the form of: infections, mutagenicity, carcinogenicity (the occurrence of malignant tumors).
During treatment with the drug, patients are prohibited from staying in the sun for a long time, they should always have a skin examination during admission. In practice, there is no accurate data regarding the incidence of tumors and an increase in the incidence of cancer in patients who received azathioprine.
The risk of the appearance of tumors in these people is not higher than the risk when using other drugs for various diseases. There are a large number of cases that indicate other causes of the development of tumors that are not related to transplantation. The development of tumors is rare, they can appear only with prolonged continuous treatment. They possess not only exclusively lymphoreticular function, but also often develop in patients who use simultaneously alkylating drugs. This is indicated by the instruction "Imuran". The price in pharmacies and analogues are of interest to many.
Overdose cases
In case of an overdose of the drug, symptomatic therapy is necessary. Azathioprine can be removed from the body by dialysis.
Drug storage
"Imuran" in the form of tablets is stored at a temperature of less than 35 ° C in a dry and dark place. The drug in the form of ampoules for injection is stored at a temperature of less than 25 ° C in a dark place.
Price
The cost of the drug is quite high. One package of the product will cost about 3,500 rubles.
Analogs
Azathioprine is the main analogue of Imuran. Its advantage is that the price is several times lower. A cheap analogue costs 250-300 rubles per package.
Reviews
In general, there are a lot of positive reviews about the Imuran preparation. It is of high quality, effective, most often well tolerated, if the doctor's instructions are followed. The negative points include its high cost.
We have reviewed the instructions for use for the medication "Imuran". Price, reviews and analogues are described.