Generic Imuran

Common use

Imuran contains azathioprine, which is an immunosuppressant. It is used to prevent rejection of kidney transplants, in treatment of rheumatoid arthritis, chronic active hepatitis, systemic lupus erythematosus, dermatomyositis, periarteritis nodosa, acquired hemolytic anemia, idiopathic thrombocytopenic purpura, gangrenous pyoderma, psoriasis, Crohn's disease, ulcerative colitis, myasthenia gravis, pemphigus (a chronic blistering skin disease), Reiter's syndrome (autoimmune condition that is caused by an infection in another part of the body), radiation dermatitis.



Dosage and direction

Take Imuran with food. The dose is administered individually for different conditions. Follow all instructions of your physician. Do not take more than one dose of Imuran at once.



Precautions

Do not stop taking this drug even if you do not feel improvement. Its effects may develop in several days or weeks. If you did not feel improvement of you symptoms after three months of treatment inform your doctor. The high risk of a draft rejection may remain even after several years of treatment. Blood tests for blood cell count should be exercised on a regular basis: each weak during first eight weeks of treatment. Avoid exposure to sun rays for a long time as this drug is able to increase risk of cancer. Regular examination of skin should be done. Patients with system diseases of joint tissues should not stop treatment without permission of a doctor not to provoke aggravation of their condition. This medication may decrease immunity status of unborn baby. Inform your doctor if you are pregnant or breastfeeding. Notify your doctor if you plan to be operated, have a fever, body aches, weakness, muscle pain, chills, sore throat, easy bruising or bleeding, mouth sores, severe nausea, vomiting, pale stools, darkened urine, and diarrhea.



Contraindications

This medicine cannot be administered to the patients with hypersensitivity to the components of the drug, inhibition of hematopoiesis (hypoplastic and aplastic anemia, leukopenia, lymphopenia, thrombocytopenia), hepatic failure, in pregnant and breastfeeding women, in children.



Possible side effect

Adverse reaction to Imuran mostly concern blood and gastrointestinal system. White blood cell count may decrease causing the increased risk of infection development. This effect most reverses when the dose is reduced or temporary discontinued. Nausea and vomiting caused by Imuran mostly disappear when its dose is diminished or divided in several intakes. In the patients with rheumatoid arthritis liver toxicity may develop. Other less common side effects include hair loss, joint pains, fatigue, and diarrhea.



Drug interaction

About 200 drugs are known to interact with Imuran. Inform your doctor about all prescribed and over-the-counter medications, herbal products and food supplements you take. The basic interactions of Imuran are described below. Imuran reduces effects of nondepolarizing muscle relaxants, increases neuromuscular block caused by suxametonium. Allopurinol (the medication for gout) inhibits azathioprine metabolism, increases its blood levels and toxicity. Imuran increases the effects of immunosuppressants, cytostatics. Anemia and leukopenia may develop if angiotensin-converting enzyme (ACE) inhibitors are used with Imuran. Imuran reduces blood concentrations and effects of indirect anticoagulants such as warfarin. Graft rejection may become a result of concomitant use of rifampicin and Imuran. When Imuran is used with co-trimoxazole a myelotoxic effect of azathioprine may increase.



Missed dose

If you missed a dose take it as soon as you remember, but not if it is almost time of the next intake by your schedule. Skip the missed dose if it is almost time of your next dose. Do not try to compensate a missed dose by taking an extra one.



Overdose

If you think you have used too much of this medicine seek emergency medical attention right away. Very large doses of this Imuran may cause marrow hypoplasia, bleeding, infection, and death, nausea, vomiting, and diarrhea, mild leukopenia and mild liver impairments.



Storage

Store at room temperature between 59-77 F (15-25 C) away from light and moisture, kids and pets. Do not use after expiration term.



Disclaimer

We provide only general information about medications which does not cover all directions, possible drug integrations, or precautions. Information at the site cannot be used for self-treatment and self-diagnosis. Any specific instructions for a particular patient should be agreed with your health care adviser or doctor in charge of the case. We disclaim reliability of this information and mistakes it could contain. We are not responsible for any direct, indirect, special or other indirect damage as a result of any use of the information on this site and also for consequences of self-treatment.

Clinical Verification

Last Clinically Updated: August 15, 2026

Written By

Dr. Elena Vance, PharmD

Clinical Specialist in Neuropharmacology

Fact Checked By

Marcus Thorne, MS

Biomedical Data & FDA Label Verification

Medically Reviewed By

Dr. Arthur Campbell, MD

Board-Certified Psychiatrist (ABPN)