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Imuran is a prescription immunosuppressive antimetabolite containing azathioprine. The current U.S. tablet contains 50 mg. It is indicated as adjunctive therapy to prevent rejection after kidney transplantation and for management of active rheumatoid arthritis.
read more about imuran ...Azathioprine is converted to 6-mercaptopurine and then to active thioguanine nucleotides. These metabolites interfere with purine metabolism and DNA synthesis and suppress cellular immune responses. TPMT and NUDT15 activity influences exposure to active metabolites and the risk of severe bone marrow toxicity.
Imuran is used as an adjunct to prevent kidney transplant rejection and to reduce signs and symptoms of active rheumatoid arthritis. Current labeling does not establish safety and efficacy for Crohn disease or ulcerative colitis. Pediatric safety and efficacy are also not established.
Kidney transplant treatment usually starts at 3 to 5 mg per kg daily around the time of transplantation and decreases to maintenance dosing of 1 to 3 mg per kg daily. Rheumatoid arthritis starts at about 1 mg per kg daily, commonly 50 to 100 mg, with gradual increases up to 2.5 mg per kg daily when needed.
Imuran carries a boxed warning for malignancy during chronic immunosuppression. Other serious concerns include severe leukopenia, thrombocytopenia, anemia, pancytopenia, serious infections, progressive multifocal leukoencephalopathy, liver toxicity, and severe myelotoxicity in patients with TPMT or NUDT15 deficiency. Complete blood counts are checked regularly during therapy.
Imuran is used to prevent kidney transplant rejection and to manage active rheumatoid arthritis.
The current U.S. tablet contains 50 mg of azathioprine.
Current labeling starts at about 1 mg per kg daily, commonly 50 to 100 mg.
Yes. The boxed warning concerns malignancy associated with chronic immunosuppression.
Azathioprine - MedlinePlus Drug Information. https://medlineplus.gov/druginfo/meds/a682167.html. Date Accessed October 2, 2026.
Azathioprine - StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK542190/. Date Accessed October 2, 2026.
DailyMed - IMURAN - azathioprine tablet. https://www.dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=4d62b6e4-a9d4-4818-e063-6394a90aa208. Date Accessed October 2, 2026.
IMURAN Azathioprine Prescribing Information. https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/016324s037%2C017391s016lbl.pdf. Date Accessed October 2, 2026.
Methotrexate Versus Azathioprine in the Treatment of Rheumatoid Arthritis - A Forty-Eight-Week Randomized Double-Blind Trial. https://pubmed.ncbi.nlm.nih.gov/1859490/. Date Accessed October 2, 2026.