Imruza Tablet

Introduction

Imruza Tablet 25 mg (brand name Imuran) is an immunosuppressive drug used to treat autoimmune diseases and to prevent organ transplant rejection. It works by suppressing the body’s immune system, slowing down its ability to produce antibodies and other immune cells that attack and damage healthy cells, tissues, and organs.

Uses for

Imruza Tablet 25 mg is mainly used to treat autoimmune diseases such as rheumatoid arthritis, Crohn’s disease, ulcerative colitis, and multiple sclerosis. It is also used to help prevent organ transplant rejection.

Brand Name	Imruza
Type	Tablet
Weight	25 mg
Generic	Azathioprine
Manufacturer	Beacon Pharmaceuticals PLC
Available in	English বাংলা

Mechanism of Action

Imruza Tablet 25 mg works by inhibiting the growth of new immune system cells. It does this by blocking the production of certain amino acids necessary for cell growth and division. Imruza Tablet 25 mg also inhibits the production of other immune system cells that can attack and damage healthy cells.

How Long Does it Take To Work?

It typically takes at least 2 to 3 weeks before the full therapeutic effects of azathioprine are seen. The time frame may vary depending on the individual and the disease being treated.

Absorption

Imruza Tablet 25 mg is absorbed rapidly following oral administration. It is metabolized in the liver and is eliminated mainly through the kidneys.

Route of Elimination

Imruza Tablet 25 mg is primarily eliminated from the body through the urine. Some of the metabolized drug is also excreted in the bile.

Dosage

Transplants:

Depending on the immunosuppressive regimen employed, a dosage of up to 5mg/kg body weight/day may be given orally or intravenously on the first day of therapy.
Maintenance dosage should range from 1 to 4mg/kg body weight/day and must be adjusted according to clinical requirements and haematological tolerance.
Evidence indicates that azathioprine therapy should be maintained indefinitely, even if only low doses are necessary, because of the risk of graft rejection.

Dosage in Other indications:

In general, the starting dosage is 1 to 3mg/kg body weight/day, and should be adjusted, within these limits, depending on the clinical response (which may not be evident for weeks or months) and haematological tolerance.
When the therapeutic response is evident, consideration should be given to reducing the maintenance dosage to the lowest level compatible with the maintenance of that response. If no improvement occurs in the patient's condition within three months, consideration should be given to withdrawing azathioprine. However, for patients with IBD, a treatment duration of at least twelve months should be considered and a response to treatment may not be clinically apparent until after three to four months of treatment.
The maintenance dosage required may range from less than 1mg/kg body weight/day to 3mg/kg body weight/day, depending on the clinical condition being treated and the individual patient response, including haematological tolerance.

Overweight children: Children considered to be overweight may require doses at the higher end of the dose range and therefore close monitoring of response to treatment is recommended.

Elderly: There is limited experience of the administration of azathioprine to elderly patients. Although the available data do not provide evidence that the incidence of side effects among elderly patients is higher than that among other patients treated with azathioprine, it is recommended that the dosages used should be at the lower end of the range.

Renal impairment: In patients with renal insufficiency, consideration should be given to reducing the dosage.

Hepatic impairment: In patients with hepatic insufficiency, consideration should be given to reducing the dosage.

The usual initial oral dose of Imruza Tablet 25 mg is 2 to 3 mg per kg of body weight per day, divided into two equal doses and taken with food. The dose may be increased by 1 to 2 mg per kg of body weight per day at weekly intervals, up to a maximum dose of 5 to 6 mg per kg of body weight per day.

Administration

Imruza Tablet 25 mg should be taken with meals, preferably at the same time each day. It is also available in tablets, capsules, and liquid forms.

Side Effects

Common side effects of azathioprine include nausea, vomiting, anorexia, hepatitis, jaundice, bone marrow suppression, anemia, and thrombocytopenia.

Toxicity

Imruza Tablet 25 mg can be toxic if taken in high doses. Overdose can cause liver damage, nausea, vomiting, rash, and decreased immunity.

Precautions

Imruza Tablet 25 mg should not be taken by people who are pregnant or nursing, or who have an impaired liver or kidney function. People taking Imruza Tablet 25 mg should also avoid exposure to sunlight, since the drug can increase the risk of sunburn.

Interaction

Imruza Tablet 25 mg may interact with other drugs, including antibiotics, antifungals, anti-parasitics, and some over the counter medications. People taking Imruza Tablet 25 mg should speak with their doctor before taking any new prescription or nonprescription medications.

Disease Interaction

Imruza Tablet 25 mg may worsen existing conditions such as leukemia, lupus, or an infection. It may also increase the risk of developing new conditions, such as cancers and other autoimmune diseases.

Drug Interaction

Imruza Tablet 25 mg may interact with certain drugs, such as barbiturates, phenytoin, carbamazepine, and some antibiotics. People taking Imruza Tablet 25 mg should speak with their doctor before taking any new prescription or non-prescription medications.

Food Interactions

Imruza Tablet 25 mg may interact with certain foods, such as dairy products, citrus juices, and alcoholic beverages. People taking azathioprine should speak with their doctor about any foods that should be avoided.

Pregnancy Use

Imruza Tablet 25 mg has not been studied in pregnant women and should not be used during pregnancy unless the potential benefits outweigh the potential risks. Women who are pregnant or planning to become pregnant should speak to their doctor before taking Imruza Tablet 25 mg.

Lactation Use

Imruza Tablet 25 mg has not been studied in nursing mothers and should not be used while breastfeeding. Women who are breastfeeding or planning to breastfeed should speak to their doctor before taking Imruza Tablet 25 mg.

Acute Overdose

Symptoms of an acute overdose may include nausea, vomiting, rash, decreased immunity, and liver damage. If an overdose is suspected, the person should be taken to an emergency room for evaluation and treatment.

Contraindication

Imruza Tablet 25 mg should not be taken by people who are pregnant or nursing, or who have an impaired liver or kidney function. People with a history of blood disorders, or with a weakened immune system, should speak with their doctor before taking azathioprine.

Use Direction

Imruza Tablet 25 mg should be taken as directed by your doctor. It is typically taken once or twice daily with food. It is important to take Imruza Tablet 25 mg at the same time every day to maintain an even level in your system.