Imuran is a drug most commonly used to suppress the immune response following a kidney transplant. Patients taking Imuran should be aware of its actions and potential serious side effects.
Function
Following any type of organ transplant, the immune system must be suppressed in order for the transplanted organ to remain viable in the body. If the immune system is not suppressed, the body will reject the organ and cause it to die. Imuran is one of the drugs most commonly used to facilitate acceptance of the new kidney in transplant patients.
Features
In addition to its use in transplant patients, Imuran is also used to reduce the signs and symptoms of rheumatoid arthritis such as swollen and painful joints. Imuran may be used in conjunction with other drugs such as aspirin, non-steroidal anti-inflammatory drugs (NSAIDS) and steroids such as Prednisone.
Considerations
Patients who begin treatment on Imuran must have regular blood work done to confirm that their white blood cell and platelet counts remain within normal limits. As Imuran is an immunosuppressant, risk for infection is high. Patients should also report any unusual bleeding or bruising, as Imuran also decreases thrombin, which is used to form clots such as those produced when you receive a cut.
Warning
The most serious side effects of Imuran are targeted toward the gastrointestinal (digestive) and hematologic (blood) systems. A gastrointestinal hypersensitivity may occur when taking Imuran and is characterized by severe nausea and vomiting, which may also be accompanied by a rash, general feeling of malaise, increased liver enzymes and fever. Severe bone marrow suppression may also occur, which may result in brittle bones. Women who are pregnant should not use Imuran, as severe fetal harm may occur. The risks versus benefits to the pregnant patient and the fetus should be weighed when making any decision about using Imuran while pregnant.
Expert Insight
For kidney transplant patients, Imuran is usually initiated with a 3 to 5 mg/kg daily dose, with the first dose being given on the day of the transplant through intravenous administration. Dose reduction to 1 to 3 mg/kg daily is usually possible within a few days following the transplant. Imuran should not be increased to near toxic levels if rejection of the organ becomes a threat.
For rheumatoid arthritis patients, Imuran is most commonly prescribed for daily consumption. The initial dose is approximately 1.0 mg/kg (50 to 100 mg) once daily or twice daily in divided doses. The dose may be increased at 6 to 8 weeks and thereafter at 4-week intervals, up to a maximum dose of 2.5 mg/kg per day.
Maintenance therapy should be at the lowest effective dose, and the dose may be lowered in 0.5 mg/kg increments. Imuran can be discontinued abruptly, but delayed effects are possible.
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