Posts Tagged ‘TPMT’
Puri-Nethol (Mercaptopurine)
Puri-Nethol 50 mg tablets
Mercaptopurine
1 What Puri-Nethol is and what it is used for
Puri-Nethol tablets contain a medicine called mercaptopurine. This belongs to a group of medicines called cytotoxics (also called chemotherapy). Puri-Nethol is used to treat leukaemia (cancer of the blood). It works by reducing the number of new blood cells your body makes.
Puri-Nethol is used for:
• Acute myelogenous leukaemia (also called acute myeloid leukaemia or AML) – a fast-growing disease that increases the number of white blood cells produced by the bone marrow. This can cause infections and bleeding.
• Acute lymphoblastic leukaemia (also called acute lymphocytic leukaemia or ALL) – a fast-growing disease which increases the number of immature white blood cells. These immature white blood cells are unable to grow and work properly. They therefore cannot fight infections and may cause bleeding.
• Chronic granulocytic leukaemia (also called chronic myeloid leukaemia) – a disease that increases the number of white blood cells. This can cause infections and bleeding.
Ask your doctor if you would like more explanation about these diseases.
2 Before you take Puri-Nethol
Do not take Puri-Nethol if:
• You are allergic (hypersensitive) to mercaptopurine or any of the other ingredients of Puri-Nethol tablets (See section 6: Further information)
Do not take if the above applies to you. If you are not sure, talk to your doctor or pharmacist before taking Puri-Nethol.
Take special care with Puri-Nethol
Before you take Puri-Nethol, tell your doctor or pharmacist if:
• you have a liver problem, your doctor will monitor your liver function
• you have a condition where your body produces too little of something called TPMT or ‘thiopurine methyltransferase’.
If you are not sure if any of the above apply to you, talk to your doctor or pharmacist before taking Puri-Nethol.
Taking other medicines
Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription. This includes herbal medicines.
In particular, tell your doctor or pharmacist if you are taking any of the following:
• other cytotoxic drugs (chemotherapy) – when used with Puri-Nethol there is a greater chance of side effects, such as breathing problems
• allopurinol (used to treat gout)
• warfarin (used to thin the blood)
• olsalazine or mesalazine (used for a bowel problem called ulcerative colitis)
• sulfasalazine (used for rheumatoid arthritis or ulcerative colitis).
Having vaccines while you are taking Puri-Nethol
If you are going to have a vaccination speak to your doctor or nurse before you have it. This is because some vaccines (like polio, measles, mumps and rubella) may give you an infection if you have them whilst you are taking Puri-Nethol.
Pregnancy and breast-feeding
Do not take Puri-Nethol if you are planning to have a baby.
This applies to both men and women. Puri-Nethol may harm your sperm or eggs. Reliable contraceptive precautions must be taken to avoid pregnancy whilst you or your partner is taking these tablets. Ask your doctor for advice.
If you are already pregnant, it is important to talk to your doctor before taking Puri-Nethol.
Do not breast-feed while taking Puri-Nethol. Ask your doctor or midwife for advice.
Important information about some of the ingredients of Puri-Nethol
Puri-Nethol tablets contain lactose. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before you take Puri-Nethol tablets.
3 How to take Puri-Nethol
Puri-Nethol should only be given to you by a specialist doctor who is experienced in treating blood problems.
Always take Puri-Nethol exactly as your doctor has told you. It is important to take your medicine at the right times. The label on your pack will tell you how many tablets to take and how often to take them. If the label doesn’t say or if you are not sure, ask your doctor, nurse or pharmacist.
• Swallow your tablets whole with a glass of water.
• If you need to break your tablet in half, do not inhale any tablet powder. Wash your hands afterwards.
• When you take Puri-Nethol your doctor will take regular blood tests. This is to check the number and type of cells in your blood and to ensure your liver is working correctly.
• Your doctor may also ask for other blood and urine tests to monitor your uric acid levels. Uric acid is a natural body chemical, levels of which can rise while taking Puri-Nethol.
• Your doctor may sometimes change your dose of Puri-Nethol as a result of these tests.
The dose of Puri-Nethol you are given will be worked out by your doctor based on:
• your body size (surface area)
• the results of your blood tests
• The usual starting dose for adults and children is 2.5 mg per kilogram of your body weight each day.
• Elderly patients will have their kidney and liver function tested and if necessary the dose may need to be reduced.
If you take more Puri-Nethol than you should
If you take more Puri-Nethol than you should, tell your doctor immediately or go to a hospital straight away. Take the medicine pack with you.
If you forget to take Puri-Nethol
Tell your doctor. Do not take a double dose to make up for a forgotten dose.
4 Possible side effects
Like all medicines, Puri-Nethol can cause side effects, although not everybody gets them.
If you get any of the following, talk to your specialist doctor or go to hospital straight away:
• allergic reaction, the signs may include:
- skin rashes
- high temperature -joint pain
- swollen face
• any signs of fever or infection (sore throat, sore mouth or urinary problems)
• any unexpected bruising or bleeding, as this could mean that too few blood cells of a particular type are being produced
• if you suddenly feel unwell (even with a normal temperature)
• any yellowing of the whites of the eyes or skin (jaundice)
• if you have diarrhoea
• if you feel sick (nausea) or you are sick (vomiting).
Talk to your doctor if you have any of the following side effects which may also happen with this medicine:
Very common (affects more than 1 in 10 people)
• a drop in the number of white blood cells and platelets
Common (affects less than 1 in 10 people)
• feeling or being sick (nausea or vomiting)
• liver problems – this may show up in your blood tests
Uncommon (affects less than 1 in 100 people)
• a drop in red blood cells which may make you tired, weak or breathless – called anaemia
• loss of appetite
Rare (affects less than 1 in 1,000 people)
• mouth ulcers
• inflammation of the pancreas which can give you abdominal pain or make you sick
• hair loss
Very rare (affects less than 1 in 10,000 people)
• leukaemia
• ulcers in the intestines
• in men: low sperm count
If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.
5 How to store Puri-Nethol
• Keep out of the reach and sight of children.
• Do not use Puri-Nethol after the expiry date which is stated on the pack after ‘EXP’.
• Do not store your Puri-Nethol tablets above 25°C. Keep the bottle tightly closed.
• If your doctor tells you to stop taking the tablets, it is important to return any which are left over to your pharmacist, who will destroy them according to disposal of dangerous substance guidelines. Only keep the tablets if your doctor tells you to.
6 Further information
- What Puri-Nethol contains
The active ingredient is mercaptopurine. Each tablet contains 50 mg of mercaptopurine.
The other ingredients are lactose, maize starch, hydrolysed starch, stearic acid and magnesium stearate.
- What Puri-Nethol looks like and contents of the pack
Puri-Nethol tablets are a pale yellow colour and are marked with ‘GX / EX2′. Your Puri-Nethol tablets are in bottles of 25 tablets.
Lanvis tablets (Tioguanine)
Lanvis tablets 40 mg
Tioguanine
1 What Lanvis is and what it is used for
Lanvis tablets contain a medicine called tioguanine. This belongs to a group of medicines called cytotoxics (also called chemotherapy). Lanvis is used for certain blood problems and cancers of the blood. It works by reducing the number of new blood cells your body makes.
Lanvis is used for acute (fast-growing) leukaemias, especially:
• Acute myelogenous leukaemia (also called acute myeloid leukaemia or AML)- a fast-growing disease that increases the number of white blood cells produced by the bone marrow. This can cause infections and bleeding.
• Acute lymphoblastic leukaemia (also called acute lymphocytic leukaemia or ALL) – a fast-growing disease which increases the number of immature white blood cells. These immature white blood cells are unable to grow and function properly and therefore cannot fight infections and may cause bleeding.
• Chronic granulocytic leukaemia (also called chronic myeloid leukaemia) – a disease that increases the number of white blood cells. This can cause infections and bleeding.
Ask your doctor if you would like more explanation about these diseases.
2 Before you take Lanvis
Take special care with Lanvis
Before you take Lanvis, tell your doctor or pharmacist if:
• you have been taking this medicine for a long period of time. This may increase the chance of side effects, such as liver problems
• you have a condition where your body produces too little of something called TPMT or ‘thiopurine methyltransferase’
• you have ‘Lesch-Nyhan Syndrome’. This is a rare condition that runs in families caused by a lack of something called HPRT or ‘hypoxanthine-guanine-phosphoribosyltransf erase’.
If you are not sure if any of the above apply to you, talk to your doctor, nurse or pharmacist before taking Lanvis.
Taking other medicines
Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription. This includes herbal medicines.
In particular tell your doctor or pharmacist if you are taking any of the following:
• olsalzine or mesalazine – used for a bowel problem called ulcerative colitis
• sulfasalazine – used for rheumatoid arthritis or ulcerative colitis.
Having vaccines while you are taking Lanvis
If you are going to have a vaccination speak to your doctor or nurse before you have it. This is because some vaccines (like polio, measles, mumps and rubella) may give you an infection if you have them whilst you are taking Lanvis.
Pregnancy and breast-feeding
Do not take Lanvis if you are planning to have a baby. This applies to both men and women. Lanvis may harm your sperm or eggs. Reliable contraceptive precautions must be taken to avoid pregnancy whilst you or your partner are taking these tablets. Ask your doctor for advice.
If you are already pregnant, it is important to talk to your doctor before taking Lanvis. Do not breast-feed while taking Lanvis. Ask your doctor or midwife for advice.
3 How to take Lanvis
Lanvis should only be given to you by a specialist doctor who is experienced in treating blood problems.
Always take Lanvis exactly as your doctor has told you. It is important to take your medicine at the right times. The label on your pack will tell you how many tablets to take and how often to take them. If the label doesn’t say or if you are not sure, ask your doctor, nurse or pharmacist.
• Swallow your tablets whole with a glass of water.
• If you need to break your tablet in half, do not inhale any tablet powder. Wash your hands afterwards.
• When you take Lanvis your doctor will take regular blood tests. This is to check the number and type of cells in your blood and to ensure your liver is working correctly. Your doctor may sometimes change your dose as a result.
The dose of Lanvis you are given will be worked out by your doctor based on:
• your body size (surface area)
• the results of your blood test
• the disease being treated.
• The usual dose is between 100 and
200 mg/m2 body surface area per day. If you have a problem with your kidneys or liver you may be given a lower dose of Lanvis.
- If you take more Lanvis than you should
If you take more Lanvis than you should, tell your doctor immediately or go to a hospital straight away. Take the medicine pack with you.
- If you forget to take Lanvis
Tell your doctor. Do not take a double dose to make up for a forgotten dose.
4 Possible side effects
Like all medicines, Lanvis can cause side effects, although not everybody gets them.
If you get any of the following, talk to your specialist doctor or go to hospital straight away:
• any signs of fever or infection (sore throat, sore mouth or urinary problems)
• any unexpected bruising or bleeding, as this could mean that too few blood cells of a particular type are being produced
• if you suddenly feel unwell (even with a normal temperature)
• any yellowing of the whites of the eyes or skin (jaundice).
Talk to your doctor if you have any of the following side effects which may also happen with this medicine:
Very common (affects more than 1 in 10 people)
• a drop in the number of your blood cells
• jaundice and severe liver damage – with long term use or high doses of Lanvis.
Common (affects less than 1 in 10 people)
• liver damage which can cause jaundice or an enlarged liver (a swelling below your ribcage) – with short term use of Lanvis.
• feeling or being sick (nausea or vomiting), diarrhoea and mouth ulcers.
Rare (affects less than 1 in 1,000 people)
• a problem with your bowels, called intestinal necrosis, which can cause severe stomach ache, being sick, diarrhoea and fever
• severe liver damage when used with other chemotherapy drugs, oral contraceptives and alcohol.
5 How to store Lanvis
• Keep out of the reach and sight of children.
• Do not use Lanvis after the expiry date which is stated on the pack after ‘Exp’.
• Do not store your Lanvis tablets above 25°C.
• If your doctor tells you to stop taking the tablets, it is important to return any which are left over to your pharmacist, who will destroy them according to disposal of dangerous substance guidelines. Only keep the tablets if your doctor tells you to.
6 Further information
What Lanvis contains
The active ingredient is tioguanine. Each Lanvis tablet contains 40 mg of tioguanine. The other ingredients are anhydrous lactose, starch (potato), acacia, stearic acid, magnesium stearate and purified water.
What Lanvis looks like and contents of the pack
Lanvis tablets are round, pale greenish-yellow tablets and are marked with ‘WELLCOME’ and ‘U3B’. Your Lanvis tablets are in bottles of 25 tablets.
Imuran Tablets (Azathioprine)
Imuran Tablets
Azathioprine
1 What Imuran is and what it is used for
Imuran tablets contain a medicine called azathioprine. This belongs to a group of medicines called immunosuppressants. These medicines reduce the activity of your body’s immune system.
Imuran is used to:
• stop your body rejecting an organ transplant
• treat diseases where your immune system reacts against your own body (called autoimmune diseases, such as rheumatoid arthritis).
Ask your doctor, nurse or pharmacist if you would like any further explanation about these uses.
2. Do not take Imuran if:
• you are allergic (hypersensitive) to azathioprine, mercaptopurine or any of the other ingredients of Imuran (listed in section 6).
Do not take Imuran if any of the above apply to you. If you are not sure, talk to your doctor, nurse or pharmacist before taking Imuran.
Take special care with Imuran
Check with your doctor, nurse or pharmacist before taking Imuran if:
• you have liver or kidney disease
• you have ‘Lesch-Nyhan Syndrome’. This is a rare condition that runs in families caused by a lack of something called HPRT or ‘hypoxanthine-guanine-phosphoribosyltransf erase’
• you have a condition where your body produces too little of something called TPMT or ‘thiopurine methyltransferase’
• you have ever suffered from chickenpox or shingles.
If you are not sure if any of the above apply to you, talk to your doctor, nurse or pharmacist before taking Imuran.
- Taking other medicines
Please tell your doctor, nurse or pharmacist if you are taking or have recently taken any other medicines. This includes medicines obtained without a prescription, including herbal medicines. This is because Imuran can affect the way some medicines work. Also some other medicines can affect the way Imuran works.
In particular, tell your doctor, nurse or pharmacist if you are taking any of the following medicines:
• allopurinol – used for gout
• tubocurarine or succinylcholine – used during operations
• warfarin – used for blood clots
• penicillamine – used for rheumatoid arthritis
• co-trimoxazole – used for infections
• captopril – used for high blood pressure or heart problems
• cimetidine – used for stomach ulcers and indigestion
• indomethacin – used for pain and inflammation
• furosemide – used for high blood pressure and heart problems
• olsalazine or mesalazine – used for a bowel problem called ulcerative colitis
• sulfasalzine or balsalazide – used for rheumatoid arthritis or ulcerative colitis.
If you are not sure if any of the above apply to you, talk to your doctor, nurse or pharmacist before taking Imuran.
Having vaccines while you are taking Imuran
If you are going to have a vaccination speak to your doctor or nurse before you have it. This is because vaccines may not work properly while you are taking Imuran.
Tests you may have while taking Imuran
Your doctor may ask you to have a blood test while you are taking Imuran. This is to check your blood cell count. Your doctor may change your dose of Imuran after the test.
Trying for a baby, pregnancy and breast-feeding
• Do not take Imuran if you are a man trying to have a baby. This is because it may affect the baby.
• Do not take Imuran if you are a women who is pregnant or think you might become pregnant. This is because it may affect the baby.
• Do not take Imuran if you are breastfeeding. This is because small amounts may pass into the mother’s milk.
Ask your doctor, midwife or pharmacist for advice before taking any medicine, if you are pregnant or breast-feeding.
- Imuran and the sun
While taking Imuran you may be more likely to develop some types of cancers such as skin cancer. Some people also become sensitive to sunlight which can cause skin discolouration or a rash. Take care to avoid too much sun, cover up and use sunscreen.
- Chickenpox /Shingles infection
Infection with chickenpox or shingles can become severe in patients taking immunosuppressive medicine. Therefore you should avoid contact with anyone suffering from chickenpox or shingles.
3 How to take Imuran
Always take Imuran exactly as your doctor has told you. You should check with your doctor, nurse or pharmacist if you are not sure.
The dose of Imuran you take depends on your illness and how bad it is. The dose also depends on your age, your weight and how well your liver and kidneys are working. Your doctor will explain this to you.
To stop your body rejecting an organ transplant
On the first day
• the usual dose is up to 5 mg per kg of body weight.
For the rest of your treatment
• you will take between 1 and 4 mg per kg of body weight each day.
For other conditions
At the start of your treatment
• you will take 1 to 3 mg per kg of body weight each day
• your doctor may reduce your dose later. If you take more Imuran than you should If you take more Imuran than you should, talk to your doctor or go to
a hospital straight away. Take the medicine pack with you.
If you forget to take Imuran
• If you forget to take Imuran, tell your doctor.
• Do not take a double dose to make up for a forgotten dose.
If you have any further questions about Imuran and how to take it, ask your doctor, nurse or pharmacist.
4 Possible side effects
Like all medicines, Imuran can cause side effects, although not everybody gets them. The following side effects may happen with this medicine:
Stop taking Imuran and see a doctor straight away, if you notice any of the following serious side effects, you may need urgent medical treatment:
• allergic reaction, the signs may include:
- general tiredness, dizziness, feeling sick (nausea), being sick (vomiting) or diarrhoea
- high temperature (fever), shivering or chills
- redness of the skin or a skin rash
- pain in the muscles or joints
- changes in the amount and colour of the urine (kidney problems)
- dizziness, confusion, feeling light headed or weak, caused by low blood pressure
• you bruise more easily or notice any unusual bleeding
• you have a high temperature (fever) or other signs of an infection
• you feel extremely tired
• you notice lumps anywhere on your body
• you notice any changes to your skin, for example blisters or peeling
• your health suddenly gets worse
• you come into contact with anyone who is suffering from chickenpox or shingles.
If you notice any of the above, stop taking Imuran and see a doctor straight away.
Other side effects include:
Very common
(affects more than 1 in 10 people)
• infections caused by a virus, fungus or bacteria
• reduction in your bone marrow function, which may make you feel unwell or show up in your blood tests
• low white blood cell level in your blood tests, which may cause an infection.
Common
(affects less than 1 in 10 people)
• low blood platelet level, which may cause you to bruise or bleed easily.
Uncommon
(affects less than 1 in 100 people)
• low red blood cell level, which may cause you to be tired, get headaches, be short of breath when exercising, feel dizzy and look pale
• inflammation of the pancreas, which may cause you severe upper stomach pain, with feeling sick (nausea) and being sick (vomiting)
• liver problems, which may cause pale stools, dark urine, itchiness and yellowing of your skin and eyes.
Rare
(affects less than 1 in 1,000 people)
• problems with your blood and bone marrow which may cause weakness, tiredness, paleness, headaches, sore tongue, breathlessness, bruising or infections
• problems with your bowel leading to diarrhoea, abdominal pain, constipation, feeling sick (nausea) and being sick (vomiting)
• hair loss which may get better even though you continue to take Imuran
• severe liver damage which can be life threatening
• various types of cancers including blood, lymph and skin cancers
• sensitivity to sunlight which can cause skin discolouration or a rash.
Very rare
(affects less than 1 in 10,000 people)
• inflammation of your lungs causing breathlessness, cough and a fever.
If any of the side effects gets serious, or if you notice any other side effects not listed in this leaflet, please tell your doctor, nurse or pharmacist.
5 How to store Imuran
• Do not store above 25°C
• Protect from light.
• Keep out of the reach and sight of children.
• Do not use Imuran after the expiry date which is stated on the label. The expiry date refers to the last day of that month.
• Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.
6 Further Information
What Imuran contains
• The active substance is azathioprine.
• The other ingredients are lactose, pregelatinised starch, maize starch, stearic acid, magnesium stearate, methylhydroxypropyl cellulose, and propylene glycol 400.
• There is no colouring in the yellow tablets.
• The colouring in the orange tablets contains titanium dioxide (E171), iron oxide yellow (E172) and iron oxide red (E172).
What Imuran looks like and contents of the pack
• Imuran tablets are covered by a thin coating and come in two strengths and colours.
• The orange tablets contain 25 mg of the active ingredient azathioprine and are marked with ‘GX EL5′.
• The yellow tablets contain 50 mg of azathioprine and are marked with ‘GXCH1′.
Imuran tablets come in packs of 28, 30, 56, 60 and 100 tablets.
The 50 mg tablets are also available in packs of 1000 tablets.
Not all pack sizes may be marketed.
Imuran Injection (Azathioprine)
Imuran Injection
Azathioprine
1 What Imuran is and what it is used for
Imuran injection contains a medicine called azathioprine. This belongs to a group of medicines called
immunosuppressants. These medicines reduce the activity of your body’s immune system. Imuran is used to:
• stop your body rejecting an organ transplant
• treat diseases where your immune system reacts againsl your own body (called autoimmune diseases, such as rheumatoid arthritis).
Ask your doctor, nurse or pharmacist if you would like any further explanation about these uses.
2 Before you have Imuran
Do not have Imuran if:
• you are allergic (hypersensitive) to azathioprine, mercaptopurine or any of the other ingredients of Imuran
If you are not sure, talk to your doctor, nurse or pharmacist before having Imuran.
Take special care with Imuran
Check with your doctor, nurse or pharmacist before having Imuran if:
• you have liver or kidney disease
• you have ‘Lesch-Nyhan Syndrome’. This is a rare condition that runs in families caused by a lack of something called HPRT or ‘hypoxanthine-guanine-phosphoribosyltransf erase’
• you have a condition where your body produces too little of something called TPMT or ‘thiopurine methyltransf erase’
• you have ever suffered from chickenpox or shingles.
If you are not sure if any of the above apply to you, talk to your doctor, nurse or pharmacist before having Imuran.
Taking other medicines
Please tell your doctor, nurse or pharmacist if you are taking or have recently taken any other medicines. This includes medicines obtained without a prescription, including herbal medicines. This is because Imuran can affect the way some medicines work. Also some other medicines can affect the way Imuran works. In particular, tell your doctor, nurse or pharmacist if you are taking any of the following medicines:
• allopurinol – used for gout
• tubocurarine or succinylcholine – used during operations
• warfarin – used for blood clots
• penicillamine – used for rheumatoid arthritis
• co-trimoxazole – used for infections
• captopril – used for high blood pressure or heart problems
• cimetidine – used for stomach ulcers and indigestion
• indomethacin – used for pain and inflammation
• furosemide – used for high blood pressure and heart problems
• olsalazine or mesalazine – used for a bowel problem called ulcerative colitis
• sulfasalzine or balsalazide – used for rheumatoid arthritis or ulcerative colitis.
If you are not sure if any of the above apply to you, talk to your doctor, nurse or pharmacist before having Imuran.
Having vaccines while you are using Imuran
If you are going to have a vaccination speak to your doctor or nurse before you have it. This is because vaccines may not work properly while you are having Imuran.
Tests you may have while having Imuran
Your doctor may ask you to have a blood test while you are having Imuran. This is to check your blood cell count. Your doctor may change your dose of Imuran after the test.
Trying for a baby, pregnancy and breast-feeding
• Do not have Imuran if you are a man trying to have a baby. This is because it may affect the baby.
• Do not have Imuran if you are a women who is pregnant or think you might become pregnant. This is because it may affect the baby.
• Do not have Imuran if you are breast-feeding. This is because small amounts may pass into the mother’s milk.
Ask your doctor, midwife or pharmacist for advice before taking any medicine, if you are pregnant or breast-feeding.
Imuran and the sun
While having Imuran you may be more likely to develop some types of cancers such as skin cancer. Some people also become sensitive to sunlight which can cause skin discolouration or a rash. Take care to avoid too much sun, cover up and use sunscreen.
Chickenpox/Shingles infection
Infection with chickenpox or shingles can become severe in patients taking immunosuppressive medicine. Therefore you should avoid contact with anyone suffering from chickenpox or shingles.
Important information about some of the ingredients of Imuran Injection
Imuran injection contains sodium. Each 50 mg vial contains 4.5 mg of sodium. If you are on a low sodium diet, talk to your doctor, nurse or pharmacist before you have Imuran.
3 How to take Imuran
The dose of Imuran you have depends on your illness and how bad it is. The dose also depends on your age, your weight and how well your liver and kidneys are working. Your doctor will explain this to you.
To stop your body rejecting an organ transplant
On the first day
• the usual dose is up to 5 mg per kg of body weight. For the rest of your treatment
• you will have between 1 and 4 mg per kg of body weight each day.
For other conditions
At the start of your treatment
• you will have 1 to 3 mg per kg of body weight each day
• your doctor may reduce your dose later. If you have more Imuran than you should
Your doctor will give you Imuran so it is unlikely that you will receive too much. If you think you have been given too much or have missed a dose, tell your doctor or nurse.
4 Possible side effects
Like all medicines, Imuran can cause side effects, although not everybody gets them. The following side effects may happen with this medicine: If you notice any of the following serious side effects, talk to your specialist doctor or go to hospital straight away:
• allergic reaction, the signs may include:
- general tiredness, dizziness, feeling sick (nausea), being sick (vomiting) or diarrhoea
- high temperature (fever), shivering or chills
- redness of the skin or a skin rash . .
- pain in the muscles or joints
- changes in the amount and colour of the urine (kidney problems)
- dizziness, confusion, feeling light headed or weak, caused by low blood pressure
• you bruise more easily or notice any unusual bleeding
• you have a high temperature (fever) or other signs of an infection
• you feel extremely tired
• you notice lumps anywhere on your body
• you notice any changes to your skin, for example blisters or peeling
• your health suddenly gets worse
• you come into contact with anyone who is suffering from chickenpox or shingles.
If you notice any of the above, stop having Imuran and see a doctor straight away.
Other side effects include:
Very common (affects more than 1 in 10 people)
• infections caused by a virus, fungus or bacteria
• reduction in your bone marrow function, which may make you feel unwell or show up in your blood tests
• low white blood cell level in your blood tests, which may cause an infection.
Common (affects less than 1 in 10 people)
• low blood platelet level, which may cause you to bruise or bleed easily.
Uncommon (affects less than 1 in 100 people)
• low red blood cell level, which may cause you to be tired, get headaches, be short of breath when exercising, feel dizzy and look pale
• inflammation of the pancreas, which may cause you severe upper stomach pain, with feeling sick (nausea) and being sick (vomiting)
• liver problems, which may cause pale stools, dark urine, itchiness and yellowing of your skin and eyes.
Rare (affects less than 1 in 1,000 people)
• problems with your blood and bone marrow which may cause weakness, tiredness, paleness, headaches, sore tongue, breathlessness, bruising or infections
• problems with your bowel leading to diarrhoea, abdominal pain, constipation, feeling sick (nausea) and being sick (vomiting)
• hair loss which may get better even though you continue to take Imuran
• severe liver damage which can be life-threatening
• various types of cancers including blood, lymph and skin cancers
• sensitivity to sunlight which can cause skin discolouration or a rash.
Very rare (affects less than 1 in 10,000 people)
• inflammation of your lungs causing breathlessness, cough and a fever.
If any of the side effects gets serious, or if you notice any other side effects not listed in this leaflet, please tell your doctor, nurse or pharmacist.
5 How to store Imuran
• Do not store above 25°C.
• Protect from light and keep dry.
• Keep out of the reach and sight of children.
• Do not use Imuran after the expiry date which is stated on the label. The expiry date refers to the last day of that month.
• Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.
6 Further Information
What Imuran contains
• The active substance is azathioprine. Each Imuran injection contains 50 mg of azathioprine.
• The other ingredient is sodium hydroxide.
• Before Imuran is injected it is diluted in sterile water.
What Imuran looks like and contents of the pack
• Each pack contains one Imuran injection in a glass vial