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Because imuran lowers your immune system, it can make you more susceptible to infections.

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Safety and efficacy of azathioprine in pediatric patients have not been established.

Drugs which may affect leukocyte productionincluding cotrimoxazolemay lead to exaggerated leukopeniaespecially in renal transplant recipients.

Depending on the immunosuppressive regimen employeda dosage of up to 5 mg/kg bodyweight/day may be given on the first day of therapyeither orally or intravenously.

IMURAN is usually given on a daily basisThe initial dose should be approximately 1.0 mg/kg50 to 100 mggiven as a single dose or on a twice-daily scheduleThe dose may be increasedbeginning at 6 to 8 weeks and thereafter by steps at 4-week intervalsif there are no serious toxicities and if initial response is unsatisfactoryDose increments should be 0.5 mg/kg dailyup to a maximum dose of 2.5 mg/kg per dayTherapeutic response occurs after several weeks of treatmentusually 6 to 8an adequate trial should be a minimum of 12 weeksPatients not improved after 12 weeks can be considered refractoryIMURAN may be continued long-term in patients with clinical responsebut patients should be monitored carefullyand gradual dosage reduction should be attempted to reduce risk of toxicities.

25Recommendations for the safe handling of parenteral antineoplastic drugsWashingtonDCDivision of SafetyClinical Center Pharmacy Department and Cancer Nursing ServicesNational Institute of Health1992US Dept of Health and Human ServicesPublic Health Service Publication NIH 92-2621.

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