Description of the medicine: Azathioprine (Azathioprinum)
AZATIOPRIN (Azathioprinum). 6- (1-Methyl-4-nitroimidazolyl-5) -mercaptopurine.
Synonyms: Imuran, Azamun, Azanin, Azapress, Imunal, Imuran, Imurel, Thiоrrine and others.
Light yellow crystalline powder with a greenish tint. Practically insoluble in water and alcohol, easily soluble in solutions of caustic alkalis.
The chemical structure and biological effect is close to mercaptopurine. It has cytostatic activity and has an immunosuppressive effect, however, compared with mercaptopurine, the immunosuppressive effect is relatively stronger with a slightly lower cytostatic activity. In large doses (10 mg / kg), the drug inhibits bone marrow function, inhibits the proliferation of granulocytes, and causes leukopenia.
Azathioprine is used to suppress the reaction of tissue incompatibility in organ transplants, as well as in certain autoimmune diseases: nonspecific rheumatoid polyarthritis, ulcerative colitis, lupus erythematosus, lupus nephritis, chronic hepatitis, etc.
Prescribe the drug inside (in the form of tablets) independently, and often in combination with other agents (prednisone, antibiotics, antileukocyte serum).
In case of organ transplantation, it is prescribed before the operation (1-7 days) daily at a dose of 0.004 g / kg (4 mg / kg). The daily dose is given in 2-3 doses. After surgery, the drug is prescribed in the same dose for 1 to 2 months, then 2 to 3 mg / kg. In case of symptoms of rejection of the transplanted organ, the dose is again increased to 4 mg / kg per day. Apply the drug for a long time. The dose and duration of treatment depend on the patient's general condition, tolerance to the drug, and the results of hematological studies.
In autoimmune diseases, 1, 5 - 2, 0 mg / kg per day is usually prescribed, however, if necessary, up to 200 - 250 mg per day is given (in 2 to 4 doses). The duration of treatment depends on the severity of the disease, the effectiveness and tolerability of the drug. To achieve a lasting effect, treatment should be carried out for a long time.
There is evidence of the use of azathioprine in the treatment of psoriasis (usually 0.05 g 3 times a day for 14 to 48 days).
Treatment with azathioprine should be carried out under close medical supervision. It is necessary to monitor the blood picture.
In the first 8 weeks of treatment, a full blood count should be performed weekly with a platelet count.
With a decrease in the number of leukocytes to 4 * 10 9 / l, the dose is reduced, and with 3 * 10 9 / l, the drug is canceled and repeated blood transfusions, leukopoiesis stimulants, etc. are prescribed.
The drug can cause nausea, vomiting, loss of appetite. With prolonged use, toxic hepatitis may develop; allergic reactions are possible.
The drug is contraindicated in severe suppression of hematopoiesis and leukopenia, severe liver disease; pregnancy.