Description of the medicine: Azathioprine (Azathioprinum)
AZATHIOPRIN (Azathioprinum). 6- (1-Methyl-4-nitroimidazolyl-5) -mercaptopurine.
Synonyms: Imuran, Azamun, Azanin, Azapress, Imunal, Imuran, Imurel, Thiorrin and others.
Light yellow with a greenish tinge crystalline powder. Virtually nerastvorim in water and alcohol, easily soluble in solutions of caustic alkalis.
By chemical structure and biological action is close to mercaptopurine. It has cytostatic activity and has an immunosuppressive effect, however, compared with mercaptopurine, the immunosuppressive effect is relatively more pronounced with a slightly lower cytostatic activity. In large doses (10 mg / kg) the drug depresses the function of the bone marrow, suppresses the proliferation of granulocytes, causes leukopenia.
Azathioprine is used to suppress the reaction of tissue incompatibility during organ transplantation, as well as in some autoimmune diseases: nonspecific rheumatoid polyarthritis, ulcerative colitis, lupus erythematosus, lupus nephritis, chronic hepatitis, and others.
Assign the drug inside (in the form of tablets) alone, and often in combination with other drugs (prednisolone, antibiotics, anti-leukocyte serum).
When homotransplantation of organs is prescribed before surgery (for 1-7 days) daily at a dose of 0.004 g / kg (4 mg / kg). The daily dose is given in 2 -3 admission. After the operation, the drug is administered at 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 raised to 4 mg / kg per day. Apply the drug for a long time. The magnitude of the dose and the duration of treatment depend on the patient's general condition, tolerability of the drug, and the results of hematological studies.
In autoimmune diseases, usually 1, 5 - 2, 0 mg / kg per day is prescribed, however, if necessary, give up to 200 - 250 mg per day (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 are data on 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 performed under close medical supervision. It is necessary to monitor the picture of blood.
In the first 8 weeks of treatment, a full blood count should be done weekly with platelet count.
With a decrease in the number of white blood cells to 4 * 10 9 / L, the dose is reduced, and at 3 * 10 9 / L the drug is canceled and repeated blood transfusions, leukopoiesis stimulants,
The drug may cause nausea, vomiting, loss of appetite. With prolonged use, toxic hepatitis may develop; Allergic reactions are possible.
The drug is contraindicated in severe oppression of hematopoiesis and leukopenia, severe liver disease; Pregnancy.