Long-term use of Imuran increases the risk of developing tumors. Imuran may also cause blood disorders. Contact your doctor at once if you develop unusual growths, easy bruising or bleeding, or signs of infection

Azathioprine (Imuran) is an antimetabolite.

Use Azathioprine (Imuran) as directed by your doctor.

Ask your doctor if you should follow any special guidelines for handling Azathioprine (Imuran).

Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Mild nausea or vomiting.

Seek medical attention right away if any of these SEVERE side effects occur:
Severe allergic reactions (rash; itching; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain or tightness; dark urine; dizziness; fever, chills, or sore throat; increased or painful urination; muscle pain or aches; pale or fatty stools; severe or persistent nausea, vomiting, or diarrhea; shortness of breath; stomach pain; unusual bleeding or bruising; unusual growths or lumps; unusual weakness or fatigue; yellowing of the eyes or skin.

This is not a complete list of all side effects that may occur. If you have questions or need medical advice about side effects, contact your doctor or health care provider.

Tell your health care provider if you are taking any other medicines, especially any of the following:

Alkylating agents (eg, cyclophosphamide, chlorambucil, melphalan) because the risk of developing a tumor may be increased
Mercaptopurine because severe toxic effects, including severe bone marrow suppression or death, may occur
Allopurinol, aminosalicylates (eg, mesalazine, olsalazine, sulfasalazine), angiotensin-converting enzyme (ACE) inhibitors (eg, enalapril), doxorubicin, or trimethoprim/sulfamethoxazole because they may increase the risk of Azathioprine (Imuran)'s side effects
Anticoagulants (eg, warfarin) or hydantoins (eg, phenytoin) because their effectiveness may be decreased by Azathioprine (Imuran)

This may not be a complete list of all interactions that may occur. Ask your health care provider if Azathioprine (Imuran) may interact with other medicines that you take.

If overdose is suspected, contact your local poison control center or emergency room immediately.

Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

if you are pregnant, planning to become pregnant, or are breast-feeding

if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement

if you have allergies to medicines, foods, or other substances

if you have kidney or liver problems, or gout

if you have an infection, a history of frequent or prolonged infections, or you have recently had a vaccination

if you have a history of bone marrow problems, anemia, low white blood cell or platelet levels, or unusual bruising or bleeding

if you have certain enzyme deficiencies (thiopurine methyltransferase [TPMT] or xanthine oxidase) or you have recently had a blood transfusion

if you are taking a disease-modifying antirheumatic drug (DMARD) (eg, methotrexate, adalimumab)

Do not double doses to make up for a misssed dose.

Preventing kidney transplant rejection along with other medicine.

Azathioprine (Imuran) may also be used to treat signs and symptoms of active rheumatoid arthritis.

Azathioprine (Imuran) may also be used for other conditions as determined by your doctor.

STORE THIS MEDICINE at room temperature, away from heat and light.

If you have any questions about Azathioprine (Imuran), please talk with your doctor, pharmacist, or other health care provider.

Talk with your doctor before you receive any vaccine while you are taking Azathioprine (Imuran).

Tell your doctor or dentist that you take Azathioprine (Imuran) before you receive any medical or dental care, emergency care, or surgery.

Tell your doctor if you have unusual bruising or bleeding. Tell your doctor if you have dark, tarry, or bloody stools.

Lab tests, including complete blood counts, liver function, and TPMT enzyme activity, may be performed while you use Azathioprine (Imuran).