Quite effective imuran azathioprine is usually prescribed as an immune suppressant in transplant patients, for rheumatoid arthritis, crohn s and ulcerative colitis.

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Inhibition of the anticoagulant effect of warfarinwhen administered with azathioprinehas been reported.

Before starting the administration of immunosuppressantsthe prescriber should check to see if the patient has a history of VZVSerologic testing may be useful in determining previous exposurePatients who have no history of exposure should avoid contact with individuals with chickenpox or herpes zosterIf the patient is exposed to VZVspecial care must be taken to avoid patients developing chickenpox or herpes zosterand passive immunisation with varicella-zoster immunoglobulinVZIGmay be considered.

Information is available on the risk of malignancy with the use of IMURAN in rheumatoid arthritissee ADVERSE REACTIONSIt has not been possible to define the precise risk of malignancy due to IMURANThe data suggest the risk may be elevated in patients with rheumatoid arthritisthough lower than for renal transplant patientsHoweveracute myelogenous leukemia as well as solid tumors have been reported in patients with rheumatoid arthritis who have received IMURAN.

Where possibleconcomitant administration of cytostatic drugsor drugs which may have a myelosuppressive effectsuch as penicillamineshould be avoidedThere are conflicting clinical reports of interactionsresulting in serious haematological abnormalitiesbetween Imuran and co-trimoxazole.

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patients should take imuran as prescribed and get regular blood tests patients should attend all doctor appointments taking imuran with food helps reduce possible stomach upset patients should avoid alcohol while taking imuran.