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In cases of multiple sclerosisImuran is generally taken orallyin the form of tablets.

Patients with inherited mutated NUDT15 gene are at increased risk for severe azathioprine toxicitysuch as early leukopenia and alopeciafrom conventional doses of thiopurine therapyThey generally require dose reductionparticularly those being NUDT15 variant homozygotessee 4.2The frequency of NUDT15 c.415C>T has an ethnic variability of approximately 10in East Asians4in Hispanics0.2in Europeans and 0in AfricansIn any caseclose monitoring of blood counts is necessary.

Xanthine oxidase activity is inhibited by allopurinoloxipurinol and thiopurinol which results in reduced conversion of biologically active 6-thioinosinic acid to biologically inactive 6-thiouric acidWhen allopurinoloxipurinol and/or thiopurinol are given concomitantly with 6-mercaptopurine or azathioprinethe dose of 6-mercaptopurine and azathioprine should be reduced to one-quarter of the original dose.

These are not all of the side effects that may occurIf you have questions about side effectscall your doctorCall your doctor for medical advice about side effects.

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