Multiple Sclerosis and Imuran Therapy

Medically Reviewed by Christopher Melinosky, MD on November 19, 2021
4 min read

Imuran is an immune system-suppressing drug. That means that it can theoretically halt the attack of the immune system on your nerves if you have multiple sclerosis. The drug ( the generic name is azathioprine) can be used to slow the progression of MS in people who are not responding well to other treatments.

Imuran may also be used with other disease-modifying therapies, such as Avonex, to boost their effect.

In cases of multiple sclerosis, Imuran is generally taken orally, in the form of tablets.

Your white blood cell count and your weight will determine the dose that is prescribed. The starting dose is low and is slowly increased. Imuran is generally taken once or twice a day. It is available in 50 mg. tablets, which may be easily broken in half if necessary.

Your prescription label tells you how much to take at each dose and how often to take it -- follow these instructions carefully and ask your pharmacist or doctor to explain any instructions that you do not understand.

It is important that you take this medication regularly as prescribed; do not stop taking it and do not take more or less of the drug than is prescribed.

When taking Imuran, keep the following tips in mind:

  • Some mild nausea often occurs when you start taking Imuran. This discomfort is expected and will go away as your body gets used to the medication. If you have extreme nausea with vomiting, contact your doctor.
  • While you are taking this medication, you may be asked to have regular blood tests (such as blood cell counts and liver function tests) to evaluate the medication's effectiveness and to monitor your response to the drug.
  • Keep all appointments with your doctor and the lab. Your doctor may reduce or even stop Imuran when you are being treated for certain infections. This allows your body to effectively fight back.
  • Be sure that you always have enough medication on hand. Check your supply before holidays or other occasions when you may be unable to fill your prescription.
  • Do not have any vaccinations without your doctor's approval.
  • Take precautions to avoid infection while taking this drug. Avoid anyone who may have an infection and report any signs of infection to your doctor.

Side effects of Imuran may include:

  • Increased stomach irritation.
  • Nausea and vomiting.
  • Changes in hair color and texture along with hair loss -- these changes are usually temporary.
  • Loss of appetite.
  • Blood in the urine or stool.
  • Unusual bruising.
  • Fatigue.
  • Development of mouth sores and ulcers.
  • Liver damage.
  • Increased risk of infection. Because Imuran is an immunosuppressive medication, it can lower the number of white blood cells in your blood, increasing the chance of infection.

It's important to remember that not everyone experiences all of these side effects. This medication is generally well-tolerated. Even though some of the side effects could be very serious, remember that precautions will be taken to detect these side effects and treat them before they become harmful.

If you forget to take a dose of Imuran, take it as soon as you remember and then continue to follow your regular dosing schedule.

  • Store Imuran at room temperature.
  • DO NOT store this medication in direct heat or light.
  • DO NOT store this medication in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause it to break down.
  • Keep this drug in the container it came in, tightly sealed.
  • Do not keep outdated medicine.
  • Keep this and other drugs out of the reach of children

If you're taking Imuran, call your doctor right away if you have any of these warning signs of infection:

    • Fever over 100°F (37.7°C).
    • Sweats or chills.
    • Skin rash.
    • Pain, tenderness, redness, or swelling.
    • Wound or cut that won't heal.
    • Red, warm, or draining sore.
    • Sore throat, scratchy throat or pain when swallowing.
    • Sinus drainage, nasal congestion, headaches, or tenderness along upper cheekbones.
    • Persistent, dry or moist cough that lasts more than two days.
    • White patches in your mouth or on your tongue.
    • Nausea, vomiting, or diarrhea.
    • Flu-like symptoms (chills, aches, headache, or fatigue) or generally feeling "lousy."
    • Trouble urinating: pain or burning, constant urge, or frequent urination
    • Bloody, cloudy, or foul-smelling urine.
    • If you have any other symptoms that cause concern.