Order Imuran tablets online from a USA pharmacy

Product Name	Imuran
Dosage	50 mg tablets (typical US strength)
Active Ingredient	Azathioprine
Form	Oral tablets
Description	Prescription immunosuppressant used in the USA to prevent organ transplant rejection and to manage autoimmune diseases (RA, Crohn’s disease, ulcerative colitis).
How to Order Without Prescription	Prescription required in the USA; consult your licensed clinician.

Imuran (azathioprine) is a long-established prescription medicine in the United States that helps suppress the immune system. In clinical practice, it is used to prevent organ transplant rejection—especially kidney—and to manage autoimmune conditions such as rheumatoid arthritis (RA) and inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis. The FDA-approved oral formulation in the US is a 50 mg tablet. Generic azathioprine is widely available nationwide and is often the most cost-effective option.

Because Imuran alters immune function, US guidelines emphasize appropriate patient selection, baseline screening, and routine safety monitoring. Clinical teams commonly assess thiopurine S-methyltransferase (TPMT) and, when available, NUDT15 activity or genotype before therapy. These enzymes influence how the body metabolizes azathioprine. Patients with very low or absent activity have a high risk of serious bone marrow suppression and typically should avoid standard dosing. During treatment, regular complete blood counts (CBC) and liver function tests (LFTs) help detect toxicity early so dosing can be adjusted or therapy paused.

Imuran cost in the USA

Imuran is available as a brand and as generic azathioprine. Generic tablets are usually substantially less expensive while providing the same active ingredient and therapeutic effect. Pricing varies by pharmacy, insurance coverage, and location. Typical online and retail cash prices for generic azathioprine 50 mg may look like the examples below (for illustration only; check current pricing at checkout):

- 30 tablets of 50 mg: from approximately $24–$49 (generic) depending on pharmacy and discount programs.

- 60 tablets of 50 mg: from approximately $45–$89.

- 90 to 120 tablets of 50 mg: often provides a lower per-tablet price and may be preferred for maintenance therapy, with totals typically ranging from $69–$159.

Brand-name Imuran may cost more than the generic. When clinically appropriate, most US prescribers authorize generic substitution to minimize out-of-pocket expenses. Your final price depends on insurance formulary tiers, copays, deductibles, and pharmacy choice.

Where can I buy Imuran in the USA?

 In the United States, Imuran (azathioprine) is a prescription medication. A valid prescription from a licensed US clinician is required to purchase it from any pharmacy. You can fill your prescription at local retail chains (for example, CVS, Walgreens, Walmart, Costco), independent community pharmacies, or through legitimate mail-order and specialty pharmacies. Many US-based, accredited online pharmacies offer home delivery across all 50 states and Washington, DC.

To get started, speak with your healthcare provider (e.g., primary care, rheumatology, gastroenterology, or transplant team). After your clinician determines that azathioprine is appropriate, they will send a prescription to your chosen pharmacy. Mail-order services can ship medications directly to your address, often with automatic refills and tracking. If you’re switching from brand to generic (or vice versa), your pharmacist can verify coverage and cost before dispensing.

We recommend choosing a pharmacy that provides easy access to pharmacists for counseling, clear refill reminders, and transparent pricing. Look for accreditation (such as NABP .pharmacy or URAC for online pharmacies) and confirm the pharmacy’s license within your state for added peace of mind.

Imuran USA: quick start checklist

As you prepare to begin therapy, consider the following:

• Confirm that your prescriber has ordered baseline labs and, when available, TPMT/NUDT15 testing.
• Tell your care team about all medications and supplements to screen for interactions (notably with allopurinol or febuxostat).
• Plan regular bloodwork during the first several months of therapy.
• Discuss vaccinations, including the timing of non-live and live vaccines.

What is Imuran (azathioprine)?

 Azathioprine is an immunosuppressive thiopurine. It is a prodrug that converts to 6-mercaptopurine (6-MP) and subsequently to active thioguanine nucleotides (6-TGNs), which interfere with DNA and RNA synthesis. The result is decreased proliferation of rapidly dividing immune cells, particularly T and B lymphocytes, leading to reduced immune activity. This property underpins its use in transplant medicine and autoimmune diseases.

Imuran has been part of US medical practice for decades. In transplantation, it is often combined with other immunosuppressants to prevent rejection. In autoimmune conditions such as rheumatoid arthritis and IBD (Crohn’s disease and ulcerative colitis), azathioprine is used as a disease-modifying or steroid-sparing therapy, helping reduce inflammation and maintain remission.

Generic azathioprine is widely used due to its effectiveness and affordability. Tablets are typically 50 mg. Some patients may receive compounded liquid formulations if they cannot swallow tablets; ask your clinician or pharmacist if such an option is needed and available in your state.

Imuran in kidney transplant medicine

 In kidney transplantation, Imuran may be part of a multi-drug regimen designed to prevent the recipient’s immune system from attacking the transplanted organ. Azathioprine dosing is usually based on body weight. A common initial dose is 1–3 mg/kg/day, adjusted according to clinical response, blood counts, and liver function. Your transplant team may combine azathioprine with other immunosuppressants (for example, calcineurin inhibitors and corticosteroids) and will tailor therapy to your unique risk profile.

Because rejection risk and infection risk must be balanced, patients receive close monitoring. Contact your transplant center promptly if you develop fever, symptoms of infection, or unexplained bruising or bleeding.

Imuran for rheumatoid arthritis

 Azathioprine is considered a disease-modifying antirheumatic drug (DMARD). It may be used in adults with moderate-to-severe rheumatoid arthritis when other therapies are not tolerated or are insufficient. A common dosing approach begins at 50 mg daily, with gradual titration as needed and tolerated, up to a target in the range of 1–2.5 mg/kg/day based on clinical response and lab parameters. Because clinical benefit can take time to appear, clinicians typically reassess response over 8–12 weeks and beyond.

As with other DMARDs, regular lab monitoring is essential. Azathioprine may be used alone or in combination with other RA therapies under specialist oversight. Report mouth sores, easy bruising, new infections, or upper abdominal pain to your prescriber without delay.

Imuran for inflammatory bowel disease (IBD)

 In Crohn’s disease and ulcerative colitis, azathioprine is commonly used for maintenance of remission and as a steroid-sparing agent. It is generally not used for rapid symptom control because onset of benefit can take 8–12 weeks or longer. Dosing is weight-based—often 1.5–2.5 mg/kg/day—adjusted according to therapeutic response and tolerance. Many gastroenterologists measure metabolite levels (6-TGN and 6-MMP) to optimize dosing and minimize toxicity, especially when response is incomplete or side effects occur.

IBD patients on azathioprine should have periodic lab tests and ongoing cancer screening as recommended by US guidelines. Pancreatitis is an idiosyncratic side effect occasionally seen in IBD patients; if sudden severe abdominal pain, nausea, or vomiting occur, seek urgent care.

Mechanism of action

 Imuran (azathioprine) is converted to 6-mercaptopurine, which then forms thioguanine nucleotides that incorporate into replicating DNA and RNA. By disrupting purine synthesis, azathioprine suppresses the proliferation of activated T and B lymphocytes, dampening immune responses that drive organ rejection and autoimmune inflammation.

Genetic polymorphisms in the enzymes TPMT and NUDT15 can alter drug metabolism. Marked reductions in enzyme activity increase exposure to cytotoxic metabolites, raising the risk of profound bone marrow suppression. Testing TPMT/NUDT15 activity or genotype when available helps predict risk and informs dosing strategies. Patients with absent activity typically should not receive standard doses; those with intermediate activity may require lower starting doses and closer monitoring.

Boxed warnings and safety considerations

 Azathioprine carries boxed warnings in the United States regarding chronic immunosuppression and increased risks of malignancy, especially lymphomas and skin cancers. Long-term use may also elevate the risk of serious infections. Patients should practice sun protection (broad-spectrum sunscreen, protective clothing, avoidance of tanning beds) and keep up with routine cancer screening. Promptly report any unusual lymph node swelling, night sweats, unexplained weight loss, persistent fever, or new skin lesions.

Additional serious risks include bone marrow suppression (leading to leukopenia, anemia, thrombocytopenia), hepatotoxicity (including cholestatic injury), and pancreatitis. Regular laboratory monitoring helps identify these problems early. If severe cytopenias or liver enzyme elevations occur, your clinician may stop Imuran and investigate further.

How long does Imuran take to work?

Onset is gradual. Many patients notice benefits within 6–12 weeks for autoimmune conditions; some require longer. In transplant, azathioprine is part of a broader regimen and is monitored by the transplant team. Do not stop this medication without medical guidance, as doing so can increase risk of disease flare or graft rejection.

Imuran dosing and administration

 Your dose is individualized based on condition, body weight, and enzyme activity (TPMT/NUDT15), with adjustments guided by labs and tolerance. Take tablets at the same time each day, ideally with food if you experience stomach upset, unless your clinician advises otherwise. Swallow tablets whole and wash hands after handling.

Typical adult dosing ranges

• Kidney transplant (prevention of rejection): commonly 1–3 mg/kg/day initially; titrate per transplant team based on response and safety labs.
• Rheumatoid arthritis: start around 50 mg daily, then titrate; typical range 1–2.5 mg/kg/day.
• IBD (Crohn’s disease/ulcerative colitis): commonly 1.5–2.5 mg/kg/day for maintenance and steroid-sparing.

Patients with low or intermediate TPMT/NUDT15 activity often require substantially reduced doses and more frequent monitoring. Severe deficiency is generally a contraindication to standard dosing. In renal or hepatic impairment, dosing and monitoring intervals may need adjustment.

Monitoring and lab tests

 Your clinician may order:

• CBC with differential: frequently during initiation (for example, weekly or every 2 weeks in the first 1–2 months), then periodically (often monthly for several months, eventually every 3 months if stable).
• Liver function tests (ALT/AST, bilirubin, alkaline phosphatase): on a similar schedule to detect hepatotoxicity.
• TPMT/NUDT15 activity or genotype: before or early in therapy where available.
• Metabolite levels (6-TGN, 6-MMP) in IBD: to improve dosing precision and reduce toxicity.

Missed dose and overdose

If you miss a dose, take it as soon as you remember on the same day. If it’s near the time for the next dose, skip the missed dose—do not double up. In case of overdose, seek immediate medical attention or contact Poison Control in the USA at 1-800-222-1222.

Safety profile and common side effects

 Not everyone experiences side effects, and many are manageable. However, because azathioprine affects bone marrow and liver function, laboratory surveillance is essential. Contact your clinician if side effects are severe or persistent.

Common side effects

• Nausea, vomiting, decreased appetite
• Mild abdominal discomfort
• Fatigue or malaise
• Rash or mild hair thinning
• Transient elevations in liver enzymes

Serious side effects—seek medical attention

• Signs of infection (fever, chills, persistent sore throat, cough, burning with urination)
• Unusual bruising or bleeding, mouth ulcers, severe fatigue (possible bone marrow suppression)
• Severe upper abdominal pain, persistent nausea/vomiting (possible pancreatitis or liver injury)
• Yellowing of the skin or eyes, dark urine, pale stools (possible cholestatic injury)
• New or changing skin lesions; swollen lymph nodes; unexplained weight loss or night sweats

Allergic reactions

 Allergic reactions are uncommon but can be serious. Seek urgent care for hives, difficulty breathing, or facial swelling. Hypersensitivity reactions have been reported; if suspected, Imuran may need to be discontinued.

Sun protection and cancer screening

Due to increased skin cancer risk with long-term immunosuppression, use broad-spectrum sunscreen, protective clothing, and avoid tanning beds. Follow US guideline-recommended cancer screening for your age and risk factors, and consider periodic dermatology checks.

Drug interactions with Imuran

 Always inform your prescriber and pharmacist about all medicines, vitamins, and herbal supplements you take. Key interactions include:

• Allopurinol and febuxostat: can markedly increase azathioprine levels. If allopurinol is necessary, azathioprine dose reductions (often to 25–33% of usual) and close monitoring are required; febuxostat is generally contraindicated with azathioprine.
• Aminosalicylates (mesalamine, sulfasalazine, olsalazine): may raise 6-TGN levels; additional monitoring advised.
• ACE inhibitors: may increase the risk of anemia or leukopenia.
• Trimethoprim-sulfamethoxazole and other myelosuppressants: additive bone marrow suppression; monitor labs closely.
• Warfarin: azathioprine may decrease anticoagulant effect; INR monitoring and dose adjustments may be needed.
• Live vaccines: generally avoid during immunosuppression. Discuss vaccine timing with your care team.

This list is not exhaustive. Keep an up-to-date medication list and share it with all your healthcare providers to minimize the risk of adverse interactions.

Use in pregnancy and breastfeeding

 Many US specialists consider azathioprine an acceptable option during pregnancy when benefits outweigh risks, particularly in transplant recipients and patients with IBD or autoimmune disease where disease control is critical. Uncontrolled disease itself can pose risks to the parent and fetus. If you are pregnant, planning to become pregnant, or breastfeeding, discuss individualized risks and benefits with your clinician. During lactation, small amounts of metabolites appear in breast milk; some experts consider breastfeeding compatible with azathioprine while recommending dosing immediately after a feed and waiting several hours before the next feed to minimize infant exposure.

Practical pharmacist tips for taking Imuran

 Take Imuran at the same time each day. If you experience stomach upset, taking it with food may help. Wash hands after handling tablets, and store them out of reach of children and pets. Keep follow-up appointments and lab draws on schedule—these are essential for your safety.

Before starting therapy, ask your care team about vaccinations. Many non-live vaccines can be given, while live vaccines are typically avoided during immunosuppression. Protect your skin from the sun, and promptly report persistent fevers or any sign of infection.

If your clinician prescribes allopurinol while you are on azathioprine, alert your pharmacist and verify that your Imuran dose has been adjusted. Never change your dose or stop the medication without consulting your healthcare provider.

Important precautions

 Do not use Imuran if you have a known hypersensitivity to azathioprine or 6-mercaptopurine. Patients with very low or absent TPMT/NUDT15 activity are at high risk for severe bone marrow suppression. Tell your care team about past pancreatitis, liver disease, or recurrent infections. Avoid unnecessary sun exposure and tanning beds.

Store tablets at room temperature (68–77°F/20–25°C), protect from moisture, and keep in the original container with the label intact. Never share prescription medications with others.

Symptoms to watch by condition

While side effects can occur in anyone, some symptoms are especially important to monitor:

• Transplant recipients: any fever, cough, urinary symptoms, or wound changes; unexplained bruising or bleeding; yellowing of the skin/eyes.
• Rheumatoid arthritis: persistent mouth sores, increased fatigue, easy bruising, or infection symptoms.
• IBD: sudden severe upper abdominal pain (possible pancreatitis); persistent nausea/vomiting; dark urine or pale stools.

Reporting side effects

 Contact your clinician or pharmacist if you experience side effects, including any not listed here. In the USA, you can also report adverse events to FDA MedWatch.

Frequently asked questions (FAQ)

 How long before I feel better? For autoimmune conditions, improvement commonly appears within 8–12 weeks, though timing varies. In transplant patients, azathioprine is part of a comprehensive regimen monitored closely by the transplant team.

Is generic azathioprine the same as brand Imuran? Yes, the generic contains the same active ingredient and is held to the same FDA standards for quality and bioequivalence. Many patients use the generic due to lower cost.

Can I take Imuran with my other medicines? It depends. Some medications interact notably (e.g., allopurinol, febuxostat, aminosalicylates). Always share your full medication list with your care team and pharmacist.

What if I get sick? If you develop fever, chills, or any sign of infection, contact your clinician promptly. Your dose may need to be held until you recover, depending on severity and lab results.

Do I need to avoid certain foods? There are no strict food bans for azathioprine itself, but taking it with food can reduce stomach upset. Alcohol should be limited, especially if you have liver concerns. Confirm lifestyle guidance with your care team.

Recommendations from our specialists

 For US patients starting Imuran, the keys to safe, effective treatment are: individualized dosing, consistent lab monitoring, awareness of major interactions (especially with allopurinol and febuxostat), and proactive skin and infection prevention. Partner with a licensed prescriber and an accredited US pharmacy. If you’re transitioning therapy or switching pharmacies, ensure your lab schedule and dose history transfer smoothly.

Ready to start your therapy? Order Imuran with confidence

Work with your US prescriber and choose a licensed pharmacy that offers clear pricing, convenient delivery, and access to pharmacist counseling. Once your prescription is received, your medication can be shipped quickly and discreetly.

• Prescription support — Imuran requires a valid US prescription; your clinician can e-prescribe directly
  
• Fast, secure shipping across the United States (where available by pharmacy)
  
• Genuine medication from licensed, reputable suppliers
  
• Budget-friendly options — consider generic azathioprine for significant savings
  
• Expert customer care — pharmacists ready to answer your questions
  

Thousands of US patients rely on azathioprine for long-term disease control. With the right care team, monitoring plan, and pharmacy partner, you can start securely and stay on track.

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