Do not use Imuran if:

• you are allergic to any ingredient in Imuran;
• you have a tumor or an unusual growth;
• you have rheumatoid arthritis and are pregnant;
• you are taking mercaptopurine.

• Imuran may lower the ability of your body to fight infection. Avoid contact with people who have colds or infections. Tell your doctor if you notice signs of infection like fever, sore throat, rash, or chills.
• Imuran may reduce the number of clot-forming cells (platelets) in your blood. Avoid activities that may cause bruising or injury. Tell your doctor if you have unusual bruising or bleeding. Tell your doctor if you have dark, tarry, or bloody stools.
• Tell your doctor or dentist that you take Imuran before you receive any medical or dental care, emergency care, or surgery.
• Talk with your doctor before you receive any vaccine while you are taking Imuran.
• Contact your doctor at once if you develop severe nausea and vomiting. This may occur with or without diarrhea, rash, fever, muscle pain, or dizziness. If this reaction occurs, it usually happens within the first several weeks of therapy.
• Imuran may increase your risk of developing a tumor or other cancer. Contact your doctor at once if you notice any unusual growths or lumps. Discuss any questions or concerns with your doctor.
• An enzyme called TPMT helps to break Imuran down in the body. Infrequently, some patients may have decreased TPMT enzyme activity. This may increase the risk of developing serious side effects (e.g., severe bone marrow problems). Patients with decreased TPMT enzyme activity may need a lower dose of Imuran. Discuss any questions or concerns with your doctor.
• Lab tests, including complete blood counts, liver function, and TPMT enzyme activity, may be performed while you use Imuran . These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
• Imuran should be used with extreme caution in children; safety and efficacy in children have not been confirmed.
• Pregnancy and breast-feeding: Imuran has been shown to cause harm to the fetus. Do not become pregnant while you are using it. If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using Imuran while you are pregnant. Imuran is found in breast milk. Do not breast-feed while taking Imuran.

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

• mild nausea or vomiting.

• 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.

Imuran is to be used only by the patient for whom it is prescribed. Do not share it with other people.
If your symptoms do not improve or if they become worse, check with your doctor.