Imuran

Adult Dosing .

Dosage forms:  TAB: 50 mg

kidney transplant rejection prophylaxis

[1-3 mg/kg/dose PO qd]

Start: 3-5 mg/kg/dose PO x1 up to 3 days before transplant; Info: transplant protocols may vary; decr. dose if heterozygous TPMT and/or nucleotide diphosphatase (NUDT15) deficiency, consider alternative tx if homozygous TPMT or NUDT15 deficiency

rheumatoid arthritis, severe

[1-2.5 mg/kg/day PO divided qd-bid]

Start: 1 mg/kg/day PO divided qd-bid; Max: 2.5 mg/kg/day; Info: after 6-8wk may incr. 0.5 mg/kg/day q4wk; decr. dose if heterozygous TPMT and/or nucleotide diphosphatase (NUDT15) deficiency, consider alternative tx if homozygous TPMT or NUDT15 deficiency

Crohn dz (off-label)

[100-250 mg PO qd]

Start: 50 mg PO qd; Max: 2.5 mg/kg/day; Info: for induction or remission maintenance and fistulizing dz, steroid-sparing effects; decr. dose if heterozygous TPMT and/or nucleotide diphosphatase (NUDT15) deficiency, consider alternative tx if homozygous TPMT or NUDT15 deficiency

ulcerative colitis (off-label)

[100-250 mg PO qd]

Start: 50 mg PO qd; Max: 2.5 mg/kg/day; Info: for induction or remission maintenance, steroid-sparing effects; decr. dose if heterozygous TPMT and/or nucleotide diphosphatase (NUDT15) deficiency, consider alternative tx if homozygous TPMT or NUDT15 deficiency

renal dosing

[adjust dose amount]

CrCl 10-50: decr. usual dose by 25%; CrCl <10: decr. usual dose by 50%

HD: decr. usual dose by 50%; give 0.25 mg/kg/dose supplement after dialysis if next maint. dose not due right after dialysis; PD: not defined

hepatic dosing

[see below]

hepatic impairment: not defined, caution advised

Peds Dosing .

Dosage forms:  TAB: 50 mg

kidney transplant rejection prophylaxis (off-label)

[1-3 mg/kg/dose PO qd]

Start: 3-5 mg/kg/dose PO x1 up to 3 days before transplant; Info: transplant protocols may vary; decr. dose if heterozygous TPMT and/or nucleotide diphosphatase (NUDT15) deficiency, consider alternative tx if homozygous TPMT or NUDT15 deficiency

juvenile idiopathic arthritis, severe (off-label)

[1-2.5 mg/kg/day PO divided qd-bid]

Start: 1 mg/kg/day PO divided qd-bid; Max: 2.5 mg/kg/day; Info: after 6-8wk may incr. 0.5 mg/kg/day q4wk; decr. dose if heterozygous TPMT and/or nucleotide diphosphatase (NUDT15) deficiency, consider alternative tx if homozygous TPMT or NUDT15 deficiency

renal dosing

[adjust dose amount, frequency]

CrCl 10-50: decr. usual dose by 25%; CrCl <10: decr. usual dose by 50%

HD: decr. usual dose by 50%; no supplement after dialysis; PD: not defined

hepatic dosing

[see below]

hepatic impairment: not defined, caution advised