Indication & Dosage |
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| Oral |
| AUTO-IMMUNE DISEASES |
| Adult:
1-3 mg/kg/day. Discontinue treatment if there is no improvement after 12 wk. |
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| Oral |
| PREVENTION OF REJECTION IN ORGAN AND TISSUE TRANSPLANT |
| Adult:
1-5 mg/kg/day. Adjust dose according to clinical response and haematological tolerance. |
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| Oral |
| RHEUMATOID ARTHRITIS |
| Adult:
Initially, 1 mg/kg/day given in 1-2 divided doses for 6-8 wk, may increase by 0.5 mg/kg every 4 wk until response or up to 2.5 mg/kg/day. Maintenance: Reduce dose gradually to achieve the lowest effective dose.
Elderly: Initiate therapy at lower doses. |
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| Administration |
May be taken with or without food. (Preferably taken w/ or after meals to reduce GI discomfort.) |
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| Precautions |
Increased risk of serious infections and neoplasia in chronic immunosuppression; leucopenia, thrombocytopenia, renal or hepatic impairment. Increased risk of haematologic toxicity in patients with thiopurine methyltransferase deficiency. Monitor CBC (including platelet count) wkly during 1st mth, twice mthly for 2nd and 3rd mth, then mthly; monitor more frequently if there are dosage adjustments. Monitor LFT periodically; discontinue treatment if jaundice occurs. Reduce dose promptly or withdraw drug temporary if there is rapid decrease/persistently low WBC or signs of bone marrow depression. |
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Potentially Life-threatening
Adverse Drug Reactions |
Fever, chills; bone marrow depression characterised by leucopenia, thrombocytopenia or anaemia; anorexia, nausea, diarrhoea; arthralgias; secondary infections; hepatotoxicity, rash, alopoecia. |
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| Adverse Drug Reactions |
Myelosuppression, mutagenicity and carcinogenicity; veno-occlussive liver disease. |
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| Interactions |
Increased haematological effects with allopurinol. Increased risk of haematotoxicity with aminosalicylates, drugs that affect myelopoesis e.g. co-trimoxazole or trimethoprim. Increased risk of infections with intra-uterine devices and live vaccines. Increased risk of leucopenia with ACE inhibitors. Increased warfarin requirements with azathioprine. |
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