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Imuranin combination with corticosteroids and/or other immunosuppressive agents and proceduresis indicated to enhance the survival of organ transplantssuch as renal transplantscardiac transplantsand hepatic transplantsand to reduce the corticosteroid requirements of renal transplant recipients.

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It is recommended that consideration be given to either genotype or phenotype patients for TPMTPhenotyping and genotyping methods are commercially availableThe most common non-functional alleles associated with reduced levels of TPMT activity are TPMT*2TPMT*3A and TPMT*3CPatients with two nonfunctional alleleshomozygoushave low or absent TPMT activity and those with one non-functional alleleheterozygoushave intermediate activityAccurate phenotypingred blood cell TPMT activityresults are not possible in patients who have received recent blood transfusionsTPMT testing may also be considered in patients with abnormal CBC results that do not respond to dose reductionEarly drug discontinuation in these patients is advisableTPMT TESTING CANNOT SUBSTITUTE FOR COMPLETE BLOOD COUNTCBCMONITORING IN PATIENTS RECEIVING IMURANSee CLINICAL PHARMACOLOGYWARNINGSADVERSE REACTIONS and DOSAGE AND ADMINISTRATION sections.

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