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Relief of chronic renal insufficiency by renal transplantation involving the administration of Imuran has been accompanied by increased fertility in both male and female transplant recipients.
Substantial transplacental and transamniotic transmission of azathioprine and its metabolites from the mother to the foetus have been shown to occur.
Imuran should not be given to patients who are pregnant or likely to become pregnant in the near future without careful assessment of risk versus benefit.
Evidence of the teratogenicity of Imuran in man is equivocal. As with all cytotoxic chemotherapy, adequate contraceptive precautions should be advised when either partner is receiving Imuran.
There have been reports of premature birth and low birth weight following maternal exposure to Imuran, particularly in combination with corticosteroids. There have also been reports of spontaneous abortion following either maternal or paternal exposure.
Leucopenia and/or thrombocytopenia have been reported in a proportion of neonates whose mothers took Imuran throughout their pregnancies.
Extra care in hematological monitoring is advised during pregnancy.
6-Mercaptopurine has been identified in the colostrum and breast milk of women receiving Imuran treatment. It is recommended that mothers receiving Imuran should not breastfeed.
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