Ortikos vs. Imuran

Ortikos (budesonide) and Imuran (azathioprine) are used to treat Crohn's disease.

Ortikos is specifically used to treat mild to moderate active Crohn's disease involving the ileum and/or the ascending colon, in patients 8 years and older; and for maintenance of clinical remission of mild to moderate Crohn's disease involving the ileum and/or the ascending colon for up to 3 months in adults.

Imuran is also used to prevent the body from rejecting a transplanted kidney and to treat symptoms of rheumatoid arthritis.

Ortikos and Imuran belong to different drug classes. Ortikos is a corticosteroid and Imuran is an immunosuppressive antimetabolite.

Side effects of Ortikos and Imuran that are similar include nausea and vomiting.

Side effects of Ortikos that are different from Imuran include headache, respiratory infection, back pain, indigestion/heartburn, dizziness, abdominal pain, gas (flatulence), fatigue, and pain.

Side effects of Imuran that are different from Ortikos include upset stomach, diarrhea, loss of appetite, hair loss, and skin rash.

Both Ortikos and Imuran may interact with cyclosporine.

Ortikos may also interact with CYP3A4 Inhibitors (e.g., ketoconazole, grapefruit juice, itraconazole, ritonavir, indinavir, saquinavir, and erythromycin).

Imuran may also interact with allopurinol, mercaptopurine, methotrexate, blood thinners, olsalazine, sulfasalazine, sulfamethoxasole, trimethoprim, and ACE inhibitors.

Common side effects of Ortikos include:

• headache,
• respiratory infection,
• nausea,
• back pain,
• indigestion/heartburn,
• dizziness,
• abdominal pain,
• gas (flatulence),
• vomiting,
• fatigue, and
• pain

Common side effects of Imuran include:

• upset stomach,
• nausea,
• vomiting,
• diarrhea,
• loss of appetite,
• hair loss, or
• skin rash.

Tell your doctor if you experience unlikely but serious side effects of Imuran including:

• muscle loss,
• hair loss,
• cold/numbness in the fingers,
• mouth sores,
• difficult/painful swallowing, or
• greasy stools.

Ortikos (budesonide) is a corticosteroid indicated for treatment of mild to moderate active Crohn's disease involving the ileum and/or the ascending colon, in patients 8 years and older; and maintenance of clinical remission of mild to moderate Crohn' disease involving the ileum and/or the ascending colon for up to 3 months in adults.

Imuran (azathioprine) is an immunosuppressive antimetabolite used to prevent the body from rejecting a transplanted kidney. Imuran is also used to treat symptoms of rheumatoid arthritis. Imuran is available in generic form.

Ortikos may interact with CYP3A4 Inhibitors (e.g., ketoconazole, grapefruit juice, itraconazole, ritonavir, indinavir, saquinavir, erythromycin, and cyclosporine). Tell your doctor all medications and supplements you use. Tell your doctor if you are pregnant or plan to become pregnant before using Ortikos; it may harm a fetus.

Imuran may interact with diuretics (water pills), blood thinners, cyclosporine, insulin or oral diabetes medications, rifampin, azole antifungals, or seizure medications.

Imuran may also interact with antibiotics, anticholinesterase, isoniazid, bupropion, cholestyramine, cyclosporine, digitalis glycosides, estrogens (including oral contraceptives), barbiturates, ritonavir, indinavir, nonsteroidal anti-inflammatory drugs (NSAIDs), quetiapine, skin tests, thalidomide, and live or inactivated vaccines.

Following prolonged therapy, withdrawal of corticosteroids such as dexamethasone or trexall may result in symptoms of the corticosteroid withdrawal syndrome including muscle or joint pain and feeling unwell (malaise).

The recommended adult dosage of Ortikos for mild to moderate active Crohn's disease is 9 mg once daily for up to 8 weeks; repeat 8-week treatment courses recurring episodes of active disease. The recommended dosage of Ortikos for pediatric patients 8 to 17 years who weigh more than 25 kg is 9 mg once daily for up to 8 weeks, followed by 6 mg once daily in the morning for 2 weeks.

The dose of Imuran to prevent transplant rejection and minimize toxicity varies. The initial dose is usually 3 to 5 mg/kg daily, beginning at the time of transplant. It is usually given as a single daily dose on the day of, and in some cases 1 to 3 days before, transplantation. Maintenance levels of 1 to 3 mg/kg daily are usually possible. For rheumatoid arthritis, the initial dose is approx. 1.0 mg/kg (50 to 100 mg) given as a single dose or twice-daily. Maximum dose is 2.5 mg/kg per day.