Azathioprine is the general form of the branded preparation Imuran, which is used together with other medicines to prevent organ rejection after transplantation.
The drug is also used to treat severe rheumatoid arthritis, psoriasis, ulcerative colitis and Crohn’s disease.
Azathioprine belongs to a class of drugs known as immunosuppressants. It works by changing the activity of the body’s immune system so that it does not attack the transplanted organ or joint.
The Food and Drug Administration (FDA) approved the drug in 1968.
Azathioprine has different names and is manufactured by several manufacturers. In the United States, Imuran is produced by GlaxoSmithKline.
Warnings of Azathioprine
Azathioprine may increase the risk of developing certain types of cancer, such as lymphoma, leukemia and skin cancer.
However, if you have a transplant, you may have an increased risk of developing cancer, even if you do not take Azathioprine.
Tell your doctor if you have ever had cancer, or if you have ever taken any of the following drugs:
- Chlorambucil (leukeran)
- Cyclophosphamide (cytoxane)
- Melphalan (Alkeran)
Avoid unnecessary exposure to sunlight to reduce the risk of skin cancer when taking Azathioprine. In the street, you should wear protective clothing, sunglasses and use sunscreen.
Azathioprine is not approved by the FDA for the treatment of Crohn’s Colitis or ulcerative colitis, but some doctors may prescribe a medication.
You should immediately call your doctor if you are taking a drug from Colon Colitis or ulcerative colitis and experience the following symptoms:
- Unexplained weight loss
- Stomach ache
- Night sweats
- Light bleeding or bruising
Azathioprine can also lead to a decrease in blood cells in your bone marrow, which can lead to serious or life-threatening infections.
Some medicines may also increase this risk when using Azathioprine. Tell your doctor if you are:
- ACE inhibitors such as benazepril (Lotensin), captopril, enalapril (Vasotec), fosinopril, lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), Ramipril (Altace) or trandolapril (Mavik)
- Trimethoprim and sulfamethoxazole (Bactrim, Septra)
- Ribavirin (Copegus, Rebetol, Virazole)
You should also call your doctor immediately if you experience the following symptoms:
- Pale skin
- Excessive fatigue
- Rapid heartbeat
- Inconsistent Breath
- Difficulty sleeping
- Sore throat
- Other signs of infection
Your health care provider will probably order tests to check your blood cells and liver enzymes during your treatment with Azathioprine.
Tell your doctor if you are allergic to Azathioprine or any other medicines.
This medicine controls the symptoms of rheumatoid arthritis, but it does not heal it. It can take up to 12 weeks before you feel all the benefits.
Do not stop taking Azathioprine without first talking to your doctor.
You should tell your doctor that you are taking this medication before any type of surgery, including a dental procedure.
Do not vaccinate during or after treatment with Azathioprine without first talking to your doctor.
Before taking this medicine, tell your doctor if you have or have had:
- Any type of infection
- Kidney disease
- Liver disease
- Any blood disorder
- Deficiency of TPMT
Azathioprine for dogs and cats
Azathioprine can be used in dogs to treat certain conditions, such as:
- Hemolytic anemia
- Arthritis and skin diseases caused by the immune problem
- Chronic liver, kidney or stomach diseases
- Thrombocytopenia (low blood platelet count)
The drug can also be used in very low doses to treat cats with certain skin disorders caused by an immune disorder.
Azathioprine and pregnancy
Azathioprine can harm an unborn baby.
You should not take this medication during pregnancy, or if there is a chance that you can become pregnant.
Immediately notify your doctor if you become pregnant or plan to become pregnant while taking this medication. You should use contraceptives if you can become pregnant while taking Azathioprine.
Most evidence shows that breastfeeding is safe when taking Azathioprine, but talk to your doctor about breastfeeding while taking the drug.
Side Effects of Azathioprine
Tell your doctor if any of the following side effects become serious or persistent:
Serious side effects
Seek immediate medical attention if you experience any of the symptoms listed in the “Warnings” section, or any of the following serious side effects:
- Pain in the muscles
You must tell your doctor about the medications you are taking, especially those listed in the “Warnings” section, or any of the following:
- Allopurinol (Zyloprim)
- Aminosalicylates, such as mesalamine (Apriso, Asacol, Pentasa, others), olsalazine (Dipentum) and sulfasalazine (Azulfidine)
- Blood solvents such as warfarin (coumadin)
Dosage of Azathioprine
Azathioprine-tablet, which must be taken through the mouth. Usually it is taken once or twice a day after meals.
The dosage is based on your weight, health status and response to treatment.
When taking this drug, follow the directions on the recipe label. Do not take more or less drugs than prescribed.
Try to take Azathioprine at about the same time every day. You can take this medication with or without food.
If you are taking Azathioprine for the treatment of rheumatoid arthritis, your doctor may start with a low dose, and then gradually increase it.
Overdose of Azathioprine
If you suspect an overdose, you should immediately contact a toxicology center or an emergency room.
The missed dose of Azathioprine
If you miss a dose of Azathioprine, take it as soon as you remember.
However, if it’s time for the next dose, skip it and continue your regular medication schedule.
Do not double the dose to make up the missed one.