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Drugs reference index «azathioprine»

azathioprine

Generic Name: azathioprine (ay za THYE oh preen)Brand Names: Azasan, Imuran

What is azathioprine?

Azathioprine lowers your body's immune system. The immune system helps your body fight infections. The immune system can also fight or "reject" a transplanted organ such as a liver or kidney. This is because the immune system treats the new organ as an invader.

Azathioprine is used to prevent your body from rejecting a transplanted kidney. It is also used to treat symptoms of rheumatoid arthritis.

Azathioprine may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about azathioprine?

Do not use this medication without telling your doctor if you are pregnant. It could cause harm to the unborn baby. Use an effective form of birth control, and tell your doctor if you become pregnant during treatment.

Taking azathioprine may increase your risk of developing cancer. Talk with your doctor about your specific risk.

Azathioprine can lower the blood cells that help your body fight infections. This can make it easier for you to bleed from an injury or get sick from being around others who are ill. To be sure your blood cells do not get too low, your blood will need to be tested on a regular basis. Your kidney function may also to need to be tested. Do not miss any scheduled visits to your doctor.

Call your doctor at once if you have a fever, chills, sore throat, body aches, weakness, muscle pain, easy bruising or bleeding, mouth sores, pale stools, darkened urine, or severe nausea, vomiting, and diarrhea.

If you need to have any type of surgery, tell the surgeon ahead of time that you are using azathioprine. You may need to stop using the medicine for a short time.

This medication can affect fertility (your ability to have children), whether you are a man or a woman. Talk with your doctor if you have concerns about this.

Do not receive a "live" vaccine while you are being treated with azathioprine and avoid coming into contact with anyone who has recently received a live vaccine. There is a chance that the virus could be passed on to you.

What should I discuss with my healthcare provider before taking azathioprine?

Do not take this medication if you are allergic to azathioprine.

Taking azathioprine may increase your risk of developing cancer. Talk with your doctor about your specific risk.

Before taking azathioprine, tell your doctor if you are allergic to any drugs, or if you have:

  • liver disease;

  • any type of viral, bacterial, or fungal infection; or

  • if you have recently received chemotherapy treatments with medications such as cyclophosphamide (Cytoxan), chlorambucil (Leukeran), melphalan (Alkeran).

If you have any of these conditions, you may need a dose adjustment or special tests to safely take this medication.

FDA pregnancy category D. This medication can cause harm to an unborn baby. Do not use azathioprine without telling your doctor if you are pregnant. It could harm the unborn baby. Use effective birth control, and tell your doctor if you become pregnant during treatment.

This medication can affect fertility (your ability to have children), whether you are a man or a woman. Talk with your doctor if you have concerns about this.

Azathioprine can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take azathioprine?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Take azathioprine with a full glass of water. Take azathioprine with food to lessen stomach upset.

If you need to have any type of surgery, tell the surgeon ahead of time that you are using azathioprine. You may need to stop using the medicine for a short time.

Azathioprine can lower the blood cells that help your body fight infections. This can make it easier for you to bleed from an injury or get sick from being around others who are ill. To be sure your blood cells do not get too low, your blood will need to be tested on a regular basis. Your kidney function may also to need to be tested. Do not miss any scheduled appointments.

Store azathioprine at room temperature away from moisture, heat, and light.

See also: Azathioprine dosage in more detail

What happens if I miss a dose?

If you take this medicine once daily and you miss a dose, take the medicine as soon as you remember. If it is almost time for the next dose, skip the missed dose and wait until your next regularly scheduled time to take the medication. Do not use extra medicine to make up the missed dose.

If you take this medicine more than once daily and you miss a dose, take the medicine as soon as you remember. If it is almost time for the next dose, take both doses together, then go back to your regular dosing schedule.

Call your doctor if you have missed more than one dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include nausea, vomiting, stomach pain, diarrhea, bleeding, fever, chills, and other signs of infection.

What should I avoid while taking azathioprine?

Avoid being near people who have colds, the flu, or other contagious illnesses. Contact your doctor at once if you develop signs of infection.

Do not receive a "live" vaccine while you are being treated with azathioprine and avoid coming into contact with anyone who has recently received a live vaccine. There is a chance that the virus could be passed on to you.

Azathioprine side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have a serious side effect such as:
  • pale skin, easy bruising or bleeding, unusual weakness;

  • fever, chills, sore throat, body aches, weakness, muscle pain, flu symptoms;

  • severe nausea, vomiting, or diarrhea;

  • severe pain in your upper stomach spreading to your back, fast heart rate;

  • pain or burning with urination;

  • stomach pain, loss of appetite, dark urine, clay-colored stools, and jaundice (yellowing of the skin or eyes); or

  • white patches or sores inside your mouth or on your lips.

Less serious side effects may include:

  • mild upset stomach, nausea, diarrhea, loss of appetite;

  • hair loss; or

  • skin rash.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

Azathioprine Dosing Information

Usual Adult Dose for Renal Transplant:

Initial: 3 to 5 mg/kg once daily orally or IV beginning at the time of transplant. In a few cases, therapy has been started 1 to 3 days before transplantation.Maintenance: 1 to 3 mg/kg once daily orally or IV.

Usual Adult Dose for Rheumatoid Arthritis:

Initial: 1 mg/kg (50 to 100 mg) orally or IV given in 1 to 2 divided doses.Titration: May increase in increments of 0.5 mg/kg/day beginning at 6 to 8 weeks and thereafter at 4 week intervals. Maintenance: Gradual dosage reduction should be attempted to reduce risk of toxicity. Maintenance therapy should be at the lowest effective dose. The dose can be lowered by 0.5 mg/kg or approximately 25 mg/day every 4 weeks. Maximum recommended dose is 2.5 mg/kg/day.

Usual Adult Dose for Crohn's Disease -- Acute:

Studies:1.5 to 4 mg/kg per day for 10 days up to 52 weeks.

Usual Adult Dose for Crohn's Disease -- Maintenance:

Studies:1.5 to 4 mg/kg per day for 10 days up to 52 weeks.

Usual Adult Dose for Chronic Inflammatory Demyelinating Polyradiculoneuropathy:

Study (n=14)2 to 3 mg/kg once daily, orally, for 9 months.

Usual Adult Dose for Atopic Dermatitis:

Study (n=37)2.5 mg/kg orally once daily, in the morning, for 3 months.

Usual Adult Dose for Sarcoidosis:

Study (n=11)Initial: 2 mg/kg per day in combination with prednisolone 0.6 to 0.8 mg/kg per day, with prednisolone reduced to 0.1 mg/kg within 2 to 3 months.Maintenance: 2 mg/kg per day along prednisolone 0.1 mg/kg per day for 21 to 22 months.

Usual Adult Dose for Ulcerative Colitis:

Study (n=9)20 to 40 mg/kg IV infusion over 36 hours. Alternatively, 40 mg/kg as three 8-hour infusions over 3 days. Followed by oral azathioprine 2 mg/kg daily beginning the day after completion of the IV loading dose.Study (n=12)50 mg per day for 2 weeks, then 2 to 2.5 mg/kg per day plus mesalamine 500 mg orally three times per day; these drugs were started immediately after signs of remission was achieved (mean: 14.5 days) with cyclosporine IV (4 mg/kg/day).

Usual Adult Dose for Uveitis:

Study (n=14) - Treatment of choroidal neovascularization:1 to 1.5 mg/kg orally per day, in combination with prednisolone and cyclosporine.

Usual Adult Dose for Multiple Sclerosis:

Study (n=6) - Patients refractory to interferon Гџ-1bInitial: Titrate azathioprine up to 1.5 mg/kg per day over 1 month, followed by 50 mg increments in 6-month intervals, concomitantly with 8 million intl units subcutaneous IFNГџ-1b on alternate days.Maintenance: 2 mg/kg per day.

Usual Adult Dose for Systemic Lupus Erythematosus:

Studies:1 to 3 mg/kg actual body weight (ABW)/day orally or IV once daily.Study (n=55) - Diffuse Proliferative Lupus GlomerulonephritisSequential therapy starting with prednisone (1 mg/kg/day) for 8 to 10 weeks, gradually tapering to maintenance dosage of 5 to 10 mg/day, together with oral cyclophosphamide (1 to 2 mg/kg/day) for 6 to 9 months followed by azathioprine 50 to 100 mg/day.

Usual Adult Dose for Chronic Active Hepatitis:

Study (n=72) - Autoimmune hepatitis1 to 2 mg/kg per day, concomitantly with prednisolone (5 to 15 mg/day) for a minimum of 1 year (average 5 years).

Usual Adult Dose for Takayasu's Arteritis:

Study (n=15)2 mg/kg actual body weight (ABW)/day for one year in combination with prednisolone taper.

Usual Pediatric Dose for Atopic Dermatitis:

Study (n=37)Greater than 17 years: 2.5 mg/kg orally once daily, in the morning, for 3 months.

Usual Pediatric Dose for Organ Transplant -- Rejection Prophylaxis:

Initial: 3 to 5 mg/kg once daily orally or IV beginning at the time of transplant. Maintenance: 1 to 3 mg/kg once daily orally or IV.

Usual Pediatric Dose for Eczema:

Study (n=91)Greater than 6 years: 2.5 to 3.5 mg/kg daily in patients with normal levels of thiopurine methyltransferase.

Usual Pediatric Dose for Systemic Lupus Erythematosus:

Case Study (n=67) - Lupus NephritisGreater than 5 years: 2 to 3 mg/kg per day. Maximum daily dose: 150 mg. Titrate dose to maintain a total white blood cell count between 3 and 4 x 10(3) cells/mL.

What other drugs will affect azathioprine?

Before taking azathioprine, tell your doctor if you are taking, have taken, or need to take any of the following medicines:

  • allopurinol (Zyloprim);

  • mercaptopurine (Purinethol);

  • methotrexate (Rheumatrex, Immunex);

  • a blood thinner such as warfarin (Coumadin);

  • cyclosporine (Neoral, Sandimmune);

  • olsalazine (Dipentum), or sulfasalazine (Azulfidine);

  • sulfamethoxasole and trimethoprim (Trimpex, Proloprim, Bactrim, Septra, others); or

  • an ACE inhibitor such as benazepril (Lotensin), captopril (Capoten), fosinopril (Monopril), enalapril (Vasotec), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), or trandolapril (Mavik).

This list is not complete and there may be other drugs that can interact with azathioprine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about azathioprine.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2006 Cerner Multum, Inc. Version: 1.11. Revision Date: 4/12/2009 4:22:21 PM.
  • azathioprine Oral, Intravenous Advanced Consumer (Micromedex) - Includes Dosage Information
  • Azathioprine Prescribing Information (FDA)
  • Azathioprine Professional Patient Advice (Wolters Kluwer)
  • Azathioprine MedFacts Consumer Leaflet (Wolters Kluwer)
  • Imuran Prescribing Information (FDA)

See Also...

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