Azathioprine

• Prevention of rejection of the organ by the immune system after transplantation surgery in patients who received organs such as kidney, liver, heart, lung or pancreas
• Severe joint pains (rheumatoid arthritis) which is not responding to other treatments
• Severe form of diseases that affect the lining of the intestines or cause ulcers (Crohn's disease, ulcerative colitis)
• Conditions due to over-reactive immune system – skin rashes and muscle weakness (dermatomyositis)
• An immune reaction that affects joints, skin, blood cells, brain, kidneys, etc. (systemic lupus erythematosus)
• Liver disease due to immune disorders (auto-immune chronic active hepatitis)
• Destruction of red blood cells (refractory warm auto-immune hemolytic anemia)
• Easy bruising and purple spots on skin due to low platelet counts (chronic refractory idiopathic thrombocytopenic purpura)
• Diseases of the arteries (polyarteritis nodosa)

When should one not use Azathioprine

• Allergy to Azathioprine or any of the components of the medicine or any other medicine of the same class
• Severe infections
• Severe liver or bone marrow diseases
• Infections of the pancreas (pancreatitis)
• Live vaccines (BCG or smallpox)

Common side effects of this drug are:

• Reduction in bone marrow function (decrease in red blood cells, white blood cells and platelets)
• Any viral, bacterial or fungal infections (due to decreased white blood cells)
• Tiredness, shortness of breath, headache, feeling dizzy (due to decreased red blood cells), Liver problems with symptoms like pale stools, itching, jaundice (uncommon)
• Stomach problems (loose motions, stomach pain, constipation, feeling sick), hair loss, sensitivity to skin, severe liver damage or cancers of the blood, lymph (a fluid made up of white blood cells) or skin (rare)
• Severe allergic reactions causing swelling of the skin of the face, breathing difficulty with or without rashes and itching, skin blistering, muscle and joint weakness, extreme tiredness, easy bruising, infections of the pancreas, lumps on the body or sudden deterioration of health (serious, but rare)

Other General Warnings

• A rare genetic disease that causes increased levels of uric acid in the body (Lesch-Nyhan syndrome)
• Kidney or liver diseases
• Azathioprine can increase the risk of tumors of the skin and the lymph nodes (avoid direct contact with light and using multiple immunosuppressant medicines together)
• Excessive activation of white blood cells in patients with joint pains (macrophage activation syndrome)
• Be watchful of any new growths or lumps on the skin or inside the body

How Does It Work?

Interactions with other medicines

• Medicines for gout (Allopurinol, Oxipurinol, Thiopurinol)
• Muscle relaxants given during anesthesia (Succinylcholine and Tubocurarine)
• Medications used to prevent blood clots (Warfarin etc.)
• Penicillamine ( treats rheumatoid arthritis)
• Co-trimoxazole (to treat infections)
• Captopril, Furosemide (treats high blood pressure)
• Cimetidine (reduces stomach acidity)
• Indomethacin (pain killer)
• Certain medicines used to treat immune system disorders (TPMT inhibitors - Olsalazine, Mesalazine, Sulfasalazine)
• Avoid live vaccines such as BCG, smallpox, or yellow fever

Interactions with food items

Overdose

Missed a Dose