Azathioprine

Azathioprine is available in tablet and injectable form.

When used to prevent kidney transplant rejection, azathioprine is usually started on the day of transplant with an intravenous (into the vein) injection. The initial dose is based on body weight at 3 to 5 mg per kilogram of body weight daily. After the transplant, tablets are used. The dose is then generally reduced to a maintenance dose of 1 mg to 3 mg per kilogram of body weight per day.

For treatment of rheumatoid arthritis, azathioprine is usually given at a dose of approximately 1 mg per kilogram of body weight (50 mg to 100 mg) per day by mouth, in a single daily dose or on a twice-daily schedule. After 6 to 8 weeks, your doctor may increase your dose by 0.5 mg per kilogram daily if needed. Additional increases may be prescribed by your doctor every 4 weeks up to the maximum daily dose of 2.5 mg per kilogram per day.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take Azathioprine exactly as prescribed by your doctor. If you miss a dose and you are taking the pills once a day, do not take the missed dose at all, but go back to your regular dosing schedule.

If you are taking pills more than once a day, skip the missed dose and go back to your regular schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Azathioprine at room temperature, protect it from light, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

In addition to its desired action, this medication may cause some adverse effects, notably: it may decrease your appetite; it may cause diarrhea; it may cause spots or redness of the skin; it may lower your white blood cell count, which can lead to unusual tiredness, fever, chills, sore throat or infections - if you experience any of these symptoms, contact your doctor right away; it may cause nausea and vomiting; it may make your skin more sensitive to UV rays (e.g., sunlight, tanning lamps) - avoid exposure to UV rays as much as possible and protect yourself when out in the sun. Each person may react differently to a treatment. If you think this medication may be causing adverse effects (including those described here, or others), talk to your health care professional. He or she can help you to determine whether or not the medication is the source of the problem.

Each pale yellow, peanut-shaped tablet, with "APO" on one side and "AZ 50" on the other, contains 50 mg of azathioprine. Nonmedicinal ingredients: lactose, magnesium stearate, microcrystalline cellulose, and starch.

Do not use azathioprine if you are allergic to azathioprine or any ingredients of the medication.

There may be an interaction between azathioprine and any of the following:

• 5-ASA medications (e.g., Mesalamine, Olsalazine, Sulfasalazine)
• Adalimumab
• Allopurinol
• angiotensin-converting enzyme (ACE) inhibitors (e.g., Enalapril, Ramipril)
• Baricitinib
• certolizumab
• Cladribine
• cotrimoxazole
• Cyclophosphamide
• Denosumab
• echinacea
• Etanercept
• Febuxostat
• Fingolimod
• Golimumab
• Infliximab
• Leflunomide
• Mercaptopurine
• Natalizumab
• Nivolumab
• Ocrelizumab
• Pimecrolimus
• ribavirin
• Roflumilast
• siponimod
• sulfamethoxazole
• Tacrolimus
• Tofacitinib
• Trastuzumab
• Trimethoprim
• upadacitinib
• vaccines
• Warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Azathioprine. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking.

Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Medications other than those listed above may interact with Azathioprine. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin taking a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Azathioprine.

Cancer: Azathioprine may increase your risk of developing certain types of cancer, specifically hepatosplenic T-cells lymphoma, a particularly severe cancer of the immune cells, and Skin Cancer.

To reduce the risk of skin cancer, limit your exposure to sunlight and ultraviolet light, wear protective clothing, and use sunscreen with a high sun protection factor. Report any unusual growths on your skin to your doctor as soon as possible.

Bleeding: Azathioprine can decrease the number of platelets (component of the blood that helps blood to clot). Your doctor will monitor your platelet levels regularly while you are taking Azathioprine. If you notice any unusual signs of bruising or bleeding (e.g., bleeding gums, blood in urine, dark-tarry stools), contact your doctor immediately or get immediate medical attention.

Infection: Azathioprine reduces the number of white blood cells that fight infection in the body and can increase the risk of bacterial, fungal, and viral infections. If you notice any signs of infection (e.g., fever, chills, cough, painful urination) or any other unusual symptoms, contact your doctor. Contact your doctor immediately if you come into contact with someone who has Chickenpox or Shingles. Your doctor will monitor your white blood cell levels regularly while you are taking Azathioprine.

Kidney function: Azathioprine may be removed from the body more slowly in people with reduced kidney function. If you have reduced kidney function discuss with your doctor how Azathioprine may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Azathioprine, and whether any special monitoring is needed.

Liver function: Liver damage or reduced liver function may cause Azathioprine to build up in the body, causing side effects. If you have liver disease, discuss with your doctor how Azathioprine may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Azathioprine, and whether any special monitoring is needed.

Azathioprine may reduce liver function and can cause liver failure. If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.

Pregnancy: Azathioprine can cause harm to the baby when taken by pregnant women. Azathioprine should not be used during pregnancy unless the benefits outweigh the risks. Effective birth control should be practiced while using Azathioprine. If you become pregnant while you are taking Azathioprine, contact your doctor at once.

Breast-feeding: Azathioprine may pass into breast milk. If you are a breast-feeding mother and are taking azathioprine it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using Azathioprine have not been established for children.

Seniors: The safety and effectiveness of using Azathioprine have not been established for people over the age of 65. Discuss the risks and benefits of taking azathioprine with your doctor.

This medication is typically used only once a day. However, your pharmacist may have suggested a different schedule that is more appropriate for you. Take it regularly and continuously to maintain its beneficial effects. Important: Follow the instructions on the label. Do not use more of this product, or more often, than prescribed. This medication should be swallowed whole. It should not be split, crushed or chewed. It is not advisable to stop using this product suddenly, particularly if you have been on it for several weeks. If you are considering stopping the medication, talk to your pharmacist first. If you forget a dose, take it as soon as you remember -- unless it is almost time for your next dose. In that case, skip the missed dose. Do not double the next dose to catch up. This medication may irritate the stomach, and should be taken with food. It is best to avoid coffee, spicy food or alcohol.