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Azathioprine

About Azathioprine

Azathioprine belongs to a class of drugs called immunosuppressants used to prevent rejection of a transplanted organ such as heart, kidney or liver. Also, it is used to treat autoimmune diseases such as systemic lupus erythematosus, severe rheumatoid arthritis, chronic active hepatitis, and certain muscle, blood and skin diseases. Organ rejection occurs when a patient’s immune system recognizes the donor organ as foreign and tries to eliminate it. 

Azathioprine contains Azathioprine which works by decreasing the number of white blood cells in the body that normally attacks foreign invaders and defend the body against foreign cells and infection. Thereby, preventing organ rejection in transplanted patients and helping the body in accepting the new organ. In autoimmune disease, Azathioprine reduces the immune system attack on normal tissues. Thereby, it helps reduce the severity of symptoms.

Azathioprine will be administered by a healthcare professional. Do not self-administer. Some people may experience bacterial, viral and fungal infections, hair loss (particularly after a kidney transplant), stomach pain with vomiting and fever, thrombocytopenia (low platelet levels), leucopenia (low white blood cell count) and depression of bone marrow function as side effects of $nsme. Most of these side effects do not require medical attention and gradually resolve over time. However, if the side effects persist or worsen, please consult your doctor. 

If you are allergic to Azathioprine, 6-mercaptopurine or any other ingredients, please tell your doctor. If you are pregnant or a breastfeeding mother, it is advised to inform your doctor before taking Azathioprine. You or your partner are advised to use effective contraceptive measures while taking Azathioprine. Avoid alcohol consumption with Azathioprine as it may increase the risk of pancreatitis (inflammation of the pancreas) and liver damage. Drive only if you are alert after taking Azathioprine. If you are about to get vaccinated or have recently been vaccinated, inform your doctor before taking Azathioprine. Inform your dentist, surgeon and anaesthetist that you are taking Azathioprine before undergoing any surgical procedure. Azathioprine may increase the risk of infections or tumours, including skin cancer, as it lowers the body’s immune defence system.

Uses of Azathioprine

Azathioprine is used to prevent organ rejection and manage autoimmune diseases. The detailed uses of Azathioprine are as follows: • Prevents organ rejection: Azathioprine is commonly prescribed after organ transplantation (such as kidney or liver) to suppress the immune system and prevent it from attacking the transplanted organ. • Treats autoimmune disorders: Azathioprine helps manage autoimmune conditions like rheumatoid arthritis, lupus, and inflammatory bowel disease by reducing abnormal immune responses. • Immunosuppressive action: Azathioprine works by interfering with DNA synthesis in immune cells, thereby decreasing inflammation and immune system activity.

Medicinal Benefits

Azathioprine contains Azathioprine, an immunosuppressant used to prevent rejection of a transplanted organ such as heart, kidney or liver. Also, it is used to treat autoimmune diseases such as systemic lupus erythematosus, severe rheumatoid arthritis, chronic active hepatitis, dermatomyositis (causes skin rash and muscle weakness), polymyositis (causes muscle weakness), polyarteritis nodosa (swollen arteries), pemphigus vulgaris (causes blisters on the skin and in the mouth), auto-immune haemolytic anaemia, ulcerative colitis (inflammation in the digestive tract) and chronic refractory idiopathic thrombocytopenic purpura (platelet disorder). Azathioprine is used alone or more commonly in combination with other medicines such as corticosteroids and other immunosuppressive drugs and procedures. Also, it reduces the corticosteroid requirements of kidney transplant recipients. Azathioprine is used in the treatment of moderate to severe Crohn’s disease in patients who cannot tolerate corticosteroid therapy and in whom corticosteroid therapy is required.

Directions for Use

  • Follow your doctor’s instructions on the dosage and timing of this medication to ensure safe and effective use.
  • Azathioprine will be administered by the doctor or healthcare professional.
  • Do not self-administer.

Storage

Store in a cool and dry place away from sunlight

Side Effects of Azathioprine

  • Bacterial, viral and fungal infections
  • Hair loss (particularly after a kidney transplant)
  • Stomach pain with vomiting and fever
  • Thrombocytopenia (low platelet levels)
  • Leucopenia (low white blood cells count)
  • Depression of bone marrow function

Drug Warnings

If you are allergic to Azathioprine, 6-mercaptopurine or any other ingredients, please tell your doctor. If you are pregnant or a breastfeeding mother, it is advised to inform your doctor before taking Azathioprine. You or your partner are advised to use effective contraceptive measures while taking Azathioprine. Avoid alcohol consumption with Azathioprine as it may increase the risk of pancreatitis (inflammation of the pancreas) and liver damage. Drive only if you are alert after taking Azathioprine. If you are about to get vaccinated or have recently been vaccinated, inform your doctor before taking Azathioprine. Inform your dentist, surgeon and anaesthetist that you are taking Azathioprine before undergoing any procedure. Azathioprine may increase the risk of infections or tumours, including skin cancer, as it lowers the body’s immune defence system. Azathioprine is not recommended if you have rheumatoid arthritis that has previously been treated with cyclophosphamide, chlorambucil or melphalan. Avoid contact with people suffering from shingles or chickenpox as the infection may become severe in patients taking Azathioprine. You are advised to wear protective clothing, a hat, and use sunscreen while going out in the skin while you are taking Azathioprine.

Drug Interactions

Drug-Drug Interaction: Azathioprine may interact with painkiller (indomethacin), medicine used to treat stomach ulcers (cimetidine), high blood pressure lowering medicine (captopril), the medicine used in the treatment of rheumatoid arthritis (penicillamine), sulphonamides (co-trimoxazole), gout medicines (allopurinol, thiopurinol, oxipurinol), medicines used to treat ulcerative colitis (olsalazine, mesalazine, sulfasalazine), medicines used during anesthesia (succinylcholine, tubocurarine), blood thinner (warfarin), water pill (frusemide), anticancer drug (methotrexate), antibiotics (erythromycin, rifampicin), antifungal (ketoconazole), anticonvulsants (phenytoin, phenobarbital) and antiviral (ribavirin).

Drug-Food Interaction: Avoid consumption of alcohol with Azathioprine as it may increase the risk of pancreatitis (inflammation of the pancreas) and liver damage.

Drug-Disease Interaction: If you have thiopurine methyltransferase (TPMT) deficiency, chickenpox, shingles, hepatitis B, Lesch-Nyhan Syndrome (birth disorder), kidney or liver disease, inform your doctor before taking Azathioprine.

Drug-Drug Interactions Checker List:

  • INDOMETHACIN
  • CIMETIDINE
  • CAPTOPRIL
  • PENICILLAMINE
  • COTRIMOXAZOLE
  • ALLOPURINOL
  • THIOPURINOL
  • OXIPURINOL
  • OLSALAZINE
  • MESALAZINE
  • SULFASALAZINE
  • SUCCINYLCHOLINE
  • TUBOCURARINE
  • WARFARIN
  • FRUSEMIDE
  • METHOTREXATE
  • ERYTHROMYCIN
  • RIFAMPICIN
  • KETOCONAZOLE
  • PHENYTOIN
  • PHENOBARBITAL
  • RIBAVIRIN
  • Safety Advice

    • Safety Warning

      Alcohol

      unsafe

      Avoid alcohol consumption with Azathioprine as it may increase the risk of pancreatitis (inflammation of the pancreas) and liver damage. Therefore, please consult your doctor in case of any concerns regarding this.

    • Safety Warning

      Pregnancy

      unsafe

      Azathioprine is not recommended for use in pregnant women as it may cause birth defects. You are advised to use effective contraceptive measures while taking Azathioprine, and if you are pregnant or planning pregnancy, inform your doctor before taking Azathioprine.

    • Safety Warning

      Breast Feeding

      unsafe

      Azathioprine is not recommended for use in breastfeeding mothers as it may cause serious side effects in the baby. However, if you are a breastfeeding mother, please inform your doctor before taking Azathioprine.

    • Safety Warning

      Driving

      caution

      Drive only if you are alert after taking Azathioprine.

    • Safety Warning

      Liver

      caution

      Please inform your doctor if you have liver problems or a history of Liver diseases/conditions. The dose may be adjusted by your doctor as required.

    • Safety Warning

      Kidney

      caution

      Please inform your doctor if you have kidney problems or a history of Kidney diseases/conditions. The dose may be adjusted by your doctor as required.

    • Safety Warning

      Children

      caution

      Azathioprine should be used with caution in children.

    Habit Forming

    No

    Diet & Lifestyle Advise

    Kidney transplant:

    • Include fruits and vegetables in your daily routine.
    • Follow a vitamin-C-rich diet.
    • Reduce salt intake.
    • Eat a handful of walnuts and almonds every day.
    • Reduce intake of unhealthy cholesterol and fats.
    • Consume dark chocolate with at least 70% cocoa.

    Liver and Heart transplant:

    • Eat whole-grain bread, cereals, other grains, fruits, vegetables, lean meats, fish, and poultry.
    • Maintain a low-fat and low-salt diet.
    • Drink low-fat milk or eat other low-fat dairy products to maintain adequate calcium.
    • Stay hydrated by drinking sufficient water and other fluids.
    • Avoid alcohol consumption.
    • Avoid grapefruit and grapefruit juice. 

    Special Advise

    • Regular blood tests are recommended while taking Azathioprine to check blood cell count and for appropriate dose adjustments. 

    Patients Concern

    Disease/Condition Glossary

    Organ rejection: It occurs when a patient’s immune system recognizes the donor organ as foreign and tries to eliminate it. Organ rejection may be hyperacute (occurs in minutes to hours), acute (occurs within the first few months), or chronic (occurs after a year or anytime beyond). The symptoms of organ rejection may vary based on the type of organ transplant you have had. However, if you experience pain, fever, or any other signs of illness, contact your doctor immediately.

    FAQs

    Azathioprine is used to prevent organ rejection and treat autoimmune diseases.

    Azathioprine contains Azathioprine, which decreases the number of white blood cells in the body that normally attacks foreign invaders and defends the body against foreign cells and infection. Thereby, preventing organ rejection in transplanted patients and helping the body in accepting the new organ.

    Azathioprine may be used to treat autoimmune diseases because Azathioprine in Azathioprine reduces the immune system attack on normal tissues. Thus, it helps reduce the severity of symptoms.

    Azathioprine may increase the risk of infections as it may weaken the immune system. Therefore, it is advised to stay away from people having chickenpox, or shingles as they can affect severely while taking Azathioprine.

    If you are about to receive any vaccinations, especially live vaccines such as measles, mumps, and rubella (MMR), polio and BCG vaccines, it is advised to inform your doctor that you are on treatment with Azathioprine as it may reduce the effectiveness of the vaccine and increase the risk of getting infection the vaccine is meant to protect.

    Azathioprine may increase the risk of skin cancer. Therefore, avoid or limit exposure to the sun for a long time or artificial light such as tanning beds. Wear protective clothing and use sunscreen before going out in the sun.

    Available Medicines for

    Azathioprine

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