Azathioprine
About
Azathioprine belongs to the class of medicine called 'immunosuppressant' that helps to reduce the pain/inflammation in rheumatoid arthritis conditions and keep the immune system from attacking new transplant organs like kidneys. Besides this, it also treats pain and inflammation in gastrointestinal issues like Crohn's disease, and ulcerative colitis, for patients who have undergone a kidney transplant.
Azathioprine contains 'Azathioprine' that works by reducing the function of the cells, causing inflammation, especially in the joint tissues thereby decreasing pain, inflammation, and slowing down the joint damage and disease progression over time. Besides this, after an organ transplant, your body will try to attack the new organ as it sees it as foreign. Azathioprine helps stop your body from rejecting a new organ by suppressing your immune system.
Take Azathioprine as prescribed. Your doctor will advise you on how often you take Azathioprine based on your medical condition. In some cases, you may experience certain common side-effects such as nausea, headaches, vomiting, diarrhoea, unusual fatigue, dizziness, headache, loss of appetite, increase in liver enzymes, lowered resistance to infections, tingling sensation, stomach pain, leukopenia (decreased number of white blood cells), and sore throat. Most of these side effects do not require medical attention and will resolve gradually over time. However, you are advised to talk to your doctor if you experience these side effects persistently.
To treat your condition effectually, continue taking Azathioprine for as long as your doctor has prescribed. To avoid recurring symptoms, do not stop it midway. Do not take Azathioprine if you are pregnant or planning for pregnancy. Azathioprine should not be taken by breastfeeding mothers as it passes into breast milk. Azathioprine should not be given to children as safety and efficacy have not been established. Azathioprine may make you more susceptible to infections; consult your doctor if you develop any signs of severe conditions such as fever, sore throat, breathlessness, jaundice, unexplained bleeding, or bruising. Avoid excessive exposure to sunlight, wear protective clothing, and use protective sunscreen with a high protection factor while using Azathioprine. While taking Azathioprine, do not contact anyone who has shingles, chickenpox, or measles. If you accidentally come in contact with any person having them, please inform your doctor immediately as it requires special treatment if you have not had these illnesses. Your doctor may advise you to undergo regular blood tests, kidney and liver tests to monitor your condition. Inform your doctor about your health condition and medicines to rule out any unpleasant side effects.
Uses of Azathioprine
Medicinal Benefits
Azathioprine contains 'Azathioprine' which is an immunosuppressant that works by reducing the function of the cells, causing inflammation in the joint tissues. It reduces pain, inflammation, and slow joint damage and disease progression over time. Besides this, after an organ transplant, your body will try to attack the new organ as it sees it as foreign. Azathioprine helps stop your body from rejecting a new organ by suppressing your immune system. Azathioprine is also used to treat severe inflammatory diseases of the skin, Crohn's disease and ulcerative colitis, and some blood disorders.
Directions for Use
Storage
Side Effects of Azathioprine
- Nausea
- Headaches
- Vomiting
- Diarrhoea
- Unusual fatigue
- Dizziness
- Headache
- Loss of appetite
- Increase in liver enzymes
- Lowered resistance to infections
- Tingling sensation
- Stomach pain
- Leukopenia (decreased number of white blood cells)
- Sore throat
In-Depth Precautions and Warning
Drug Warnings
Do not take Azathioprine if you are allergic to any immunosuppressant medicines or Azathioprine. Let your doctor know before using Azathioprine if you have liver or kidney problems, serious blood disorders, immune system problems, bone marrow problems, serious infections, immunodeficiency syndrome, or if you have a condition where your body produces too little of a natural chemical called thiopurine methyltransferase (TPMT), received any vaccinations. Do not take Azathioprine if you are pregnant or planning for pregnancy as Azathioprine is a Pregnancy category risk D medicines which can cause serious congenital disabilities to the unborn baby. Azathioprine should not be taken by breastfeeding mothers as it passes into breast milk. While taking Azathioprine, do not contact anyone who has shingles, chickenpox, or measles. If you accidentally come in contact with any person having them, please inform your doctor immediately as it requires special treatment if you have not had these illnesses. Azathioprine causes dizziness and drowsiness, so drive with caution. Azathioprine should not be given to children as safety and efficacy have not been established. Avoid consuming alcohol along with Azathioprine as it could lead to increased dizziness. Your doctor may advise you to undergo regular blood tests, kidney and liver tests to monitor your condition. Using Azathioprine for a long time can increase your chance of getting certain types of cancer, such as lymphoma (cancer of the spleen, thymus gland, and bone marrow), leukemia (blood cancer), and skin cancer. Avoid excessive exposure to sunlight, wear protective clothing, and use protective sunscreen with a high protection factor while using Azathioprine.
Drug Interactions
Drug-Drug Interaction: Azathioprine may have interaction with other immunosuppressant medicines (tacrolimus), anti-gout (allopurinol, oxypurinol, thiopurine), angiotensin-converting enzyme (ACE) inhibitors (benazepril, captopril, enalapril, fosinopril, moexipril, perindopril, quinapril, ramipril), blood thinner (warfarin, phenprocoumon), medicines used to treat inflammation of the bowels (infliximab), medicines used to treat ulcers (cimetidine, olsalazine, mesalazine, sulfasalazine), diuretics (furosemide), medicines used to treat bacterial infections (trimethoprim, sulfamethoxazole), pain killers (indomethacin), medicines used as muscle relaxants (d-tubocurarine, pancuronium, succinylcholine).
Drug-Food Interaction: Avoid alcohol consumption while taking Azathioprine as it may increase dizziness.
Drug-Disease Interaction: Azathioprine may cause interactions with disease conditions such as leukopenia (low levels of white blood cells), infections, have any unusual bleeding or bruising liver, and kidney dysfunction.
Drug-Drug Interactions Checker List:
Safety Advice
Alcohol
cautionYou are recommended to avoid alcohol consumption while taking Azathioprine. It could lead to increased dizziness and drowsiness.
Pregnancy
cautionAzathioprine is a Category D pregnancy drug that is not recommended for pregnant women or given only when strictly guidance of the doctor as there is no clinical data available on use in pregnant women.
Breast Feeding
cautionIt is not recommended to take Azathioprine while you are breastfeeding. Azathioprine passes into breast milk.
Driving
cautionAzathioprine may cause dizziness, drowsiness, and tiredness; do not drive or operate heavy machinery if you feel dizzy.
Liver
cautionTake Azathioprine only after the doctor's prescription, especially if you are dealing with Liver diseases/conditions as your doctor may adjust the dose as required.
Kidney
cautionPlease consult your doctor if you have kidney impairment before taking Azathioprine.
Children
unsafeAzathioprine should not be used by children below 18 years of age, as the efficacy and safety have not been established.
Habit Forming
Diet & Lifestyle Advise
- Physical activity helps in strengthening muscles and relieves joint stiffness. Gentle activities like 20-30minutes of walking or swimming would be helpful.
- Performing yoga may also help in improving joint flexibility and pain management.
- Maintain a healthy weight by performing regular low-strain exercises and eating healthy food.
- Get adequate sleep as resting the muscles can help in reducing inflammation and swelling.
- Follow heat or cold therapy, apply a cold or hot compress on the joints for 15-20minutes regularly.
- De-stress yourself by meditating, reading books, taking a warm bubble bath, or listen to soothing music.
- Acupuncture, massage, and physical therapy may also be helpful.
- Eat food rich in antioxidants such as berries, spinach, kidney beans, dark chocolate, etc.
- Foods containing flavonoids help in reducing inflammation. These include soy, berries, broccoli, grapes, and green tea.
- Avoid smoking and alcohol consumption.
Special Advise
- Use sunscreen while taking Azathioprine, as it can make your skin more sensitive to sunlight and may cause skin cancer.
- Long-term use of Azathioprine may increase your risk of developing cancers like blood cancer, skin cancer and immune system cancer (lymphoma).
Patients Concern
Disease/Condition Glossary
Rheumatoid arthritis: It is an autoimmune disease (the body's immune system attacks its tissue) that leads to joint pain and damage. Symptoms of rheumatoid arthritis include pain, inflammation of joints, difficulty moving, and swelling.
Kidney transplant rejection: When you get a new kidney transplanted to your body, your body recognizes it as a foreign element and tries to attack, and reject it because it is not originally part of your body. So, immunosuppressant drugs like Azathioprine are given to such patients to suppress your immune system to attack a newly transplanted kidney. The ultimate goal is to adjust immunosuppressant to prevent rejection and to minimize any side effects of the drugs.
FAQs
Azathioprine causes leukopenia (decreased number of white blood cells) and hence may make you more susceptible to infections. Consult your doctor if you develop any signs of infections such as fever, sore throat, breathlessness, jaundice, unexplained bleeding, or bruising.
Azathioprine acts as an immunosuppressant, which helps in reducing inflammation and prevents joint stiffness, thereby provides relief from rheumatoid arthritis.
If you miss a dose of Azathioprine, take the missed dose as soon as you remember it. However, if it's almost time for the next dose, do not take a double dose to make up for a missed one.
Diarrhoea might be a side-effect of Azathioprine. Drink lots of fluids and eat food rich in fibre if you experience diarrhoea. If you find blood in stools (tarry stools) or if you experience excess diarrhoea consult your doctor. Do not take anti-diarrheal medicine on your own.
Azathioprine is a Category D pregnancy drug that is not recommended for pregnant women or given only when strictly guidance of the doctor as there is no clinical data available on use in pregnant women.
