All about Azathioprine

Azathioprine is FDA approved drug for adjunctive therapy in the prevention of rejection of kidney transplants and in active rheumatoid arthritis. It is a potent immunosuppressant and has been used in many other situations when suppressing the immune system is desired. You are being given Azathioprine for your neurologic problem. 

Uses of Azathioprine:

Azathioprine (Imuran) is used to treat dermatomyositis, systemic lupus erythematosus (lupus), inflammatory bowel disease, vasculitis (inflammation of the blood vessels), rheumatoid arthritis, as well as other inflammatory conditions. The potential of medication suppresses the immune system by interfering with DNA synthesis (the creation of DNA molecules). 
It is also used in combination with other medications to suppress the immune system after organ transplantation to prevent rejection of transplanted organs. 

Azathioprine Dosage:

Azathioprine comes in tablet form and is available in two different strengths: 50mg and 25mg. The dose should be taken once a day with, or soon after food (it can cause stomach irritation if taken on an empty stomach).

Side Effects of Azathioprine:

Patients with this drug may experience some most common adverse reactions that may involve the gastrointestinal tract (which includes the stomach, intestines, liver, and pancreas) and the blood cells. Consume this medicine twice daily instead of all at once, or you should take it after eating, it may help avoid these problems.
Less often, azathioprine 50 mg tablet may cause damage to the liver, pancreas, or an allergic reaction that may include a flu-like illness or a rash. Azathioprine also may decrease the number of infection-fighting WBC (white blood cells). 
Before or while treatment, your healthcare team may perform a blood test known as TPMT activity level. TPMT is helpful in order to clear the medication from your system. Patients with lower amounts of TPMT are at higher risk for medication toxicity. 
It is important to take azathioprine tablets as directed and have regular blood tests.

How Does Azathioprine Work:

Azathioprine is an immunosuppressive medicine, which means that it works by reducing the activity of the immune system. 
In RA (rheumatoid arthritis) this action works by reducing the inflammation and thus reducing the pain as well as swelling. It also limits damage to the joints and helps to prevent disability in the long term. 
The reason is, azathioprine functions to reduce the damage to the joints, rather than just relieve the pain, it belongs to the group of medicines called disease modifying antirheumatic drugs (DMARDs).

Interactions: The existence of some drugs may interfere with the azathioprine and potentially may also be responsible for serious problems, including the gout medicines allopurinol (Aloprim), warfarin (Coumadin), some blood pressure medications, including a few ACE (angiotensin-converting enzyme) inhibitors (Accupril or Vasotec); olsalazine 
(Dipentum); mesalamine (Asacol, Pentasa); and sulfasalazine (Azulfidine). 

Contraindications: Azathioprine should not be given to patients who have shown hypersensitivity to the drug. The use of Imuran (Azathioprine)  should be avoided in order to treat rheumatoid arthritis in those women who are pregnant. Patients who carried rheumatoid arthritis (RA) and previously taken alkylating agents such as chlorambucil, cyclophosphamide, melphalan may have a prohibitive risk of malignancy if treated with Azathioprine. 

Precautions: If you are pregnant or considering pregnancy. Breast-feeding should be avoided while taking azathioprine because the drug can enter breast milk. You should discuss with your healthcare team before initiating any vaccines or undergoing any surgeries while taking this medication. Live vaccines are recommended and should be avoided while taking this medicine and you should discuss updating your vaccinations prior to starting this medication.

When This Medicine Should Not Be Used:

You should not use this medicine if you have had an allergic reaction to azathioprine, or if you are pregnant. 
You should not use azathioprine 50 mg if you have received other medicines such as cyclophosphamide (Cytoxan, Neosar), chlorambucil (Leukeran), or melphalan (Alkeran) to treat your arthritis.

In missed dose circumstances:
If you forget to use your medicine, promptly use it. If it is approximate time for your upcoming dose, you should wait until then to use the drug and skip the missed dose. You should not use extra medication in order to make up for a missed dose. 
Check with your healthcare provider if you miss more than one dose.

How to Store as well as Dispose of azathioprine:
The medicine should be stored in a closed container at room temperature, it should be away from the moisture, heat, and direct light. 
Ask your health caregiver or health provider about the best way in order to dispose of any leftover medicine after you have finished your treatment. You should also throw away old medications after the expiration date has passed. 
Keep all medications away from the children and never share your any kind of medicine with anyone.
 

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