Azathioprine: Key Information for Patients

Summary or Key Points

Azathioprine is a medication used to suppress the immune system in the treatment of diseases like Rheumatoid Arthritis, Crohn’s Disease, Ulcerative Colitis, and Systemic Lupus Erythematosus. It helps manage symptoms and reduce flare-ups. Adverse reactions and side effects can occur, thus close monitoring by your healthcare provider is essential. Our telemedicine services make these regular consultations convenient and accessible.

Names of Medication

US Brand Name: Imuran (Azathioprine)

The ‘generic name’ refers to the standard name of a drug, in this case, Azathioprine, irrespective of the brand. This is mentioned in parentheses to provide transparency and choice to patients.

Pharmacologic Category

Azathioprine belongs to a class of drugs known as immunosuppressants. Other medications in this category include Cyclosporine (Neoral, Sandimmune), Tacrolimus (Prograf), Mycophenolate (Cellcept), and Sirolimus (Rapamune).

Dosing

Dosing varies depending on the condition being treated. Always consult your healthcare provider before adjusting your dose. Remember, you can consult with one of our providers via our telemedicine service right away.

• Rheumatoid Arthritis: 1.0-2.5 mg/kg orally once daily
• Crohn’s Disease: 2-3 mg/kg orally once daily
• Ulcerative Colitis: 1-2.5 mg/kg orally once daily
• Systemic Lupus Erythematosus: 1-3 mg/kg orally once daily

Dosage Forms and Strengths

Azathioprine is available in the following forms and strengths:

• Tablets: 50 mg and 75 mg
• Injection: 100 mg (available in vials)

Administration Instructions

Take Azathioprine orally with or without food, usually once or twice daily or as directed by your healthcare provider. If stomach upset occurs, take with food. The dosage is based on your medical condition, weight, and response to treatment.

Adverse Reactions and Side Effects

Azathioprine can cause side effects, and the likelihood of experiencing these may vary. If any of these side effects persist or worsen, promptly contact your doctor or make a telemedicine appointment with one of our providers:

• Common: Nausea, vomiting, diarrhea
• Uncommon: Skin rash, hair loss
• Rare: Serious infections, liver disease, pancreatitis

Adverse Reactions and Side Effects (continued)

Rare but serious side effects include symptoms of liver disease such as persistent nausea/vomiting, severe stomach/abdominal pain, yellowing eyes/skin, dark urine, easy bleeding/bruising.

Remember, this is not a complete list of possible side effects. If you notice other effects not listed, please consult your healthcare provider promptly. If the side effects persist or worsen, don’t hesitate to make a telemedicine appointment with one of our providers.

Special Considerations

Before starting azathioprine, inform your healthcare provider if you have any allergies, especially to azathioprine or to mercaptopurine. The medication might contain inactive ingredients which can cause allergic reactions or other issues.

Before using this medication, discuss your medical history, especially of: kidney disease, liver disease, certain enzyme deficiencies (TPMT or NUDT15 deficiency), blood disorders, certain types of cancer (skin, lymphoma), current infections.

This drug may make you more susceptible to getting infections or may worsen any current infections. Therefore, wash your hands well to prevent the spread of infection. Avoid contact with people who have infections that may spread to others (such as chickenpox, measles, flu).

Finally, remember to always communicate openly with your healthcare provider about your symptoms and any concerns you may have about your medication. Our telemedicine service allows you to do this at your convenience, right from home.

Conclusion

Azathioprine is a powerful medication used in the management of a number of conditions, and understanding how to use it effectively and safely is crucial for the best outcome. Your healthcare provider is your partner in managing your condition and optimizing your treatment plan. Do not hesitate to reach out via our telemedicine service for any questions or concerns about your medication.

Contraindications

‘Contraindications’ refer to situations where a particular drug should not be used because it may be harmful to the patient. Here are a few situations where Azathioprine is contraindicated:

• Allergy to Azathioprine: If you have a known allergy to Azathioprine or any of its components, avoid this medication to prevent allergic reactions.
• Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. Azathioprine may harm an unborn baby.
• Certain genetic enzyme deficiencies: People with certain genetic deficiencies (such as thiopurine S-methyltransferase deficiency) should not take Azathioprine because they cannot metabolize the medication correctly, leading to increased risk of severe side effects.

Drug to Drug Interactions

Here are a few examples of medications that may interact with Azathioprine. Always inform your healthcare provider about all the medications you are currently taking, including prescription, over-the-counter drugs, and supplements.

• Allopurinol (Zyloprim)
• Warfarin (Coumadin, Jantoven)
• Angiotensin-converting enzyme (ACE) inhibitors, such as Lisinopril (Prinivil, Zestril)
• Certain live vaccines (like MMR, BCG)

Azathioprine in Pregnancy

Azathioprine should only be used during pregnancy if the potential benefits to the mother outweigh the potential risks to the unborn baby. If you are pregnant or planning to become pregnant, discuss this with your healthcare provider. Remember, you can consult with one of our providers via our telemedicine service right away.

Azathioprine while Breastfeeding

Azathioprine is excreted in breast milk and may affect a nursing infant. If you are breastfeeding, discuss this with your healthcare provider to weigh the benefits and risks. Our telemedicine service allows you to do this at your convenience, right from home.

Estimated Cost of Medication

The estimated cost for a 30-day supply of Azathioprine without insurance, using a GoodRX coupon, is approximately $25 to $35. Prices may vary depending on the pharmacy.

Possible Alternatives

For each disease, there are alternative treatments or lifestyle changes that may help. Always discuss these alternatives with your healthcare provider before making any changes to your treatment plan. Our telemedicine service makes this discussion possible right from your home.

• Rheumatoid Arthritis: NSAIDs, physical therapy, balanced diet, and regular exercise
• Crohn’s Disease: Aminosalicylates, antibiotics, corticosteroids, diet modifications, stress management
• Ulcerative Colitis: Aminosalicylates, corticosteroids, diet modifications, stress management
• Systemic Lupus Erythematosus: NSAIDs, antimalarial drugs, corticosteroids, regular exercise, sun protection

Recent Updates on Azathioprine Research

Recent studies indicate that Azathioprine may be more effective when used in combination with other immunosuppressive drugs. However, this combined therapy requires close monitoring due to the increased risk of side effects. Ongoing research is also evaluating the long-term safety and effectiveness of Azathioprine in treating various autoimmune diseases. Always stay informed about new research and don’t hesitate to ask your healthcare provider or one of our telemedicine providers about the latest information regarding your medication.

Brief Legal Disclaimer

This article is for informational purposes only and not intended as medical advice. Always consult a healthcare professional for diagnosis and treatment. Reliance on the information provided here is at your own risk.
Brief Legal Disclaimer: This article is for informational purposes only and not intended as medical advice. Always consult a healthcare professional for diagnosis and treatment. Reliance on the information provided here is at your own risk.