Azathioprine
Uses of Azathioprine
The primary use of Azathioprine is to manage conditions like rheumatoid arthritis and prevent organ rejection after transplants. It falls under the classification of immunosuppressant medicines.
Additionally, it is prescribed for managing certain autoimmune diseases such as severe vasculitis, inflammatory bowel disease and certain blood disorders where the immune system mistakenly attacks the body's tissues.
Side effects of Azathioprine
Nausea
Vomiting
Diarrhoea
Bone marrow suppression
Liver toxicity
How Azathioprine works
Azathioprine is an immunosuppressant medicine.
It belongs to the category of purine synthesis inhibitors, working by integrating into the DNA of immune cells. By doing so, it disrupts the creation of purines, essential components needed for these cells to multiply and function effectively. This interference results in fewer active immune cells, thus reducing the intensity of the immune response and inflammation in the body. Overall, Azathioprine suppresses the immune system's overactivity, helping manage various immune-related conditions and preventing organ rejection post-transplant surgeries.
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Expert Advice
Dosage Forms Available
Azathioprine can be taken orally (tablet) and administered intravenously (injection).
Age and Dose Restrictions
This medicine is prescribed for adult patients and children above 6 years of age with caution and under close medical supervision.
Contraindications
Azathioprine is contraindicated in patients with known allergies to the medicine itself. It is also contraindicated for patients with severe liver disease, pancreatitis, or those with a certain enzyme deficiency (TPMT deficiency).
Other Medications to Avoid
Azathioprine may interact with certain blood thinners (like warfarin), angiotensin-converting enzyme (ACE) inhibitors (like lisinopril, ramipril) and antiviral medications (like ribavirin).
Overdose and Missed Dose
In case of an overdose of Azathioprine, immediate medical attention is required. Overdose symptoms may include nausea, vomiting, and diarrhoea.
If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue your regular dose schedule. Do not double your dose to make up for the missed one.
Management of Side Effects
Most side effects are temporary and generally harmless and resolve when discontinuing this medicine. However, if you experience any severe side effects or worsening of any of the symptoms, please consult your doctor.
Drink plenty of water to manage nausea or vomiting.
Rest more and avoid physical activity if you feel tired.
Try eating small but frequent meals to deal with loss of appetite.
Use in Driving and Operating Machinery
Azathioprine may cause dizziness or tiredness in some patients. If you experience these side effects, avoid driving or operating heavy machinery.
Use in Pregnancy and Lactation
Azathioprine should be used during pregnancy only if needed. Consult your doctor before using this medication during pregnancy or breastfeeding.
Caution in Other Conditions
Caution is advised for patients with liver or kidney disease when taking Azathioprine.
Also, patients with a history of certain gastrointestinal disorders, such as pancreatitis, should use this medicine with caution.
Special Dietary and Lifestyle Recommendations
Practise good hygiene to prevent infections due to a suppressed immune system.
Avoid exposure to sunlight and wear protective clothing as Azathioprine can make your skin more sensitive to sunlight.
Frequently asked questions
Is Azathioprine a steroid?
No, Azathioprine is not a steroid. It belongs to a group of medicines known as immunosuppressants, which are used to reduce the activity of the body's immune system.
Does Azathioprine have any effect on sleep?
If you are experiencing sleep disturbances after starting this medication, consult your doctor.
Will Azathioprine affect fertility?
Azathioprine may potentially affect fertility in men and women. If you are considering starting a family, discuss this with your doctor.
Is it safe to take Azathioprine daily?
Azathioprine should be taken as per the doctor's instructions. Do not alter your dose or stop taking it without consulting your doctor.
How much time does Azathioprine take to work?
The time taken by Azathioprine to work can vary depending on the condition it is being used to manage. For example, in rheumatoid arthritis, it may take 6-8 weeks for improvements to be noted.
What is the best time to take Azathioprine?
Azathioprine is usually taken as directed by your doctor with food to reduce stomach upset. The exact dosage and timing should be determined by your doctor.
Is Azathioprine available over the counter, or do I need a prescription?
Azathioprine usually requires a doctor's prescription and is not typically available over the counter.
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