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Azathioprine may make several cancers more likely to develop in you, including skin cancer and lymphoma (cancer that begins in the cells that fight infection). Even if you do not use azathioprine, there may be an increased risk of cancer if you have had a kidney transplant. Inform your doctor if you are now taking or have previously used alkylating medications for cancer, such as melphalan (Alkeran), cyclophosphamide (Cytoxan), or chlorambucil (Leukeran). Avoid lengthy or unnecessary exposure to the sun, and wear protective clothes, sunglasses, and sunscreen to reduce your risk of developing skin cancer. If you see any changes in your skin or any lumps or tumours anywhere in your body, call your doctor right once.
Some male teenagers and young adults who took azathioprine, either by itself or in combination with another drug called a tumour necrosis factor (TNF) blocker, to treat Crohn’s disease or ulcerative colitis (conditions that cause swelling and sores in the lining of the colon [large intestine] and rectum) eventually developed hepatosplenic T-cell lymphoma (HSTCL). HSTCL is a particularly dangerous form of cancer that frequently results in death within a short time. Although the Food and Drug Administration (FDA) has not approved azathioprine for the treatment of Crohn’s disease or ulcerative colitis, physicians occasionally prescribe it to treat these disorders. Call your doctor right away if any of these symptoms appear while you are receiving treatment: stomach discomfort, fever, unexpected weight loss, sweats at night, or easy bleeding or bruising.
Your bone marrow may produce fewer blood cells as a result of azathioprine, which could result in serious or fatal infections. The likelihood that you will have fewer blood cells is greater if you have a genetic (inherited) risk factor. Before or during your treatment, your doctor could conduct a test to determine whether you have this risk factor. Inform your doctor if you are taking any of the following medications as they may increase your risk of having your blood cells fall off. ACE medicines like benazepril, which block the angiotensin-converting enzyme (Lotensin),Captopril, enalapril (Vasotec), fosinopril (Prinivil, Zestril), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), or trandolapril (Mavik); trimetho Call your doctor right away if you experience any of the following symptoms: unusual bleeding or bruising; extreme exhaustion; pale skin; headache; confusion; dizziness; fast heartbeat; trouble falling asleep; weakness; shortness of breath; and sore throat, fever, chills, and other infection-related symptoms. Before, during, and after your treatment, your doctor will order tests to determine whether this medication has had an impact on your blood cells.
The dangers of using this drug should be discussed with your doctor.
Why is this medication prescribed?
In patients who have received kidney transplants, azathioprine is used with additional drugs to avoid transplant rejection (the immune system attacking the transplanted organ). When other medications and treatments have failed to relieve the symptoms of severe rheumatoid arthritis (a disorder in which the body attacks its own joints, resulting in pain, swelling, and loss of function), it is also used to treat the condition. Azathioprine belongs to the immunosuppressant drug subclass. It functions by reducing immune system activity so that the body won’t attack the transplanted organ or the joints.
How should this medicine be used?
Azathioprine is available as an oral tablet. After meals, it is often taken once or twice daily. Take azathioprine every day at around the same time(s). Ask your doctor or pharmacist to explain any instructions on your prescription label that you are unsure about following. Adopt azathioprine dosage guidelines precisely. Never take it in larger or less amounts or more frequently than directed by your doctor.
Your doctor may start you on a low dose of azathioprine to treat your rheumatoid arthritis and progressively raise it after 6 to 8 weeks, but not more frequently than once every four weeks after that. When your disease is under control, your doctor may gradually reduce your dose. Your doctor may start you on a high dose of azathioprine to avoid kidney transplant rejection and gradually lower it as your body becomes used to the transplant.
Rheumatoid arthritis is not cured by azathioprine, but it can be managed. You might not experience azathioprine’s full benefits for up to 12 weeks. Only while you are taking azathioprine will a transplant be protected from rejection. Even if you feel well, keep taking azathioprine. Without consulting your doctor, do not stop taking azathioprine.
Other uses for this medicine
Azathioprine is also used to treat Crohn’s disease and ulcerative colitis, conditions that result in swelling and sores in the rectum and colon (large intestine) lining. Discuss the potential risks of using this medication for your condition with your doctor.
Ask your doctor or pharmacist for more details if you’re interested in using this medication for any other conditions.
What special precautions should I follow?
Before taking azathioprine,
- If you have an allergy to azathioprine, any other medications, or any of the ingredients in azathioprine tablets, let your doctor and pharmacist know right away. For a list of the ingredients, ask your doctor or pharmacist.
- Inform your doctor and pharmacist about all prescription and over-the-counter drugs, vitamins, dietary supplements, and herbal products that you are now taking or intend to use. Mention any of the following medications as well as the ones listed in the IMPORTANT WARNING section, including allopurinol (Zyloprim), aminosalicylates like mesalamine (Apriso, Asacol, Pentasa, and others), olsalazine (Dipentum), and sulfasalazine (Azulfidine), as well as anticoagulants (also known as “blood thinner (Coumadin). Your physician might need to adjust the dosage of your drugs or keep a close eye on you for side effects.
- If you have any kind of illness or if you have ever had renal problems, let your doctor know.
- Inform your doctor if you are expecting, intend to get pregnant, or are nursing a baby. To ensure that neither you nor your spouse becomes pregnant while taking this medicine, use birth control. If you or your partner become pregnant while taking azathioprine, call your doctor right away. The foetus could suffer from azathioprine.
- Inform your doctor or dentist that you are taking azathioprine if you are having surgery, including dental surgery.
- Without first consulting your doctor, avoid getting any vaccinations during or after your treatment.
What special dietary instructions should I follow?
Keep eating normally unless your doctor instructs you otherwise.
What should I do if I forget a dose?
If you miss a dosage, take it as soon as you recall. If the next dose is soon due, skip the missed one and carry on with your regular dosing plan. To make up for a missing dose, do not take a second one.
What side effects can this medication cause?
Azathioprine could have negative effects. If any of these symptoms are severe or do not go away, let your doctor know right once:
Some adverse effects can be very harmful. Call your doctor right away if you notice any of the following signs or any of those in the IMPORTANT WARNING section.
- Muscle ache
Other negative effects of this medication could occur. If you experience any unusual issues while taking azathioprine, contact your doctor right away.
You or your doctor can submit a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting programme online or by phone if you have a serious side event (1-800-332-1088).
What should I know about storage and disposal of this medication?
Keep this medication tightly closed in the original container and out of the reach of children. Store it away from excessive heat and moisture at room temperature (not in the bathroom).
Unused prescriptions must be disposed of carefully to prevent pets, kids, and other people from ingesting them. You should not, however, dispose of this medication in the toilet. Instead, utilising a medicine take-back programme is the easiest approach to get rid of your medication. To find out about take-back programmes in your area, speak with your pharmacist or the garbage/recycling department in your city. If you do not have access to a take-back programme, see the FDA’s Safe Disposal of Medicines website at http://goo.gl/c4Rm4p for additional information.
As many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and are simple for young children to open, it is crucial to keep all medications out of sight and out of reach of children. Always lock safety caps and promptly stash medication up and away from young children where it is out of their sight and reach to prevent poisoning. http://www.upandaway.org
In case of emergency/overdose
Call the poison control hotline at 1-800-222-1222 in the event of an overdose. Additionally, information can be found online at https://www.poisonhelp.org/help. Call 911 right once if the person has collapsed, experienced a seizure, is having difficulty breathing, or cannot be roused.
Symptoms of overdose may include the following:
- Infection symptoms such as a sore throat, fever, chills, and others
What other information should I know?
No one else should take your medication. Any queries you may have regarding medication refills should be directed to your pharmacist.
You should keep a written record of every medication you take, including any over-the-counter (OTC) items, prescription drugs, and dietary supplements like vitamins and minerals. This list should be brought with you whenever you see a doctor or are admitted to the hospital. You should always have this information with you in case of emergencies.