Azathioprine (Imuran)

Uses
Azathioprine is an immunosuppressant that may be used with other immunosuppressive medications to prevent organ rejection. Azathioprine is often prescribed so that doses of other immunosuppressant medications may be decreased and side effects may be less severe. Azathioprine also can be used to treat rheumatoid arthritis and other conditions.

Action
This medication prevents rejection by suppressing the body's immune system.

Types Available
Azathioprine is taken by mouth or is given by injection. The oral medication is available in 50-mg tablets.

How to Take
Take your Azathioprine dose at the same time each night. (Taking the medication at night allows your coordinator to reach you during the day if your dosage needs to be changed before the next dose.)

Missed Doses
If you forget to take a dose of Azathioprine and more than 12 hours have passed since your last dose, contact your coordinator for advice.

Side Effects
Common side effects include:

• tiredness or weakness
• loss of appetite
• nausea, vomiting, upset stomach

Taking this medication with food or milk will prevent or lessen stomach upset.

Rare side effects include:

• diarrhea, stomach cramps
• fever, muscle aches, joint pain
• sore throat, mouth sores
• swelling of hands or feet
• changes in vision
• pale stools or darkened urine

Other effects include:

• Unusual bleeding or bruising. Azathioprine may reduce the number of blood cells needed for clotting. To prevent bleeding, avoid situations where bruising or injury may occur.
• Low white blood cell count. Azathioprine can lower your white blood cell (WBC) count, increasing your risk of infection and decreasing your ability to fight infection. It is important that your WBC count be checked when your blood tests are performed. If your WBC count is too low, your doctor may recommend decreasing your dose of azathioprine or stopping it temporarily. These actions should help to improve your WBC count.
• Skin lesions. Notify your coordinator if you notice this effect.
• Thinning of hair. Notify your coordinator if you notice this effect.

Drug Interactions
Allopurinol (Zyloprim), a medication used to treat gout, can produce toxic effects when taken with Azathioprine.  Notify your doctor or pharmacist if you are taking Allopurinol: The dose of Azathioprine must be reduced. Check with your coordinator before taking any new medication, and notify your coordinator of any medication changes.

Tell your doctor or pharmacist about any other prescription or over-the- counter medication you are taking, so you can be warned of  interactions and prevent them.

Storage
Store at room temperature.

Precautions
Take this medication exactly as prescribed. Never stop taking this medication unless advised to do so by a transplant surgeon or your transplant coordinator.

Availability
Pharmacies usually keep limited supply of Azathioprine in stock. It is wise to call your pharmacist at least five days in advance of filling a prescription.

Symptoms

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