GENERIC NAME: azathioprine

BRAND NAME: Imuran

DRUG CLASS: Azathioprine is classified as an immunosuppressant medication. Azathioprine is used to suppress the immune system in patients who have had kidney transplants. Although its exact mechanism of action in rheumatoid arthritis is not known, its effect in suppressing the immune system appears to decrease the activity of this illness.

PRESCRIPTION: yes

GENERIC AVAILABLE: yes

PREPARATIONS: Tablet: 50mg; It can also be given intravenously.

STORAGE: Store at 59 to 77degrees F, in a sealed, light-resistant, container, avoid moisture.

PRESCRIBED FOR: Azathioprine is used to inhibit the immune response that causes rejection of kidney transplants. Azathioprine is also used for the treatment of severe, active rheumatoid arthritis . It is considered a "second-line," or "slow- acting" drug and is usually reserved for rheumatoid arthritis patients who do not respond to other first-line or second-line medications.

DOSING: Should be taken with food.

DRUG INTERACTIONS: Azathioprine can cause an increase in cancer risk when used long-term. This particular risk increases in patients with a prior history of treatment with other powerful immunosuppressants, such as Cytoxan, Leukeran, and Alkeran. It also increases the risk of serious infections. Azathioprine can impair fertility by reducing sperm counts in males. Because azathioprine's toxicity increases when taken with the gout medication allopurinol (Zyloprim), its dose is reduced with simultaneous use. Severely low white blood counts can occur when taken with other drugs that can affect the bone marrow or with ACE-inhibitor class drugs used to treat elevated blood pressure, such as Accupril and Vasotec. The safety and effectiveness for use in children has not been established.

PREGNANCY: Azathioprine is transferred to the fetus and is avoided in pregnancy.

NURSING MOTHERS: It is also found in breast milk and is not used in nursing mothers.

SIDE EFFECTS: The most common serious side effects of azathioprine involve the blood elements and gastrointestinal system. Azathioprine can cause serious lowering of the white blood cell count, resulting in an increased risk of infections. This can reverse when the dose is reduced or temporarily discontinued. Azathioprine can cause nausea, vomiting, and loss of appetite, which can resolve when the dose is reduced or divided through the day. Azathioprine can also cause liver toxicity (in less than 1% of rheumatoid arthritis patients). All patients taking azathioprine require regular blood testing for blood counts and liver function tests for monitoring. Other side effects encountered less frequently include fatigue, hair loss , joint pains, and diarrhea .

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