Long-term use of azathioprine may rarely increase your risk of developing certain types of cancer (e.g., skin cancer, lymphoma). This risk is higher in people using azathioprine after an organ transplant and in children/young adults being treated for certain bowel diseases (such as Crohn's disease, ulcerative colitis). You must be closely monitored by your doctor during treatment and regularly afterwards if your doctor stops treatment with this medication.
Azathioprine may also cause serious (rarely fatal) blood disorders (decreased bone marrow function leading to anemia, low number of white blood cells and platelets). It can lower your body's ability to fight an infection.
Keep all medical and laboratory appointments. Tell your doctor right away if you develop any of the following signs: unusual skin changes, change in the appearance/size of moles, unusual growths/lumps, swollen glands, swollen or painful abdomen, unexplained weight loss, night sweats, unexplained itching, signs of infection (e.g., fever, persistent sore throat), easy bruising/bleeding, or unusual tiredness.Who should not take Imuran injection?
Azathioprine is used with other medications to prevent rejection of a kidney transplant. It works by weakening your body's defense system (immune system) to help your body accept the new kidney as if it were your own. This medication belongs to a class of drugs known as immunosuppressants.
Azathioprine is also used to treat patients with severe rheumatoid arthritis who have not responded to other medications (e.g., nonsteroidal anti-inflammatory drugs/NSAIDs such as ibuprofen). Rheumatoid arthritis is thought to be caused by the immune system attacking the joints. Early treatment of rheumatoid arthritis with more aggressive therapy such as azathioprine helps to reduce further joint damage and to keep joints working better.
This medication is given by injection until you are able to take azathioprine by mouth.
Talk to the doctor about the risks and benefits of azathioprine, especially when used in children and young adults.
OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.
This medication may also be used to prevent rejection of other transplanted organs, to treat a certain type of bowel condition (Crohn's disease) that is not responsive to usual treatment, and to treat other immune system problems (autoimmune diseases) as determined by your doctor.
This medication is given by injection into a vein by a health care professional, usually once or twice daily as directed by your doctor.
Dosage is based on your medical condition, weight, and response to treatment.
Use this medication regularly in order to get the most benefit from it. Remember to use it at the same time(s) each day.
For arthritis, it may take up to 2 months of continued use to notice relief of symptoms. Tell your doctor if your condition does not improve after 3 months of treatment.
See also Warning section.
Temporary hair loss may occur. Normal hair growth should return after treatment has ended.
Stomach/intestinal symptoms such as nausea, vomiting, diarrhea, or loss of appetite may occur. These symptoms may be reduced by giving the medication after a meal or in divided doses. If any of these effects persist or worsen, tell your doctor or pharmacist right away.
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
Although unlikely, more severe stomach/intestinal symptoms (e.g., severe nausea/vomiting/diarrhea, stomach/abdominal pain) may occur as part of a very serious allergic reaction. Seek immediate medical attention if you have severe stomach/intestinal symptoms or other symptoms of a serious allergic reaction, which may include: fever, severe chills, rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing, cough, new or worsening joint/muscle aches, dark urine.
Tell your doctor right away if any of these unlikely but serious side effects occur: muscle weakness, cold/numbness in the fingers, mouth sores, difficult/painful swallowing, greasy stools.
Seek immediate medical attention if any of these rare but very serious side effects occur: yellowing eyes/skin, swelling/extra fluid around the abdomen, vomit that contains blood or looks like coffee grounds, black stools.
This medication may increase your risk of getting a rare but very serious (sometimes fatal) brain infection (progressive multifocal leukoencephalopathy-PML). Get medical help right away if any of these rare but very serious side effects occur: clumsiness, loss of coordination, weakness, sudden change in your thinking (such as confusion, difficulty concentrating), difficulty moving your muscles, problems with speech, seizure, vision changes.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
In the US -
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.
In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
Before using azathioprine, tell your doctor or pharmacist if you are allergic to it; or to mercaptopurine; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease, liver disease, blood disorders, decreased bone marrow function, history of cancer (such as lymphoma), current infections, a certain enzyme disorder (TPMT deficiency).
Do not have immunizations/vaccinations without the consent of your doctor, and avoid contact with people who have recently received polio vaccine by mouth or flu vaccine inhaled through the nose.
Since this medication can increase your risk of developing serious infections, wash your hands well to prevent the spread of infections. Avoid contact with people who have illnesses that may spread to others (e.g., flu, chickenpox).
To lower the chance of getting cut, bruised, or injured, use caution with sharp objects like safety razors and nail cutters, and avoid activities such as contact sports.
Kidney function declines as you grow older. This medication is removed by the kidneys. Therefore, the elderly may be more sensitive to the effects of this drug.
This medication is not recommended for use during pregnancy. It may harm an unborn baby. Discuss the use of reliable forms of birth control (such as condoms, birth control pills) with your doctor. This medication can decrease the effectiveness of intrauterine devices (IUDs). This can result in pregnancy. Talk to your doctor about other reliable birth control choices.
This medication passes into breast milk and may have undesirable effects on a nursing infant. Therefore, breast-feeding while using this drug is not recommended. Consult your doctor before breast-feeding.
Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.
Some products that may interact with this drug include: allopurinol, aminosalicylates (e.g., mesalamine, olsalazine, sulfasalazine), "blood thinners" (e.g., enoxaparin, heparin, warfarin), drugs affecting the bone marrow (e.g., trimethoprim/sulfamethoxazole, cancer chemotherapy drugs), febuxostat, past or present use of alkylating-type cancer drugs (such as cyclophosphamide, melphalan), other drugs that weaken the immune system/increase the risk of infection (such as rituximab, tofacitinib).
Azathioprine is very similar to mercaptopurine. Do not use medications containing mercaptopurine while using azathioprine.
If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.
Laboratory and/or medical tests (e.g., complete blood counts, liver and kidney function tests) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.
If you have had an organ transplant, it is recommended that you attend a transplant education class or support group. Learn the signs of organ rejection such as tenderness around the transplanted organ, a feeling of being ill, or fever. Signs of a failing kidney transplant include a decrease in the amount of urine, swelling arms/legs/face, trouble breathing, or increase in blood pressure. Seek immediate medical attention if any of these symptoms occur.
It is important that each dose of this medication is given as scheduled. If you miss a dose, contact your doctor to establish a new dosing schedule.
Not applicable. This medication is given in a hospital or clinic and will not be stored at home.
MEDICAL ALERT: Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507 (Canada).
Information last revised August 2016. Copyright(c) 2016 First Databank, Inc.
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