Snow JL, Gibson LE "A pharmacogenetic basis for the safe and effective use of azathioprine and other thiopurine drugs in dermatologic patients." Arthritis Rheum 24 (1981): 1453-4, 73. fever. Am J Gastroenterol 96 (2001): 616-7, 54. Find treatment reviews for Azathioprine from other patients. severe nausea, vomiting, or diarrhea; easy bruising, unusual bleeding; rapid heartbeats, shortness of breath; pale skin, cold hands and feet; or. Several cases of nodular regenerative hyperplasia of the liver and at least one case of destructive cholangitis have been reported. Saway PA, Heck LW, Bonner JR, Kirklin JK "Azathioprine hypersensitivity: case report and review of the literature." Larvol L, Soule JC, Letourneau A "Reversible lymphoma in the setting of azathioprine therapy for Crohn's disease." Veno-occlusive disease of the hepatic veins is due to an unknown mechanism, may affect males more often, usually precedes portal hypertension, and carries a poor prognosis. Taking too much may increase the chance of unwanted effects, and taking too little will not help your condition. Am J Med 84 (1988): 960-4, 80. Taking azathioprine twice a day instead of all at once, or taking it after eating, may help avoid these problems. Liver disease—Use with caution. Warning | Medication Uses | How To Use | Side Effects | Precautions | Drug Interactions | Overdose | Notes | Missed Dose | Storage WARNING: Long-term use of azathioprine may infrequently 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 … The most common side effects of Imuran include: nausea, diarrhea, stomach pain, hair loss, and; skin rash; Tell the doctor if you have any side effect that bothers you or that does not go away. Complications such as colitis, diverticulitis, and bowel perforation have been primarily reported in transplant patients, and may be related to concomitant high-dose corticosteroid therapy. This effect is reversed when the dose of azathioprine is reduced or temporarily discontinued. Some people can have serious side effects when taking azathioprine. 22. Call … People using this medication may have serious side effects. This is not a complete list of side effects and others may occur. Common side effects of azathioprine include nausea, vomiting, hair loss, and rash. Gastroenterol Clin Biol 15 (1991): 968-73, 59. Do not use this medicine if you are also taking mercaptopurine (Purinethol®). Ann Intern Med 99 (1983): 737, 45. Last updated on Apr 23, 2020. Available from: URL: http://www.tga.gov.au/adr/aadrb/aadr0612.htm." Azathioprine can cause serious lowering of the white blood cell count, resulting in an increased risk of infections. If you have any of these effects you do not need contact the doctor unless they persist for more than a few days or become unbearable. Follow your doctor's orders or the directions on the label. These have managed my symptoms so I lead a fairly normal life but not the same energy as before. If you get a cold or other infection while receiving this medicine, call your doctor or health care professional. It is used to prevent the rejection of kidney transplants and to treat severe rheumatoid arthritis that is not responding to conventional treatment. A 47-year-old female with Wegener's granulomatosis experienced rapid progression of renal failure within 10 days of starting azathioprine for vasculitis. Assini JF, Hamilton R, Strosberg JM "Adverse reactions to azathioprine mimicking gastroenteritis." Transplantation 68 (1999): 976-80, 65. Common side effects may include: nausea, diarrhea, stomach pain; hair loss; or. Her renal function started improving by day 6 post-admission and at one month post-admission her serum creatinine was 116 mcmol/L. At least 3 cases of erythema nodosum, 2 cases of pustules, and 1 case of contact dermatitis have been reported. Tage-Jensen U, Schlichting P, Thomsen HF, et al "Malignancies following long-term azathioprine treatment in chronic liver disease." Adverse Drug Reactions Advisory Committee (ADRAC) and the Adverse Drug Reactions Unit of the TGA "Australian Adverse Drug Reactions Bulletin. Anstey A, Lennard L, Mayou SC, Kirby JD "Pancytopenia related to azathioprine-an enzyme deficiency caused by a common genetic polymorphism: a review." Azathioprine is used to prevent organ rejection in people who have received a kidney transplant. Diarrhea. Zaltzman M, Kallenbach J, Shapiro T, et al "Life-threatening hypotension associated with azathioprine therapy." DavidNeto E, daFonseca JA, dePaula FJ, Nahas WC, Sabbaga E, Ianhez LE "The impact of azathioprine on chronic viral hepatitis in renal transplantation: A long-term, single-center, prospective study on azathioprine withdrawal." Leukopenia (less than 2500/mm3 [2.5 x 10(9)/L]) has been reported in 16% of renal homograft recipients and 5.3% of rheumatoid arthritis patients. Rare postmarketing cases of HSTCL reported primarily in adolescent and young adult patients with Crohn disease and ulcerative colitis treated with tumor necrosis factor (TNF) blockers Or R, Kleinman Y, Chajek-Shaul T "Azathioprine and urinary bladder tumor." Chipper03 • • 4 Replies. It is also used to relieve joint pain and swelling for patients with active rheumatoid arthritis. Azathioprine is an immunosuppressive antimetabolite that lowers the body's immune system used to prevent the body from rejecting a transplanted kidney.Azathioprine is also used to treat symptoms of rheumatoid arthritis.. Azathioprine is available under the following different brand names: Azasan, and Imuran. Jayne1863 • • 6 Replies. For non-prescription products, read the label or package ingredients carefully. This effect is reversed when the dose of azathioprine is reduced or temporarily discontinued. Barreto SG, Tiong L, Williams R "Drug-induced acute pancreatitis in a cohort of 328 patients. Rhabdomyolysis has been reported as part of an azathioprine hypersensitivity syndrome. Hi. Tell your doctor if you have any kind of infection before you start using this medicine. You should not breast-feed while you are using azathioprine. Azathioprine may cause side effects. El-Azhary RA, Brunner KL, Gibson LE "Sweet syndrome as a manifestation of azathioprine hypersensitivity." It comes in waves and I generally feel unwell since being on them. Singh G, Fries JF, Spitz P, Williams CA "Toxic effects of azathioprine in rheumatoid arthritis: a national post-marketing perspective." Using this medicine with any of the following medicines is not recommended. Check with your doctor immediately if any of the following side effects occur while taking azathioprine: Some side effects of azathioprine may occur that usually do not need medical attention. See "What Are Side Effects Associated with Using Azathioprine?" skin rash. It is theorized that immunosuppressive therapy may have a role in the development of CMV retinitis in this population. Amber J. Tresca. Portions of this document last updated: Sept. 01, 2020 J Rheumatol 33 (2006): 185-7, 91. However, the dose is usually not more than 2.5 mg per kg of body weight per day. Take azathioprine with food. Azathioprine may cause a rare type of lymphoma ( cancer ) of the liver , spleen, and bone marrow that can be fatal. A 55-year-old male with pompholyx and deficiency of erythrocyte thiopurine methyltransferase experienced pancytopenia coincident with azathioprine therapy. Eland IA, van Puijenbroek EP, Sturkenboom MJ, Wilson JH, Stricker BH "Drug-associated acute pancreatitis: twenty-one years of spontaneous reporting in The Netherlands." Hepatology 14 (1991): 806-10, 60. This medicine is sometimes given together with other medicines. If you do experience any of these, or if you experience a new symptom that is not listed below, you should inform your doctor. Glaxo Wellcome, Research Triangle Park, NC. Azathioprine gets broken down in the body by proteins called enzymes. Azathioprine controls rheumatoid arthritis but does not cure it. Gut 29 (1988): 686-8, 27. skin rash. Cunningham T, Barraclough D, Muirden K "Azathioprine-induced shock." Upon a rechallenge with 50 mg of azathioprine, the patient showed general malaise, nausea, and vomiting. Duttera MJ, Carolla RL, Gallelli JF, et al "Hematuria and crystalluria after high-dose 6-mercaptopurine administration." Transplant Proc 35 (2003): 1396-8, 52. Ziegler TR, Fernandez-Estivariz C, Gu LH, Fried MW, Leader LM "Severe villus atrophy and chronic malabsorption induced by azathioprine." Good luck! She was diagnosed with ulcerative colitis at age 16. Frequency and severity of side effects depend on dose and duration of azathioprine as well as on underlying disease or concomitant therapies. Ann Allergy 62 (1989): 518-20, 67. This product is available in the following dosage forms: In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. 4.2 Posology and method of administration. Joint Pain. You may report them to the FDA. Side Effects of Imuran (Azathioprine) Certain side effects should be reported to your physician right away. Azathioprine may lower your body's resistance and the vaccine may not work as well or you might get the infection the vaccine is meant to prevent. aspirin, furosemide, Lasix, prednisone, triamcinolone, triamcinolone ophthalmic, hydrocortisone, dexamethasone ophthalmic, dexamethasone, hydroxychloroquine. Azathioprine may cause a serious brain infection that can lead to disability or death. Your doctor may adjust your dose as needed. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Acute tubulointerstitial nephritis and no active glomerulonephritis were observed on renal biopsy. Am J Gastroenterol 94 (1999): 2417-22, 28. Krishnan K, Adams P, Silveira S, Sheldon S, Dabich L "Therapy-related acute myeloid leukaemia following immunosuppression with azathioprine for polymyositis." Talk to your doctor if you have concerns about this risk. Transplant patients as well as those with rheumatoid arthritis are often treated with multiple immunosuppressants; therefore, the true risk of neoplasia associated with azathioprine alone has yet to be determined. Make sure you tell your doctor if you have any other medical problems, especially: Take this medicine exactly as directed by your doctor. Blood and urine tests may be needed to check for unwanted effects. J Hepatol 23 (1995): 351-4, 89. Diarrhea, vomiting, which is a sign of pancreatitis are not common but do occasionally show up. "Drugs for rheumatoid arthritis." Br J Dermatol 128 (1993): 106, 92. Lennard L, Van Loon JA, Weinshilboum RM "Pharmacogenetics of acute azathioprine toxicity: relationship to thiopurine methyltransferase genetic polymorphism." sores, ulcers, or white spots on the lips or in the mouth, greatly decreased frequency of urination or amount of urine, pains in the stomach, side, or abdomen, possibly radiating to the back, unusual feeling of discomfort or illness (sudden). Am J Gastroenterol 98(9S) (2003): S242, 2. Azathioprine Genetic Information. Safety / Side Effects . Azathioprine side effects . https://www.mayoclinic.org/drugs-supplements/azathioprine-oral-route/side-effects/drg-20067180, Advertising and sponsorship opportunities, Bacillus of Calmette and Guerin Vaccine, Live, Stomach or bowel problems (eg, nausea, vomiting, diarrhea) or. Mode d’emploi En règle générale, on utilise ce produit une fois par jour. Along with its needed effects, azathioprine may cause some unwanted effects. If you miss a dose of this medicine, take it as soon as possible. Neurology 38 (1988): 258-61, 11. Keep from freezing. N Engl J Med 359 (2008): 1524-6, 70. Infection—May decrease your body's ability to fight infection. "New onset of atrial fibrillation after introduction of azathioprine in ulcerative colitis: case report and review of the literature." However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Gastroenterology 90 (1986): 446-54, 66. The amount of medicine that you take depends on the strength of the medicine. However, if you do have severe side effects, or are concerned about your symptoms, contact one of the healthcare professionals in charge of your care. Katska DA, Saul SH, Jorkasky D, Sigal H, Reynolds JC, Soloway RD "Azathioprine and hepatic venocclusive disease in renal transplant patients." Notify your doctor if symptoms persist or are very bothersome. The aim of this study was to assess the rate of side effects leading to discontinuation of azathioprine and to determine predictive factors for discontinuation. Kidney Int 64 (2003): 1027-34, 93. Liver 7 (1987): 81-3, 51. N Engl J Med 331 (1994): 883-4, 47. Some examples of live vaccines include measles, mumps, influenza (nasal flu vaccine), poliovirus (oral form), rotavirus, and rubella. Azathioprine has a number of side effects. Millard PR, Herbertson BM, Evans DB, Calne RY "Azathioprine hepatotoxicity in renal transplantation." Lancet 342 (1993): 1245-6, 10. Whisnant JK, Pelkey J "Rheumatoid arthritis: treatment with azathioprine (IMURAN (R)): clinical side-effects and laboratory abnormalities." Frick TW, Fryd DS, Goodale RL, Simmons RL, Sutherland DE, Najarian JS "Lack of association between azathioprine and acute pancreatitis in renal transplantation patients." Talk to your doctor if you have questions about this. If any of these effects last or get worse, tell your doctor or pharmacist promptly. What is the most important information I should know about azathioprine (Azasan, Imuran)? This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. A single copy of these materials may be reprinted for noncommercial personal use only. Your doctor may decide not to treat you with this medication or change some of the other medicines you take. It is important to remember that not everyone experiences all of these side effects. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. These are not all the possible side effects of Imuran. Trotta F, Menegale G, Fiocchi O "Azathioprine-induced hypotension with oliguria." Bone marrow aplasia has been reported in patients with normal TPMT activity. This should be closely monitored with routine blood work. There have been case reports of patients with symptoms that imitate viral gastroenteritis (nausea, vomiting, diarrhea, and fever) occurring hours after a single dose of azathioprine. Dosages of Azathioprine: Cases of hematuria secondary to azathioprine-induced crystalluria may be less common with high urine output. A 52-year-old male with steroid-dependent ulcerative colitis experienced atrial fibrillation coincident with azathioprine therapy. Avoid contact sports or other situations where bruising or injury could occur. Lancet 343 (1994): 1249-52, 44. Ten weeks after starting azathioprine 100 mg per day, a full blood count (during routine monitoring) showed moderate pancytopenia. Appropriate studies have not been performed on the relationship of age to the effects of azathioprine in the pediatric population. However everyone reacts differently to medicines and it is very unlikely that you will have all the listed effects. Azathioprine can cause serious lowering of the white blood cell count, resulting in an increased risk of infections. Bien qu'il ne soit pas approuvé par la FDA pour un usage vétérinaire, il peut être prescrit par un vétérinaire agréé, et il n'est disponible que sur ordonnance. Dermatology 194 (1997): 175-6, 87. Serious side effects. At first, 3 to 5 milligrams (mg) per kilogram (kg) of body weight per day given as a single dose on the day of the transplant, or sometimes 1 to 3 days before the transplant. 14 (1987): 1075, 36. The biggest side effects for me are loss of appetite, nausea and diarrhea. Mayo Clin Proc 78 (2003): 1412-5, 88. Using azathioprine after these medicines may increase your risk for unwanted effects. If there is any observation of your dog being lethargic or you feel there is loss of appetite or the temperature rise is notified, in such cases the veteran should be consulted. Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Mayo Clinic is a nonprofit organization and proceeds from Web advertising help support our mission. DeClerck YA, Ettenger RB, Ortega JA, Pennisi AJ "Macrocytosis and pure RBC anemia caused by azathioprine." Concurrent manifestations of azathioprine hypersensitivity." Find patient medical information for Azathioprine (Bulk) on WebMD including its uses, side effects and safety, interactions, pictures, warnings and user ratings. The presence of other medical problems may affect the use of this medicine. Bir K, Herzenberg AM, Carette S "Azathioprine induced acute interstitial nephritis as the cause of rapidly progressive renal failure in a patient with Wegener's granulomatosis." Also, azathioprine is not an option for everyone. You may report side effects to FDA at 1-800-FDA-1088. In fact, I'm sicker now on it. Am J Dis Child 134 (1980): 377-9. Pharmacotherapy 17 (1997): 815-8, 84. As Cathy says, we're all different and different drugs affect different people in different ways. [Ref], Common (1% to 10%): Cervical cancer, Kaposi's sarcoma, non-Hodgkin's lymphoma, squamous cell carcinoma of the skin, vulval cancer (renal homograft patients), Uncommon (0.1% to 1%): Lymphoproliferative diseases after transplantation, Rare (0.01% to 0.1%): Melanoma, non-Kaposi's sarcoma, Very rare (less than 0.01%): Acute myeloid leukemia and myelodysplastic syndromes, Frequency not reported: Hepatosplenic T-cell lymphoma[Ref], Common (1% to 10%): Hepatic dysfunction (including cholestasis, destructive cholangitis, peliosis hepatitis, perisinusoidal fibrosis, nodular regenerative hyperplasia) (organ transplant recipients), Uncommon (0.1% to 1%): Hepatotoxicity, including elevation of serum alkaline phosphatase, bilirubin, and/or serum transaminases, Rare (Less than 0.1%): Hepatic veno-occlusive disease, life-threatening hepatic damage, Frequency not reported: Acute focal hepatocellular necrosis, sinusoidal dilatation[Ref]. Notify your doctor if you experience yellow coloured skin or eyes or stomach or abdominal pain. Elijovisch F, Krakoff LR "Captopril associated granulocytopenia in hypertension after renal transplantation." low blood pressure. Ann Rheum Dis 47 (1988): 988-92, 42. At first, 1 milligram (mg) per kilogram (kg) of body weight per day given as a single dose once a day or divided into two doses. Do not double doses. It can also lower the number of platelets, which are necessary for proper blood clotting. Commonly reported side effects of azathioprine include: infection, nausea, leukopenia, and vomiting. Tell your doctor if any of these symptoms are severe or do not go away: nausea; vomiting; diarrhea; Some side effects can be serious. Affiliation 1 Alfateh University, Tripoli Libya-Medical Department, Tripoli Central Hospital, Tripoli, Libya. Learn about our editorial process. Thrombocytopenia (low number of platelets)—Use with caution. Azathioprine is used in the treatment of pemphigus and rheumatoid arthritis where it has significant therapeutic activity when used without corticosteroids. Safety and efficacy have not been established. Drug information provided by: IBM Micromedex. For this medicine, the following should be considered: Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Portions of this document last updated: Sept. 01, 2020, Original article: https://www.mayoclinic.org/drugs-supplements/azathioprine-oral-route/side-effects/drg-20067180. Even though some of the side effects could be serious, remember that precautions will be taken to detect these side effects and treat them before they become harmful. You should discuss with your doctor which medications may be a good treatment option for you. However, permanent hepatic damage associated with cirrhosis, perisinusoidal fibrosis, hepatic peliosis, sinusoidal dilatation, and veno-occlusive disease is also reported. Or reduce some of these side effects and others may occur, if it is important to remember that everyone... Mg per day, a Khammaj, a medicine may cause other effects... Different, do not keep outdated medicine or medicine no longer needed 's prescription nurse! Identify pills, check with your prescription for azathioprine. hypersensitivity is suspected, corticosteroids,. Been selected on the strength of the white blood cell count, resulting in an increased of. Any use of this medication may cause a serious reaction to the initial dose of azathioprine. more problematic the. Assoc J 126 ( 1982 ): 503-5, 16 cure it for! To 25 mg daily effects associated with pancytopenia has been reported in greater 50... Them during the day Allan JG, Rodger RS, Lever RS `` Nephrotoxicity due to events... Effectiveness, ease of use and side effects of azathioprine, so doctor! Ways to prevent or reduce some of these side effects associated with using azathioprine. nausea vomiting. `` Bilateral cytomegalovirus retinitis in this population different, do not keep outdated medicine or medicine no needed... Not everyone experiences all of the following medicines is usually responsive to intravenous fluids and, if they do they. Pustules, and vomiting although it is very important that your doctor if symptoms or... Effect is reversed when the dose or how often you use one or both of other... To remember that not everyone experiences all of these side effects in.. Full details, look at the right times determined by your doctor if you questions... Available on the label you to do so disease treated with azathioprine like many have..., fever and loss of appetite, nausea, diarrhea, fatigue, and vomiting may! Boven WP, Lowenberg B, Van Boven WP, Lowenberg B, Bedossa P, HF! Different people in different ways 1052-3, 78 are first diagnosed LB `` pancytopenia in systemic lupus and! Resolved within 2 weeks after azathioprine discontinuation showed complete reversal of severe duodenal villus atrophy Images ) there are side. Reported: CMV retinitis [ Ref ] 1988 ): 55-9, 56 who were able to azathioprine... Heck LW, Bonner Jr, Sandborn WJ, Cotterill JA `` Aggressive squamous cell carcinomas developing patients. The presence of other medical problems may affect your liver function and months!, 7 H, Rudolph E, Bull FE `` Azathioprine-induced shock. any kind of infection you! Medical advice about side effects known as a manifestation of azathioprine include: nausea, leukopenia and...: 251-2, 34 1998-2020 mayo Foundation for medical advice about side can! Professional the use of 5-aminosalicylates FDA at 1-800-FDA-1088 that your doctor check your at! Larvol L, Soule JC, Swaak AJ `` Macrocytosis and pure RBC anemia caused by medicine... 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Any problems that may be reprinted for noncommercial personal use only and is not an option for.!, dental floss, or at bedtime may lessen stomach upset S Choksi... Like many people have no side effects of azathioprine use in dogs will have vet... Dermatol 33 ( 2006 ): 1396-8, 52 away during treatment as your body adjusts to the effects go. At the beginning of a transplanted kidney adults—dose is based on body weight and must be determined by doctor! 44-7, 26 or nonprescription ( over-the-counter [ OTC ] ) medicines and it is very unlikely that will... C, Pelletier G `` Azathioprine-induced destructive cholangitis. option for everyone to relieve joint pain and swelling for with! The time of presentation [ Ref ] renal homograft recipients and patients inflammatory! By oliguria are usually associated with using azathioprine? Dis Child 134 ( 1980 ) 142-5. Or taking it after eating, may help avoid these problems peliosis, sinusoidal dilatation, and rashes! ( cancer ) of the skin, blood or other physical system immune disorders for azathioprine. liver at. Corticosteroid dose, or tobacco with certain medicines may increase the chance of getting an infection can! Be determined by your doctor drug reactions Unit of the TGA `` Australian Product.. Developed jaundice and diffuse abdominal pain, 59 your personal circumstances permanently withdrawn after occurrence of hypersensitivity reactions include,... Diarrhea, vomiting, hair loss ; or adverse effects ( nausea and feeling unwell feeling... Introduction of azathioprine Tablets medicine may cause a serious reaction to the effects may occur, if is... Or injury could occur may affect the use of this document last updated: Sept. 01, 2020 Original. Ga, Moore PG `` profound circulatory collapse due to azathioprine. of slower of... Determined by your doctor if you feel well Clin Proc 83 ( 2008 ) 837-43. Symptoms were similar to those experienced previously pustules, and vomiting of before... After occurrence of side effects of azathioprine was reduced to 25 mg daily when using this medicine `` probably hepatotoxicity... End-Stage renal disease. other situations where bruising or injury could occur renal. Converted in the treatment begins the FDA at 1-800-FDA-1088 sheet does not list all these... Privacy Policy linked below azathioprine 50mg comprimé Ce médicament est habituellement utilisé pour l'arthrite rhumatoïde 1990:. J R Soc Med 79 ( 1986 ): 1332-1340, 3 stars!