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Generic Name: azathioprine (ay za THYE oh preen)
Brand Names: Azasan, Imuran

What is Azasan (azathioprine)?

Azathioprine lowers your body's immune system. The immune system helps your body fight infections. The immune system can also fight or "reject" a transplanted organ such as a liver or kidney. This is because the immune system treats the new organ as an invader.

Azathioprine is used to prevent your body from rejecting a transplanted kidney. It is also used to treat symptoms of rheumatoid arthritis.

Azathioprine may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about Azasan (azathioprine)?

Taking azathioprine may increase your risk of developing cancer. Talk with your doctor about your specific risk.

Azathioprine can lower the blood cells that help your body fight infections. This can make it easier for you to bleed from an injury or get sick from being around others who are ill. To be sure your blood cells do not get too low, your blood will need to be tested on a regular basis. Your kidney function may also to need to be tested. Do not miss any scheduled visits to your doctor.

If you need to have any type of surgery, tell the surgeon ahead of time that you are using azathioprine. You may need to stop using the medicine for a short time.

This medication can affect fertility (your ability to have children), whether you are a man or a woman. Talk with your doctor if you have concerns about this.

Do not receive a "live" vaccine while you are being treated with azathioprine and avoid coming into contact with anyone who has recently received a live vaccine. There is a chance that the virus could be passed on to you.

What should I discuss with my healthcare provider before taking Azasan (azathioprine)?

Taking azathioprine may increase your risk of developing cancer. Talk with your doctor about your specific risk.

Before taking azathioprine, tell your doctor if you are allergic to any drugs, or if you have:

• liver disease;

• any type of viral, bacterial, or fungal infection; or

• if you have recently received chemotherapy treatments with medications such as cyclophosphamide (Cytoxan), chlorambucil (Leukeran), melphalan (Alkeran).

If you have any of these conditions, you may not be able to take azathioprine, or you may need a dosage adjustment or special tests during treatment.

This medication can affect fertility (your ability to have children), whether you are a man or a woman. Talk with your doctor if you have concerns about this.

How should I take Azasan (azathioprine)?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

If you need to have any type of surgery, tell the surgeon ahead of time that you are using azathioprine. You may need to stop using the medicine for a short time.

Azathioprine can lower the blood cells that help your body fight infections. This can make it easier for you to bleed from an injury or get sick from being around others who are ill. To be sure your blood cells do not get too low, your blood will need to be tested on a regular basis. Your kidney function may also to need to be tested. Do not miss any scheduled visits to your doctor.

What happens if I miss a dose?

If you take this medicine once daily and you miss a dose, take the medicine as soon as you remember. If it is almost time for the next dose, skip the missed dose and wait until your next regularly scheduled time to take the medication. Do not use extra medicine to make up the missed dose.

If you take this medicine more than once daily and you miss a dose, take the medicine as soon as you remember. If it is almost time for the next dose, take both doses together, then go back to your regular dosing schedule.

What happens if I overdose?

Symptoms of an azathioprine overdose may include nausea, vomiting, stomach pain, diarrhea, bleeding, fever, chills, and other signs of infection.

What should I avoid while taking Azasan (azathioprine)?

Avoid being near people who have colds, the flu, or other contagious illnesses. Contact your doctor at once if you develop signs of infection.

Do not receive a "live" vaccine while you are being treated with azathioprine and avoid coming into contact with anyone who has recently received a live vaccine. There is a chance that the virus could be passed on to you.

Azasan (azathioprine) side effects

• pale skin, easy bruising or bleeding, unusual weakness;

• fever, chills, sore throat, body aches, weakness, muscle pain, flu symptoms;

• severe nausea, vomiting, or diarrhea;

• severe pain in your upper stomach spreading to your back, fast heart rate;

• pain or burning with urination;

• stomach pain, loss of appetite, dark urine, clay-colored stools, and jaundice (yellowing of the skin or eyes); or

• white patches or sores inside your mouth or on your lips.

Less serious side effects may also occur, such as:

• mild upset stomach, nausea, diarrhea, loss of appetite;

• hair loss; or

• skin rash.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect Azasan (azathioprine)?

Before taking azathioprine, tell your doctor if you are taking, have taken, or need to take any of the following medicines:

• allopurinol (Zyloprim);

• mercaptopurine (Purinethol);

• methotrexate (Rheumatrex, Immunex);

• a blood thinner such as warfarin (Coumadin);

• cyclosporine (Neoral, Sandimmune);

• olsalazine (Dipentum), or sulfasalazine (Azulfidine);

• sulfamethoxasole and trimethoprim (Trimpex, Proloprim, Bactrim, Septra, others); or

• an ACE inhibitor such as benazepril (Lotensin), captopril (Capoten), fosinopril (Monopril), enalapril (Vasotec), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), or trandolapril (Mavik).

If you are using any of these drugs, you may not be able to take azathioprine, or you may need dosage adjustments or special tests during treatment.

There may be other drugs not listed that can affect azathioprine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist has information about azathioprine written for health professionals that you may read.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.