Azathioprine
Buy Azathioprine Online at Affordable Price
Azathioprine is an FDA-approved immunosuppressant used to prevent organ rejection in transplant patients and treat rheumatoid arthritis. It also manages various autoimmune conditions by inhibiting DNA synthesis, which reduces immune cell proliferation. Available in capsules and injectable forms, it requires careful monitoring for side effects like nausea and liver issues. Essential precautions include avoiding live vaccines and excessive sunlight. Store at room temperature and consult with healthcare providers regularly to ensure safe and effective use.
Product Overview
Azathioprine is a versatile immunosuppressant medication FDA-approved for preventing organ transplant rejection, particularly for kidney transplants, and treating rheumatoid arthritis. It is also widely used off-label to manage a variety of autoimmune conditions, such as Crohn’s disease and ulcerative colitis. Azathioprine functions by interfering with DNA synthesis, effectively reducing the proliferation of immune cells. This action helps prevent the body from attacking its tissues and helps manage inflammation and immune response in autoimmune disorders.
Available in capsule forms of 50 mg, 75 mg, and 100 mg, as well as a powder for injection (100 mg/vial), Azathioprine is tailored to meet diverse patient needs. Common side effects include nausea, diarrhea, and liver enzyme abnormalities. It requires careful monitoring of blood levels and liver function, and patients should avoid live vaccines due to diminished immune response.
Safety measures include regular medical consultations, especially during pregnancy, and avoiding excessive sunlight due to increased photosensitivity. Patients should keep the medication at room temperature and keep it out of reach of children. Azathioprine remains a critical tool in managing severe immune-mediated conditions, offering significant benefits in controlling symptoms and improving patient quality of life.
Uses of Azathioprine
- To lower the chances of rejection of a transplanted kidney
- Rheumatoid arthritis
Benefits of Azathioprine
- Prevents organ transplant rejection
- Reduces rheumatoid arthritis symptoms
- Manages autoimmune conditions
- Lowers immune system activity
Side Effects of Azathioprine
Common side effects of Azathioprine may include:
- Nausea
- Vomiting
- Diarrhea
- Abdominal pain
- Loss of appetite
- Leukopenia (low white blood cell count)
- Thrombocytopenia (low platelet count)
- Anemia
- Elevated liver enzymes
- Hepatotoxicity
- Rash
- Increased sensitivity to sunlight
- Fatigue
- Fever
- Muscle aches
- Flu-like symptoms
- Increased risk of infections due to immunosuppression
[Note: This list is not exhaustive; if you notice any other symptoms not mentioned above, consult your doctor immediately.]
Azathioprine Dosage
Forms & Strengths
Azathioprine comes in the following forms and strengths:
Capsule
- 50 mg
- 75 mg
- 100 mg
Powder for injection
- 100 mg/vial
Recommended Dosages
Rheumatoid Arthritis
- Initial dose: 1 mg/kg/day orally.
- Maintenance dose: Adjusted based on response and tolerance, typically not exceeding 2.5 mg/kg/day.
Preventing Kidney Transplant Rejection
- Initial dose: 3-5 mg/kg/day orally, starting at the time of transplant.
- Maintenance dose: After stabilization, the dose may be gradually reduced to 1-3 mg/kg/day.
Inflammatory Bowel Disease
- Initial dose: 2-3 mg/kg/day orally.
- Maintenance dose: Adjust based on response and clinical condition, typically 1.5-2.5 mg/kg/day.
Other Autoimmune Conditions
- Dosage is typically started at a low level and adjusted according to the clinical response and side effects, often within a 1-3 mg/kg/day range.
How to Take Azathioprine?
- Take as prescribed by your doctor.
- It can be taken with or without food.
- Swallow tablets whole with water.
- Do not crush or chew tablets.
- If you miss a dose, take it as soon as you remember unless it’s close to the next dose.
- Regularly monitor blood levels and liver function.
Missed Dose
If you forget to take a dose of Azathioprine, administer it as soon as you remember. However, if your next medication dose is nearly due, skip the one you missed and proceed with your usual dosing routine. Do not double up the dosage to compensate for the missed dose of Azathioprine. If uncertain about how to proceed, seek advice from your healthcare provider.
[Note: Do not simultaneously take two doses of Azathioprine to compensate for a missed dose. This can elevate your risk of experiencing side effects.]
Overdose
An overdose of Azathioprine can lead to severe side effects, including bone marrow suppression, infections, and liver damage. Immediate medical attention is crucial. Contact the nearest poison control center or seek emergency care if an overdose is suspected.
[Note: If you notice you have taken too much medication, call your local emergency number immediately.]
How Does Azathioprine Work?
Azathioprine works by interfering with DNA synthesis, thereby reducing the proliferation of immune cells. This dampening of the immune response prevents the body from targeting its own tissues in autoimmune disorders and helps ensure transplanted organs are not rejected. By diminishing the immune response, Azathioprine aids in managing conditions like rheumatoid arthritis and Crohn’s disease and preventing organ transplant rejection.
Important Safety Precautions
- Medical History Disclosure: To prevent drug interactions, share your complete list of medications, including over-the-counter drugs and herbal supplements, with your healthcare provider.
- Regular Lab Tests: Frequent testing is essential to tracking liver functionality and white blood cell count.
- Vaccination Caution: Steer clear of live vaccines due to the reduced immune response caused by Azathioprine.
- Sun Protection Measures: Wear sunscreen and protective clothing outdoors to guard against increased sun sensitivity.
- Consultation During Pregnancy: Speak with your healthcare provider if you are pregnant or nursing, as Azathioprine could be harmful during these periods.
- Limit Alcohol Consumption: Alcohol may heighten liver damage risks, so it’s advisable to minimize intake.
- Infection Awareness: Remain vigilant for symptoms like fever or a sore throat, which indicate possible infections.
- Safe Handling Practices: When dealing with crushed or broken tablets, ensure to wear gloves to prevent skin absorption.
Storage
- Store at an average temperature, away from moisture and heat.
- Keep in a tightly closed container.
- Do not store it in the bathroom or near the kitchen sink.
- Keep out of reach of children and pets.
- Dispose of unused or expired Azathioprine properly, according to local regulations, or consult your pharmacist.
Azathioprine Interactions
- Allopurinol – Can increase Azathioprine levels and risk of toxicity like bone marrow suppression.
- ACE inhibitors (e.g., lisinopril, enalapril) – May increase Azathioprine levels.
- Febuxostat – May decrease metabolism and increase levels of Azathioprine’s active metabolites.
- Warfarin – Azathioprine may decrease warfarin’s anticoagulant effect.
- Trimethoprim/sulfamethoxazole – May increase Azathioprine levels and toxicity risk.
- Other immunosuppressants (e.g. cyclosporine) – Combining with Azathioprine may increase immunosuppressive effects and toxicity.
- Ribavirin – Can potentially increase Azathioprine toxicity.
- Infliximab – May decrease Azathioprine’s active metabolite levels.
- Mesalamine – Theoretical risk of increased toxicity when used together.
- Antacids – May decrease the absorption of Azathioprine if taken together.
[Note: This list of interactions isn’t complete. Talk to your doctor if you notice any interaction with food, over-the-counter drugs, prescriptions, or supplements.]
Azathioprine Alternatives
- Purinethol, Purixan (mercaptopurine, 6-MP)
- Trexall, Rasuvo, Otrexup (methotrexate)
- Neoral, Sandimmune, Gengraf (cyclosporine)
- Prograf, Astagraf, Envarsus (tacrolimus)
- CellCept, Myfortic (mycophenolate mofetil)
- Arava (leflunomide)
- Cytoxan, Neosar (cyclophosphamide)
- Rituxan, Truxima, Riabni (rituximab)
- Plaquenil (hydroxychloroquine)
- Azulfidine, Salazopyrin (sulfasalazine)
- Brodinsert (mizoribine)
- Xeljanz, Xeljanz XR (tofacitinib)
- Olumiant (baricitinib)
- Rinvoq (upadacitinib)
[Note: Your healthcare provider will choose which Azathioprine alternative is best for you. Taking or consuming them by yourself may cause serious side effects.]
Frequently Asked Questions
Is it safe to get vaccinated while on Azathioprine?
While taking Imuran (Azathioprine), not all vaccines are safe due to the risk of infection. Live vaccines, like those for measles, mumps, and rubella, should be avoided because they contain live viruses. Since Imuran weakens the immune system, these live viruses could cause harm.
Should I undergo a genetic test before starting Azathioprine?
Due to differences in how individuals metabolize Azathioprine, some may experience higher medication levels in the body, increasing the likelihood of side effects. This metabolism is mainly dependent on the enzyme thiopurine methyltransferase (TPMT). It’s suggested that you consult with your healthcare provider about testing for TPMT activity to determine if you have lower levels of this enzyme.
Is Azathioprine only prescribed for kidney transplants?
No, Azathioprine is utilized for a variety of conditions beyond kidney transplantation. While not all uses are FDA-approved, this medication is commonly prescribed for other organ transplants, including liver, lung, and heart transplants, as well as for managing Crohn’s disease.
Can Azathioprine lead to skin cancer?
The FDA has reported warnings about the potential for cancer, including skin cancer, associated with long-term use of Azathioprine, especially after kidney transplantation. Due to this risk, healthcare providers strongly advise wearing sunscreen and protective clothing minimizing exposure to direct sunlight to help mitigate this risk.
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