1 What is Azasan?

Brand: Azasan, Imuran

Generic: Azathioprine

Azathioprine is an immunosuppressive agent that used to allow the body to accept a transplanted kidney.

Azathioprine acts by weakening the body’s natural defense to prevent it from rejecting the transplanted kidney.

This medicine is also used to treat patients with

This product is available in tablet.

2 What to Know Before Using

Tell to your doctor if you are allergic to Azathioprine or to any other medications.

Safety and effectiveness of this medication have not been established for children.

Pregnancy Category D – Do not use Azathioprine while you are pregnant as it can cause risk to the unborn baby.

There are no adequate studies whether Azathioprine can pass through breast milk or if it could cause harmful effects to the infant. Discuss with your doctor if you are breastfeeding a baby.

Taking this medicine with Febuxostat is not recommended and you may not be required to receive this medication. Otherwise, alternative medicine may be prescribed for your other medications.

Taking this medicine with any of the following medicines is usually not recommended, but with exception in some cases. Dosage or frequency of one or both of your medicines may be changed if both medicines are prescribed together.

  • Adenovirus Vaccine Type 4, Live
  • Adenovirus Vaccine Type 7, Live
  • Alacepril
  • Alfalfa
  • Allopurinol
  • Bacillus of Calmette and Guerin Vaccine, Live
  • Benazepril
  • Black Cohosh
  • Captopril
  • Cilazapril
  • Doxorubicin
  • Doxorubicin Hydrochloride Liposome
  • Enalaprilat
  • Enalapril Maleate
  • Fosinopril
  • Influenza Virus Vaccine, Live
  • Lisinopril
  • Measles Virus Vaccine, Live
  • Mercaptopurine
  • Moexipril
  • Mumps Virus Vaccine, Live
  • Mycophenolic Acid
  • Olsalazine
  • Oxypurinol
  • Pentopril
  • Perindopril
  • Poliovirus Vaccine, Live
  • Quinapril
  • Ramipril
  • Ribavirin
  • Rotavirus Vaccine, Live
  • Rubella Virus Vaccine, Live
  • Smallpox Vaccine
  • Spirapril
  • Sulfamethoxazole
  • Sulfasalazine
  • Trandolapril
  • Trimethoprim
  • Typhoid Vaccine
  • Varicella Virus Vaccine
  • Yellow Fever Vaccine
  • Zofenopril

Taking this medicine with any of the following medication may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. Dosage or frequency of one or both of your medicines may be changed if both medicines are prescribed together.

  • Acenocoumarol
  • Cyclosporine
  • Phenprocoumon
  • Warfarin

Some medical conditions can interact with this medication.

Tell your doctor if you have any of the following conditions:

3 Proper Usage

Take Azathioprine exactly as prescribed by your doctor. Excessive use of this medication will increase the chance for side effects while inadequate use will not help your condition.

Azathioprine is sometimes given together with other medicines. If you are using several medicines together, you should know how to take them during the day.

You should not stop taking this medicine without first checking with your doctor.

This medicine may causes nausea or vomiting at times. Taking this medicine after meals or at bedtime may lessen stomach upset.

Recommended dosage for kidney transplant rejection in adults:

  • Dose is based on body weight and must be determined by your doctor. Initial dose is usually 3 to 5 milligrams per kilogram of body weight per day given as a single dose once a day. The first dose is given on 1 to 3 days before the transplant or on the day of the transplant. Your doctor may adjust your dose as necessary.

Recommended dosage for rheumatoid arthritis in adults:

  • Dose is based on body weight and must be determined by your doctor. Initial dose is usually 1 milligram per kilogram of body weight per day given as a single dose once a day or divided into two doses. Your doctor may adjust your dose up to 2.5 mg per kg of body weight per day as necessary.

If you miss a dose of this medicine, use it as soon as possible. However, if it is near for your next dose, skip the missed dose and start again to your regular dosing schedule. Do not take a double dose to make up for a missed one.

Store the medication in a closed container at room temperature, away from heat, moisture, and direct light. Keep out of reach of children. Do not keep expired medications.

4 Precautions to Take

Your doctor will be checking you regularly for the effectiveness of the medication. Blood tests may be ordered as well for undesirable effects.

This medication may cause fetal abnormalities. Contraceptives may be used to keep you or your partner from getting pregnant.

Tell your doctor immediately if you think you have become pregnant while using this medication.

You should not use this medicine with mercaptopurine (Purinethol®). Using these medicines together could cause serious undesirable effects.

If you are going to use Azathioprine for arthritis, tell your doctor if you received chlorambucil, cyclophosphamide, or melphalan in the past to treat your arthritis. Using azathioprine after these medicines may increase your risk for undesirable effects.

Azathioprine may increase your risk of getting certain types of cancer, especially of the skin, lymph system, or blood.

Talk to your doctor if you have concerns about this risk.

Avoid extensive sun exposure and using of sun lamps or tanning beds when you are using this medication. When you are planning to go outdoors, use sunscreen or sunblock lotions with SPF of at least 15.

Do not receive any vaccinations without your doctor’s approval while you are under azathioprine treatment or after using this medication to prevent the risk of getting an infection. 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. Furthermore, avoid people who have received live virus vaccines to prevent the chance of getting the virus.

Azathioprine can lower your body’s resistance temporarily as well as your platelet count.

To reduce the risk of bleeding and infection, these certain precautions should be followed:

  • Avoid coming into close contact with sick people.
  • Consult with your doctor immediately if you notice any unusual bleeding or bruising, black, tarry stools, blood in the urine or stools, or pinpoint red spots on your skin.
  • Be cautious when using a regular toothbrush, dental floss, or toothpick.
  • Use protective equipment such as mask for added protection.
  • Avoid activities that might cause injuries.

Check with your doctor right away if you notice any

  • unusual bleeding or bruising,
  • black, tarry stools,
  • blood in the urine or stools,
  • pinpoint red spots on your skin, 

Check with your doctor immediately if you have more than one of these symptoms while you are using this medicine:

These could be symptoms of a serious reaction to the medicine in your intestine.

Do not take other medicines unless they have been discussed with your doctor.

5 Potential Side Effects

If any of the following side effects occur, check with your doctor right away:

  • Black, tarry stools
  • Bleeding gums
  • Blood in the urine or stools
  • Chest pain
  • Cough or hoarseness
  • Fever or chills
  • Lower back or side pain
  • Painful or difficult urination
  • Pinpoint red spots on the skin
  • Shortness of breath
  • Sore throat
  • Sores, ulcers, or white spots on the lips or in the mouth
  • Swollen glands
  • Unusual bleeding or bruising
  • Unusual tiredness or weakness
  • Abdominal or stomach pain or tenderness
  • Clay-colored stools
  • Dark urine
  • Decreased appetite
  • Fast heartbeat
  • Fever (sudden)
  • Headaches
  • Itching
  • Loss of appetite
  • Muscle or joint pain
  • Nausea, vomiting, and diarrhea (severe)
  • Redness or blisters on the skin
  • Swelling of the feet or lower legs
  • Unusual feeling of discomfort or illness (sudden)
  • Yellow eyes or skin
  • Abdominal or stomach cramps
  • Diarrhea
  • Difficulty with breathing
  • Difficulty with moving
  • Fat in the stool
  • General feeling of illness
  • Pale skin
  • Sores on the skin
  • Sudden loss of weight
  • Troubled breathing with movement
  • Weight loss

Less serious side effects:

  • Nausea or vomiting (mild)
  • Swollen joints
  • Hair loss or thinning of the hair

Not all side effects are listed above.

If you notice any other effects, check with your healthcare professionals.