Brand names of azathioprine

  • Alti-Azathioprine
  • Gen-Azathioprine
  • Imuran
  • Med-Azathioprine
  • Novo-Azathioprine
  • Riva-Azathioprine

Azathioprine belongs to a group of medicaments known as immunosuppressants and this medication is used to repress the immune system. Azathioprine is given to patients who have undergone kidney transplantation as well as for ailments wherein the actions of the immune system is vital. Azathioprine is basically a pro-drug, denoting a predecessor of a drug, which is transformed inside the body to its vigorous variety known as mercaptopurine (Purinethol). However, scientists are yet to ascertain the precise mode of action of this medicament.

As any other immunosuppressant, azathioprine also represses the proliferation of T and B lymphocytes - categories of white blood cells, which form an element of the immune system and protect the body against alien materials as well as infectious diseases. For instance, an immunosuppressant helps the body to immunologically avoid the new organ in the case of an organ transplant. In the instance of autoimmune ailments (diseases caused by anomalous immune reaction against the tissues of the body) like rheumatoid arthritis, repression of the immune system results in the lessening of inflammation that occurs together with immune reactions and inhibits damage to the joints caused by such inflammations.

Things you need to tell your physician before taking azathioprine

Like in the case of any other medicament, you need to follow certain precautions before using azathioprine. First and foremost, before you start using azathioprine, you need to tell your physician if you have allergic reactions to this medication or any other drug. In addition, tell your physician regarding all the prescription, over-the-counter (non-prescription) medicaments and herbal products as well as nutritional supplements, vitamins and minerals taken by you. Before you start taking azathioprine, inform your physician regarding your entire medical conditions too, especially if you have been suffering from any kind of infection or if you have or ever had kidney ailments, liver problems and/ or diseases of the pancreas.

Women who wish to begin therapy with azathioprine need to tell their doctor if they are pregnant, planning to get pregnant or are breast feeding. In addition, they should also use birth control so that they do not become pregnant while taking azathioprine. In case you become pregnant while using this medication, call your doctor straight away and ask him what needs to be done. As this medication is likely to pass on to breast milk, nursing mothers taking azathioprine should not breast feed till their treatment with this medication is complete.

In the event you need to undergo any type of surgery, inclusive of dental surgery, tell your surgeon that you are taking azathioprine. Here is a word of caution for anyone using this medication. People taking azathioprine should not take any kind of vaccination, including measles or flu shots, during as well as after their treatment with this medication without prior consultation with their physician. You should be aware that azathioprine may diminish your ability to combat infections. At the same time, such people should keep away from those who are ailing as well as wash their hands quite frequently.


The immunosuppressant medicament azathioprine is generally used along with other medications with a view to avoid rejection of a kidney transplant. This medicament works by waning the body's immune system (defense mechanism) to facilitate the body in accepting the new kidney as if it were its own. In addition, this medication is also prescribed for patients suffering from acute cases of rheumatoid arthritis and those who have not benefitted from the use of other drugs, such as non-steroidal anti-inflammatory drugs also known as NSAIDs, including ibuprofen. It is believed that rheumatoid arthritis is caused by the immune system of the body attacking the joints. In fact, aggressive treating rheumatoid arthritis in its early stage with azathioprine not only facilitates in lessening further damage of the joints, but also in preserving the normal functioning of the joints.

Besides the above mentioned health conditions, azathioprine is also used to prevent rejection of other transplanted organs, to cure a specific type of bowel condition, such as Crohn's disease, which does not respond well to conventional treatment and also to cure other problems of the immune system, such as autoimmune diseases.

How to use azathioprine

Azathioprine is an oral medication that is available in the form of tablets. Generally, this medication is taken once or twice every day after meals. In order to help you remember when you ought to take azathioprine, take this medication at the same time every day. Before you start using this medication, it is important that you read the instructions of the prescription label watchfully and in case you have any problem in comprehending some portions of the instruction, ask your pharmacist or physician to explain it to you. It is also important to take azathioprine strictly as prescribed by your doctor. It is advisable not to take the medication in excess or lesser amounts or take it more frequently than what has been advised by your physician.

If you are taking azathioprine to treat rheumatoid arthritis, it is likely that your physician will start your treatment with a low dose of the medication and gradually increase the dosage after a period of six to eight weeks. Subsequently, your physician may increase the dosage of the medication at the most once in very four weeks or each month. On the other hand, if you are taking azathioprine to prevent rejection of kidney transplant, it is likely that your physician will start your treatment with a high dose and gradually lessen the dosage as your body begins to fine-tune with the transplant.

It is important to note that azathioprine is useful in controlling rheumatoid arthritis, but does not help to cure the condition completely. Azathioprine works quite slowly and, therefore, it may take some time before you begin to experience the benefits of using this medication. In addition, azathioprine also helps in preventing transplant rejection only till the time you are taking this medicine. Therefore, it is important to continue taking azathioprine even after you start feeling better and complete the full schedule prescribed by your doctor. Besides, before you discontinue this medication, it is essential to talk to your doctor regarding this issue.

If you suspect that you have taken an overdose of azathioprine, immediately get in touch with your neighbourhood poison control center or an emergency room. It is important to remember that you should not share this medication with anyone else.

It is essential for patients taking the immunosuppressant drug azathioprine to take laboratory and/ or medical tests, for instance, liver and kidney functioning, complete blood count, etc, on a regular basis with a view to monitor their progress as well as check for any adverse after-effects cause by the use of the medicament. It is advisable to consult your doctor for further details in this regard.

In the event of having an organ transplant, it is advisable that you attend a transplant education class or participate in a support group. It is important that you learn the indications of organ rejection, for instance, a feeling of being sick, fever, and/ or tenderness in the region of the transplanted organ. In fact, the signs of an unsuccessful kidney transplant may include a decline in the amount of urine, swelling of the face and the limbs, increase in blood pressure and/ or difficulty in breathing. If you notice any of these symptoms, seek medical help instantly.

How azathioprine works

The immunosuppressant medicament azathioprine works by preventing the immune system from showing any kind of aggression towards the transplanted organs. In effect, it inhibits the immune cells that are responsible for inflammations in the joints and other areas of the body.

Side effects

Less common
  • skin rash, sores in mouth
  • swelling of feet or lower legs
  • liver problems
  • shortness of breath
  • stomach pain

Possible interactions

The immunosuppressant medicament azathioprine is known to interact with certain herbal products and minerals and, hence, they should not be used concurrently.

A number of patients use the herb Echinacea with a view to perk up their immune system. However, it is unfortunate to note that using the herb Echinacea is not advisable for people having impaired immune systems. In effect, this herb has the aptitude to further weaken the immune system if it is used very frequently and also for a prolonged period of time.


Never stop taking azathioprine abruptly or without prior consultation with your physician. Generally, a gradual decrease in dosage is preferred. In addition, before discontinuing the medication, it is important to discuss with your physician regarding the withdrawal schedule as well as the possibilities of any withdrawal symptoms.

Storage instructions

Azathioprine should always be stored in the same container in which it came. After placing the medication in the container, seal it tightly and keep it away from the reach of children. In addition, this medication needs to be stored in room temperature and in a cool, dry and dark place. Never, keep this medication in your bathroom, which is mostly damp. Never discard the medication by flushing it into the toilet or pouring it in the drain. All medicines that have lapsed validity or a not needed any longer should be discarded in a proper and safe manner. If there is need, talk to your pharmacist or the local disposal company regarding the safe disposal of all unwanted medicines.


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