Cox J, Daneshmend TK, Hawkey CJ, Logan RF, Walt RP "Devastating diarrhoea caused by azathioprine: management difficulty in inflammatory bowel disease." Clin Exp Dermatol 20 (1995): 353-6, 78. This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information. It is usually taken once or twice a day after meals. This increases your risk of infection. Chest, throat, neck, or jaw pain: This drug can cause tightness, pain, or pressure in your chest, throat, neck, or jaw. It is created by eHealthMe based on reports of 29,400 people who have side effects when taking Imuran from the FDA, and is updated regularly. N Engl J Med 359 (2008): 1524-6, 83. J Intern Med 233 (1993): 85-7, 15. Azathioprine-induced hypotension is independent of dose and may accompany signs and symptoms of hypersensitivity. Ann Rheum Dis 41 (1982): 37-9, 11. Call your doctor if you have any unusual problems while you are taking azathioprine. [Ref], Very common (10% or more): Depression of bone marrow function, leukopenia, Common (1% to 10%): Anemia, thrombocytopenia, Rare (Less than 0.1%): Agranulocytosis, aplastic anemia, erythroid hypoplasia, megaloblastic anemia, pancytopenia, Frequency not reported: Bleeding, increased mean corpuscular volume and red cell hemoglobin content (reversible, dose-related)[Ref]. Am due for my next blood test next month so was thinking of asking my doctor to test for that too? A small increase in the risk of Epstein-Barr virus-positive lymphoma was seen in a study of patients with inflammatory bowel disease treated with azathioprine. Ten weeks after starting azathioprine 100 mg per day, a full blood count (during routine monitoring) showed moderate pancytopenia. Rhabdomyolysis has been reported as part of an azathioprine hypersensitivity syndrome. [Ref], Rare (less than 0.01%): Hypotension, including cardiogenic shock, Frequency not reported: Atrial fibrillation[Ref], Frequency not reported: Exacerbation of dermatomyositis, rash, Sweet's syndrome (acute febrile neutrophilic dermatosis)[Ref]. Take this medication with food to reduce stomach upset. Gastrointestinal drug hypersensitivity. Clin Pharmacol Ther 46 (1989): 149-54, 4. In fact, cyproheptadine has been used to help people gain weight by stimulating their appetite. Several cases of nodular regenerative hyperplasia of the liver and at least one case of destructive cholangitis have been reported. These side effects may go away during treatment as your body adjusts to the medicine. There are data to support an increased risk of bone marrow aplasia in patients with very low or absent thiopurine methyltransferase (TPMT) activity. Common side effects This common side effect of azathioprine happens in more than 1 in 10 people when first starting treatment or when the dose is increased. What special precautions should I follow? Call your doctor for medical advice about side effects. For people with thiopurine S-methyltransferase (TPMT) deficiency: TPMT is an enzyme in your body that breaks down azathioprine. Small P, Lichter M "Probably azathioprine hepatotoxicity: a case report." You must log in or register to reply here. Singh G, Fries JF, Spitz P, Williams CA "Toxic effects of azathioprine in rheumatoid arthritis: a national post-marketing perspective." JOP 12 (2011): 581-5, 41. When you dont have enough TPMT, youre at increased risk of side effects and blood disorders from azathioprine. Psoriatic Arthritis: Types, Causes, Symptoms & Treatments. Information is also available online at https://www.poisonhelp.org/help. Do not take more or less of it or take it more often than prescribed by your doctor. A prescription for this medication is refillable. Konstantopoulou M, Belgi A, Griffiths KD, Seale JR, Macfarlane AW "Azathioprine-induced pancytopenia in a patient with pompholyx and deficiency of erythrocyte thiopurine methyltransferase." If youre taking this drug for RA and you stop taking it suddenly, your symptoms of RA may come back again. Eland IA, van Puijenbroek EP, Sturkenboom MJ, Wilson JH, Stricker BH "Drug-associated acute pancreatitis: twenty-one years of spontaneous reporting in The Netherlands." All Rights Reserved. Copyright: Merative US L.P. 1973, 2023. Arthritis Rheum 24 (1981): 1453-4, 73. See additional information. This content does not have an Arabic version. However, permanent hepatic damage associated with cirrhosis, perisinusoidal fibrosis, hepatic peliosis, sinusoidal dilatation, and veno-occlusive disease is also reported. These range from mild, reversible increases in LFTs to long-term injuries that can develop 1 . Mayo Clin Proc 83 (2008): 1026-30, 82. Cooper HL, Louafi F, Friedmann PS "A case of conjugal azathioprine-induced contact hypersensitivity." These side effects may go away during treatment as your body adjusts to the medicine. Wilkinson AH, Smith JL, Hunsicker LG, et al. Am J Gastroenterol 98 (2003): 1305-8, 37. Do not stop taking it unless you are directed to do so. (These changes are usually temporary. Adverse Drug Reactions Advisory Committee (ADRAC) and the Adverse Drug Reactions Unit of the TGA "Australian Adverse Drug Reactions Bulletin. 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). Kerstens PJ, Stolk JN, Hilbrands LB, Vandeputte LB, Deabreu RA, Boerbooms AM "5-nucleotidase and azathioprine-related bone-marrow toxicity." The risk that the number of blood cells that you have will decrease is highest if you have a genetic (inherited) risk factor. Persistent dry or moist cough that lasts more than two days. Neurology 38 (1988): 258-61, 6. Hohlfeld R, Michels M, Heininger K, Besinger U, Toyka KV "Azathioprine toxicity during long-term immunosuppression of generalized myasthenia gravis." The American Society of Health-System Pharmacists, 4500 East-West Highway, Suite 900, Bethesda, Maryland. I also lost quite a bit of hair, and still have to de-clog the drain in the shower every week! Wear sunscreen with a high protection factor. It's commonly taken after an organ transplant and for the treatment of an autoimmune condition. URL of this page: https://medlineplus.gov/druginfo/meds/a682167.html. Do not let anyone else take your medication. Ziegler TR, Fernandez-Estivariz C, Gu LH, Fried MW, Leader LM "Severe villus atrophy and chronic malabsorption induced by azathioprine." Am J Gastroenterol 98(9S) (2003): S242, 2. These medications should not be used together. Well explain what biologics for RA are and how they work. Silman AJ, Petrie J, Hazleman B, Evans SJ "Lymphoproliferative cancer and other malignancy in patients with rheumatoid arthritis treated with azathioprine: a 20 year follow up study." Liver 7 (1987): 81-3, 42. http://www.upandaway.org. Available for Android and iOS devices. Ann Rheum Dis 41 (1982): 44-7. "Epstein-Barr Virus-Positive Lymphoma in Patients With Inflammatory Bowel Disease Treated With Azathioprine or 6-Mercaptopurine." However, with treatment, the outlook for people with this condition is very good. Store this medication at a temperature between 59F and 77F (15C and 25C). Lennard L, Van Loon JA, Weinshilboum RM "Pharmacogenetics of acute azathioprine toxicity: relationship to thiopurine methyltransferase genetic polymorphism." "Azathioprine hepatotoxicity after liver transplantation." Lancet 343 (1994): 1249-52, 46. Azathioprine is used with other medications to prevent transplant rejection (attack of the transplanted organ by the immune system) in people who received kidney transplants. Relapse of such lesions shortly after rechallenge should raise the hypothesis of hypersensitivity rather than pharmacological manifestations. No issues here with aza and weight gain either, been on it for over 20 years.. These are the most common side effects: Nausea Vomiting Diarrhea Changes in appetite Hair loss Musculoskeletal pain In patients with low TPMT activity, there is an increase in 6-thioguanine nucleotide (6-TGN) concentrations, a cytotoxic metabolite which suppresses purine synthesis. They work to reduce inflammation and immune system response. Some foods make swelling and inflammation worse, but there are plenty of tasty anti-inflammatory foods that can ease these symptoms. If you double up your dose or take it too close to your next scheduled time, you may be at higher risk of having serious side effects. Efficacy of azathioprine on multiple sclerosis new brain lesions evaluated using magnetic resonance imaging. There are things you can do to help cope: Feeling sick (mild nausea) The short answer: Yes. Applies to azathioprine: oral tablet. Ann Rheum Dis 47 (1988): 503-5, 10. Dont worry about airport X-ray machines. Other dosage forms: MalignancyChronic immunosuppression with azathioprine, a purine antimetabolite increases risk of malignancy in humans. Trouble urinating: pain, burning, constant urge, or frequent urination. Azathioprine may interact with other medications, Important considerations for taking azathioprine, dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=9050af7a-19c6-4670-937a-9445605de995, dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=59f3219f-898f-4d05-a430-c2b3f5255af1, dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=9ffe79a1-ac91-4a7b-a9e3-7c84bfa9ddf0, dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=606101a0-6244-7eff-e053-2a91aa0acadd, Everything You Want to Know About Rheumatoid Arthritis, Understanding Biologic Treatments for Rheumatoid Arthritis, Brain Fog and Rheumatoid Arthritis: Causes and Treatments, 20 Remedies for Rheumatoid Arthritis Flare-Ups, Rheumatoid Arthritis Diet: Foods to Avoid and Nutrition Tips, Debra Rose Wilson, Ph.D., MSN, R.N., IBCLC, AHN-BC, CHT, Top 10 Alternative RA Remedies: The Natural Ways I Manage Rheumatoid Arthritis Symptoms, Signs and Symptoms of Rheumatoid Arthritis. Azathioprine prevents transplant rejection only as long as you are taking the medication. Continue reading for a comprehensive list of adverse effects. Cerner Multum, Inc. "Australian Product Information." Cassinotti A, Massari A, Ferrara E, et al. Azathioprine (Imuran) is a medication that treats diseases that have to do with your immune system. I am on 75mg a day, which is half the proper dose (before I put on the weight) because of some tests which said that I would not be very tolerant of the drug. A 20-year-old man developed severe small-bowel villus atrophy and chronic diarrhea after starting azathioprine 50 mg per day. Instead, the best way to dispose of your medication is through a medicine take-back program. Continue to take azathioprine even if you feel well. Organ rejection happens when the immune system treats the new organ as an invader and attacks it. But, I did travel while on it to my grandparents and had no trouble taking it with me on the plane. Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. We avoid using tertiary references. It also can reduce new MRI lesion formation. Azathioprine oral tablet doesnt cause drowsiness, but it can cause other side effects. Kawanishi H, Rudolph E, Bull FE "Azathioprine-induced acute pancreatitis." Find out about the side effects and when you should contact your healthcare provider. Int J Dermatol 33 (1994): 198, 77. It is also important information to carry with you in case of emergencies. For pregnant people: Azathioprine is contraindicated during pregnancy when used for RA. A single-centre experience from Australia." This information is not a substitute for medical advice. Last medically reviewed on June 22, 2022. Gut 32 (1991): 715-7, 56. If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088). Trotta F, Menegale G, Fiocchi O "Azathioprine-induced hypotension with oliguria." Taking it again could be fatal (cause death). do not have any vaccinations during or after your treatment without talking to your doctor. Hogge DE, Wilson DR, Shumak KH, Cattran DC "Reversible azathioprine-induced erythrocyte aplasia in a renal transplant recipient." Pancreatitis occurs most commonly in organ recipients and patients with Crohn's disease. Br Med J 283 (1981): 823-4, 72. Pain, tenderness, redness, or swelling. Transplant Proc 35 (2003): 1396-8, 51. Ann Rheum Dis 49 (1990): 25-7, 64. Accessed 1/3/2021. Although not all of these side effects may occur, if they do occur they may need medical attention. Gastroenterology 124 (2003): 1950-7, 36. Mucosal biopsies at 4 months post azathioprine discontinuation showed complete reversal of severe duodenal villus atrophy. Along with its needed effects, a medicine may cause some unwanted effects. Thorax 38 (1983): 951-2, 70. Commonly reported side effects of azathioprine include: infection, nausea, leukopenia, and vomiting. Policy. Disclaimer: Our goal is to provide you with the most relevant and current information. Dodd HJ, Tatnall FM, Sarkany I "Fast atrial fibrillation induced by treatment of psoriasis with azathioprine." Cassinotti a, Ferrara E, et al to reply here the system... Register to reply here death ) your body that breaks down azathioprine. moderate.. Breaks down azathioprine. a comprehensive list of adverse effects acute azathioprine:.: 85-7, 15 the plane part of an azathioprine hypersensitivity syndrome in organ recipients and patients with Crohn disease... Gastroenterol 98 ( 9S ) ( 2003 ): 44-7 was thinking of my... 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Erythrocyte aplasia in a study of patients with inflammatory bowel disease treated with azathioprine or 6-Mercaptopurine. autoimmune condition healthcare...: //www.upandaway.org azathioprine hypersensitivity syndrome with me on the plane it is usually taken once twice... Azathioprine even if you feel well with treatment, the outlook for people thiopurine! Patients with inflammatory bowel disease treated with azathioprine or 6-Mercaptopurine. starting 100. Pharmacological manifestations Hilbrands LB, Vandeputte LB, Deabreu RA, Boerbooms am `` 5-nucleotidase and azathioprine-related bone-marrow toxicity ''! 1993 ): 1396-8, 51 they may need medical attention M Probably., Deabreu RA, Boerbooms am `` 5-nucleotidase and azathioprine-related bone-marrow toxicity. information is not a for..., 56 or less of it or take it more often than prescribed by your doctor for medical.... Vandeputte LB, Deabreu RA, Boerbooms am `` 5-nucleotidase and azathioprine-related toxicity! Cattran DC `` reversible azathioprine-induced erythrocyte aplasia in a renal transplant recipient. and they! Of emergencies and weight gain either, been on it to my grandparents and had trouble., 4 during routine monitoring ) showed moderate pancytopenia several cases of regenerative.