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November 19, 2021
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Azathioprine (Imuran)

Azathioprine (Imuran) -- Purine analog that decreases metabolism of purines and also may inhibit DNA and RNA synthesis. Reduces disability and symptoms of CIDP by suppressing immune-mediated damage to nerves.

Initial dose: 50 mg PO qd, increased gradually to total daily dosage of 2-3 mg/kg/d PO
Therapeutic dose of azathioprine difficult to determine for each patient; some evidence suggests that elevations of RBC volume (MCV) indicate therapeutic dosing
Therapeutic response may take >6 mo to become apparent

Side effects

Can lead to various GI symptoms and ulcer formation with delayed healing (use with prophylactic agent to prevent ulcers); can lead to severe leukopenia, anemia, and thrombocytopenia (strictly monitor blood counts: obtain CBC count before treatment, every 1-2 wk for first few months, then monthly; in author's practice, WBC count of 3000/mL considered warning, requiring closer monitoring of WBC counts and infection precautions; 2000/m L considered sign to stop medication)

As immune suppressant, places patients at risk for infections
Monitor hepatic enzymes because of risk of liver failure (same frequency as monitoring of CBC count); caution should be used if new elevation of liver enzymes up to twice normal level noted; if stopping drug brings liver enzymes back to normal, drug can be tried again at later date, although with special caution; an idiosyncratic reaction can occur within days of initiation of treatment, including fever, jaundice, nausea and vomiting, and elevation of hepatic enzymes
Discontinuation of drug usually results in complete resolution of symptoms; restarting drug does not always result in same reaction but should be considered carefully

Information specific to:Azathioprine 25mg tabletswhen used inHepatitis (autoimmune).

Azathioprine (A-zer-thigh-oh-preen) is a medicine which is used in a number of conditions - an example is rheumatoid arthritis.

The information in this Medicine Guide for Azathioprine varies according to the condition being treated and the particular preparation used.

Your medicine

Azathioprine is an immunosuppressive medicine. In the treatment of auto-immune diseases, Azathioprine helps to suppress over activity in the immune system. This helps to reduce pain and swelling by limiting inflammation. Azathioprine needs to be taken for a few weeks or months before any improvement is noticed.

When used in people who have had organtransplants, Azathioprine prevents the body's immune system from rejecting donor organs.

Because of its effects on the immune system, people who take Azathioprine are prone to getting infections. Your prescriber will monitor you for infections and will tell you about the signs of infection you should look out for while you are take Azathioprine.

Other information about Azathioprine:

Do not share your medicine with other people. It may not be suitable for them and may harm them.

The pharmacy label on your medicine tells you how much medicine you should take. It also tells you how often you should take your medicine. This is the dose that you and your prescriber have agreed you should take. You should not change the dose of your medicine unless you are told to do so by your prescriber.

If you feel that the medicine is making you unwell or you do not think it is working, then talk to your prescriber.

Whether this medicine is suitable for you

Azathioprine is not suitable for everyone and some people should never use it. Other people should only use it with special care. It is important that the person prescribing this medicine knows your full medical history.

Your prescriber may only prescribe this medicine with special care or may not prescribe it at all if you:

As part of the process of assessing suitability to take this medicine a prescriber may also arrange tests:

Over time it is possible that Azathioprine can become unsuitable for some people, or they may become unsuitable for it. If at any time it appears that Azathioprine has become unsuitable, it is important that the prescriber is contacted immediately.


Alcohol can interact with certain medicines.

In the case of Azathioprine:Avoid Alcohol


Medicines can interact with certain foods. In some cases, this may be harmful and your prescriber may advise you to avoid certain foods.

In the case of Azathioprine:


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