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When the therapeutic response is evident consideration should be given to reducing the maintenance dosage to the lowest level compatible with maintenance of the response. Do not take a double dose to make up for the missed dose. However, if it is already time for next dose, carry on with your regular schedule. Remember to take Azathioprine only on a full stomach.Azathioprine is generally prescribed once or twice daily. The principal signs of bone marrow suppression are ulceration of the throat, fever and infections. on prescription). However, in various systems it appears to modify the activity of azathioprine compared with that of 6-MP.Azathioprine has an effect on both immunological reaction and tumour growth. You must not chew, crush or break the tablet while taking it. Leucopenia may occur in over 50% of all patients treated with azathioprine in conventional doses. Menstruation usually follows within three days of finishing the treatment. The increased risk appears to be related to the degree and duration of immunosuppression.
The maintenance dose can range from 1-4 mg/kg/body weight/day and must be adjusted according to the clinical requirements and haematological tolerance.In general, the starting dosage is 1-3mg/kg/body weight/day and should be adjusted according to the clinical response (which may not be evident for weeks or months) and haematological tolerance. Azathioprine must not be used during pregnancy without careful assessment of risks and benefit (see section 4.3).In animal studies Azathioprine was teratogenic and embryotoxic (see section 5.3)Azathioprine and its metabolites have been found in low concentrations in foetal blood and amniotic fluid after administration to the mother. A single large dose of azathioprine is less likely to have a toxic effect than a chronic minor overdose (e.g.
But make sure to discuss this with them first. Your dose Azathioprine is usually taken as a tablet once or twice a day, initially at a low dose (e.g.
If you’re unsure about whether you should be having a vaccine, have a chat with your rheumatology team first. However, if it is already time for next dose, carry on with your regular schedule.
Azathioprine is contra-indicated in severe hepatic impairment.
In many instances the symptom resolved spontaneously despite continuing therapy.Reporting suspected adverse reactions after authorisation of the medicinal product is important. Phenotyping or genotyping the patient is desirable, before administration of the medicinal product in order to investigate a possible thiopurine transferase deficiency.Limited data indicate that azathioprine is not effective in patients with hereditary hypoxanthineguanine- phosphoribosyl transferase deficiency (Lesch-Nyhan syndrome). If MAS occurs, or is suspected, evaluation and treatment should be started as early as possible, and treatment with azathioprine should be discontinued.
These complications only occur after transplantation. Typically the tumours occur in connection with immunosuppression (induced by oncovirus or natural irradiation).Hair loss has been described on a number of occasions in patients receiving azathioprine alone or combined with other immunosuppressive agents.
Your doctor may alter your dosage and its frequency depending upon the severity of your condition.Long-term use of Azathioprine is not safe for the patients with kidney and liver disease. Azathioprine has been reported to interfere with the effectiveness of intrauterine contraceptive devices. Patients should be advised to inform their anaesthesiologist of their treatment with azathioprine prior to surgery.Coagulation should be closely monitored when anticoagulants of the coumarin type are given concomitantly with azathioprine (see section 4.5).Withdrawal of azathioprine can result in a severe worsening of the condition, e.g.
Consult your doctor if it is absolutely necessary to take this medication.Azathioprine is known to pass in mother’s milk to baby. Therefore azathioprine should not be used in these patients.If allopurinol, oxipurinol and/or thiopurinol are given concomitantly with azathioprine, the dosage of azathioprine must be reduced to a quarter of the original dose (see section 4.2 and 4.5).Special care is necessary when azathioprine is given concomitantly with neuromuscular acting agents like tubocurarine or succinylcholine (see section 4.5). What happens if I miss a dose of Azathioprine?
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