COMMON BRAND NAMES: Imuran
Why is this drug prescribed?
Azathioprine is an immunosuppressive medication that prevents organ rejection by interfering with the body’s normal immune response.
The body’s immune system protects you from infection. Immune cells recognize the transplanted lung as different from the rest of the body and attempt to destroy it. This is called rejection and is your body’s way of not accepting the new organ.
After transplant surgery, you are prescribed immunosuppressive drugs to “fool” your immune system into thinking your new lung is your own so it doesn’t try to attack the new lung.
One way the body fights a transplanted organ is by producing white blood cells. Although not a treatment for rejection, azathioprine can prevent the body’s refusal of the organ by interfering with the growth of white blood cells.
How and when should azathioprine be used?
Azathioprine is generally taken in the form of tablets, but also is available as an injection.
Your white blood cell count and your weight determine the dosage of azathioprine that is prescribed. It is generally taken once a day. Azathioprine is available in 50 mg. tablets, which may be easily broken in half if necessary. Your prescription label tells you how much to take at each dose and how often to take it. Follow these instructions carefully and ask your pharmacist or doctor to explain any part that you do not understand.
It is important that you take this medication regularly as prescribed; do not stop taking it. You will need to take immunosuppressant drugs every day for the rest of your life to prevent rejection.
Your health care provider may reduce or even stop azathioprine when you are being treated for certain infections. This allows your body to effectively fight the infection.
What special instructions should I follow?
- You must take all of the prescribed amount of azathioprine to maintain enough immunosuppression to prevent rejection. Follow your dosage schedule carefully.
- Be sure that you always have enough medication on hand. Check your supply before holidays or other occasions when you may be unable to fill your prescription.
- Keep all appointments with your doctor and the laboratory so that your response to the drug can be monitored.
- Do not have any vaccinations without your doctor’s approval.
- Take precautions to avoid infection while taking this medication.
You take all of the prescribed amount of azathioprine to maintain enough immunosuppression to prevent rejection. Follow your dosage schedule carefully.
What should I do if I forget to take a dose?
If you forget to take a dose, take it as soon as you remember. If it is almost time for your next dose or if you have forgotten more than one dose, contact the Transplant Center for instructions.
What are the side effects of this drug?
Even though the side effects of azathioprine could be very serious, remember that this drug is necessary to prevent rejection. Precautions will be taken to detect these side effects and treat them before they become harmful.
Any of the following side effects could occur:
- Decreased white blood cell count
- Increased risk of infection
- Liver damage (To prevent or detect this side effect, liver function tests are performed twice a year.)
- Jaundice (yellowing of the skin and whites of the eyes) caused by altered liver function
- Changes in hair color and texture along with hair loss (These changes are usually temporary.)
- Development of mouth sores and ulcers
- Increased risk of bleeding
- Increased stomach irritation, including nausea and vomiting
- Counteraction of other medications
- Increased susceptibility to some cancers
What storage conditions are necessary for this drug?
- Store this medication at room temperature.
- DO NOT store this medication in direct heat or light.
- DO NOT store this medication in the bathroom, near the kitchen sink or in other damp places. Heat or moisture may cause it to break down.
- Keep this medication in the container it came in, tightly sealed.
- Do not keep outdated medicine.
- Keep it and other medications out of the reach of children.
- Store this medication at room temperature.
When should I call my health care provider?
Call your health care provider right away if you have any of these warning signs of infection:
- Fever over 100°F (38°C)
- Sweats or chills
- Skin rash
- Pain, tenderness, redness or swelling
- Wound or cut that won’t heal
- Red, warm or draining sore
- Sore throat, scratchy throat or pain when swallowing
- Sinus drainage, nasal congestion, headaches or tenderness along upper cheekbones
- Persistent dry or moist cough that lasts more than two days
- White patches in your mouth or on your tongue
- Nausea, vomiting or diarrhea
- Flu-like symptoms (chills, aches, headache or fatigue) or generally feeling “lousy”
- Trouble urinating: pain or burning, constant urge or frequent urination
- Bloody, cloudy or foul-smelling urine or black, tarry stools
Also contact your health care provider if you have any other symptoms that cause concern or if you have any questions.
| Possible Side Effects |
What You Should Do |
| Increased risk of infection |
Avoid anyone who may have an infection and report any signs or symptoms of infection to your health care provider. |
| Sunburn or skin cancer |
Wear a sunblock with an SPF of at least 15. Avoid the sun and report any skin changes to your health care provider. |
| Mouth sores |
Practice good oral hygiene to prevent mouth sores and infections in your mouth. Brush carefully and frequently, and floss daily. Report any mouth sores to your health care provider. Visit your dentist every six months, and notify your transplant physician before any dental procedures. |
| Decreased white blood cell count |
Have your blood drawn exactly as instructed by your health care providers so they can monitor your white blood cell count. |
| Hair loss |
You may want to have your hair cut short. If you decide to wear a wig, you should shop before you have hair loss in order to match color and style. Generally, hair loss is temporary; and hair will probably re-grow about 3 to 6 months after you stop taking the medication. You may notice that the re-growth of hair is thinner or a different texture. |
| Liver damage |
Schedule frequent appointments with your primary care physician and have your blood drawn as scheduled. |
| Increased risk of cancer |
Visit your primary care physician regularly and have a yearly prostate or gynecologic exam. Report any changes to your health care provider. |
For More Information
If you have any questions or concerns, please call us at 216.444.8282. We will be happy to answer your questions.
