Learn about Azathioprine 50 mg tablet, its uses, side effects and precautions. Get all the information you need on this medical topic.

Azatioprina 50 mg, its uses, side effects and precautions. Get all the information you need on this medical issue.

Azathioprine 50 mg tablets is a medication commonly prescribed by healthcare professionals to treat various medical conditions. Also known by its trade name Imuran, this immunosuppressive drug is primarily used to prevent organ rejection in transplant recipients and to treat autoimmune disorders such as rheumatoid arthritis or inflammatory bowel disease. The active ingredient in azathioprine works by suppressing the activity of the immune system, which helps reduce inflammation and prevent the body from attacking its own organs or tissues.

  1. Azathioprine 50 mg tablets are usually taken by mouth, with or without food, as directed by your doctor.
  2. It is important to take the medication at the same time every day to maintain a constant level of the drug in your body.
  3. Do not stop taking azathioprine suddenly without consulting your doctor, as this could cause a flare-up of your condition.

Important information: Azathioprine 50 mg tablet may increase the risk of developing certain types of cancer, including skin cancer and lymphoma. Regular monitoring and routine check-ups with your doctor are crucial to detect any potential complications. Discuss the benefits and risks of Azathioprine with your doctor before starting treatment.

Tradename: Imuran
Generic name: Azathioprine
Drug class: Immunosuppressant
Indications: Prevention of organ transplant rejection, rheumatoid arthritis, inflammatory bowel disease

Azathioprine: Uses, dosage and side effects


Below, we will explore the uses of Azathioprine, proper dosing guidelines, and possible side effects that patients should be aware of before using this medication.

Uses of Azathioprine

Azathioprine finds application in a number of medical conditions, thanks to its immunosuppressive properties. Some of the common uses of Azathioprine include:

  • Treatment of autoimmune diseases: Azathioprine is prescribed for the treatment of autoimmune diseases, such as rheumatoid arthritis, systemic lupus erythematosus, and inflammatory bowel disease, to reduce inflammation and control symptoms.
  • Prevention of organ rejection: Azathioprine is usually used in combination with other immunosuppressive drugs to prevent organ rejection in patients who have undergone an organ transplant, such as a kidney or liver transplant.
  • Treatment of inflammatory diseases: Azathioprine can be prescribed for conditions such as vasculitis and Crohn’s disease to reduce inflammation and help control symptoms.

Dosage Guidelines

The dose of azathioprine can vary depending on the patient and the disease being treated. It is essential to follow the dosing instructions prescribed by the health professional. Normally, azathioprine occurs in the form of tablets, being the standard dose of 50 mg.

Disease Initial dose Regular maintenance dose
Rheumatoid arthritis 1-3 mg/kg/day 1-2 mg/kg/day
Intestinal inflammatory disease 2. 5 mg/kg/day 1-2 mg/kg/day
Organ transplant 3-5 mg/kg/day 1-3 mg/kg/day

Side Effects

Azathioprine can cause certain side effects in some patients. It is essential to be aware of these possible side effects and consult a healthcare professional if they persist or worsen over time. The most common side effects of azathioprine can include:

  • Nausea and vomiting
  • Loss of appetite
  • Fatigue
  • Infections
  • Increased risk of certain types of cancer

It is important to note that this is not an exhaustive list of side effects and that individual experiences can vary. If any unusual or severe side effect occurs, it is crucial to seek immediate medical attention for adequate evaluation and orientation.

How Azathioprine Works to Treat Autoimmune Diseases

Mechanism of Azathioprine Action

  1. Azathioprine is an immunosuppressive agent that belongs to the class of drugs known as purine analogues.
  2. Once ingested, azathioprine is metabolized in the body to form a substance called 6-Mercoptopurin (6-MP).
  3. The 6-MP acts interfering with the production and synthesis of DNA and RNA, two essential components that intervene in cell replication and the activation of the immune response.
  4. By altering these processes, azathioprine effectively inhibits the proliferation of cells that are quickly divided, including immune cells responsible for the autoimmune response.

Azathioprine exerts its immunosuppressive effects by selectively addressing the immune system cells that are divided rapidly, thus reducing inflammation and preventing subsequent damage in autoimmune diseases.

Therapeutic uses of azathioprine in autoimmune diseases

  • Azathioprine is often prescribed for the treatment of rheumatoid arthritis, an autoimmune disorder characterized by joint inflammation and tissue damage.
  • It is also used in the treatment of systemic lupus erythematosus, a chronic autoimmune disease that affects multiple body systems.
  • Inflammatory bowel diseases such as Crohn’s disease and ulcerative colitis may also benefit from the immunosuppressive properties of azathioprine.

By effectively suppressing the immune system, azathioprine helps control the symptoms of these autoimmune conditions and prevent further disease progression. However, it is essential to note that the use of azathioprine requires careful monitoring and close supervision by healthcare professionals to minimize the risk of possible side effects.

Benefits and Risks of Azathioprine in Treating Rheumatoid Arthritis

One of the main benefits of using azathioprine in the treatment of rheumatoid arthritis is its ability to suppress the overactive immune response that characterizes the disease. By inhibiting the proliferation of immune cells, azathioprine helps reduce inflammation and joint damage. This can lead to decreased pain, improved joint function, and reduced frequency and severity of RA flares.

  • Reducing inflammation: Azathioprine works by selectively targeting and suppressing specific immune cells, such as T lymphocytes, which play a crucial role in the inflammatory process. This can result in a significant reduction in overall joint inflammation, relieving symptoms and preventing further damage.
  • Slow disease progression: Studies have shown that azathioprine treatment can slow the progression of rheumatoid arthritis. By modulating the immune response, it helps prevent joint destruction and deformity, preserving long-term function and mobility.

“Azathioprine has proven effective as a disease-modifying antirheumatic drug (DMARD) in the treatment of rheumatoid arthritis. It works by suppressing the immune system, reducing inflammation and preventing joint damage.”

Despite its benefits, the use of azathioprine in the treatment of rheumatoid arthritis also carries certain risks and considerations. Like any medication, it can cause side effects ranging from mild to severe. Patients should be closely monitored by their healthcare professional to ensure proper dosing and to identify any potential adverse reactions.

  1. Possible side effects: Common side effects of azathioprine include nausea, vomiting, loss of appetite, and fatigue. These symptoms are usually temporary and can be controlled with dose adjustments or supportive measures. However, in rare cases, azathioprine may cause serious adverse effects, such as bone marrow suppression, liver toxicity, or increased susceptibility to infections.
  2. Individual response and monitoring: Since the effectiveness and safety of azathioprine may vary from person to person, regular monitoring of blood cell counts, liver function, and kidney function is essential during treatment. This helps ensure that the medication is well tolerated and effective in treating rheumatoid arthritis without causing harm.
Benefits of azathioprine in rheumatoid arthritis Risks and considerations of azathioprine in rheumatoid arthritis
Reduction of inflammation Possible side effects
Slowing of disease progression Individual response and follow-up

Azathioprine in the Treatment of Inflammatory Bowel Disease

A medication commonly used in the treatment of IBD is azathioprine. Azathioprine is an immunosuppressive drug that works by inhibiting the production of DNA and RNA, thereby reducing the overall activity of the immune system. In this way, it helps reduce the inflammation associated with IBD and can relieve symptoms such as abdominal pain, diarrhea, and rectal bleeding.

Important information:

  • Azathioprine is usually prescribed for people with moderately to severely active IBD who have not responded well to other forms of treatment.
  • The dose of azathioprine varies depending on the specific case and can be adjusted over time based on the patient’s response and possible side effects.
  • It is important to closely monitor patients receiving azathioprine due to the potential for adverse effects, such as bone marrow suppression, liver toxicity, and increased risk of infection.

Comparison of Azathioprine and Other IBD Medications
Medicine Action mode Common side effects Control requirements
Azathioprine Inhibits the synthesis of DNA and RNA, suppresses the activity of the immune system Bone marrow suppression, liver toxicity, increased risk of infection Ongoing blood tests to evaluate liver function and blood cell counts
Infliximab Blocks tumor necrosis factor (TNF) in the immune system Infusion reactions, increased risk of infections, increased risk of certain cancers Continuous monitoring of adverse reactions during and after infusions
Mesalamine Anti-inflammatory action in the gastrointestinal tract Nausea, vomiting, diarrhea, headache Regular kidney function evaluations and blood tests

Overall, azathioprine may be a valuable component of the treatment plan for people with inflammatory bowel disease. However, it is essential that patients are closely monitored and receive regular reviews to ensure the safety and effectiveness of the medication. As with any medical treatment, the decision to use azathioprine should be made in consultation with a healthcare professional who can evaluate the individual’s specific condition and adapt the treatment plan accordingly.

Azathioprine as an Adjunct Therapy in Organ Transplantation

Azathioprine is an immunosuppressive drug that inhibits the proliferation of immune cells, particularly T and B lymphocytes. It achieves this effect by interfering with the proliferation of T and B lymphocytes. It achieves this effect by interfering with DNA synthesis and preventing thematuration of these cells. This drug has a broad spectrum of action and has been used as an adjunctive treatment in various organ transplants, such as kidney, liver, heart and lung.

Benefits of azathioprine in organ transplantation:

  • Azathioprine reduces the risk of acute rejection episodes, which can threaten the survival of the transplanted organ.
  • It helps maintain the delicate balance between immunosuppression and the risk of infection by reducing the necessary dose of other immunosuppressive drugs.
  • By suppressing the immune response, azathioprine promotes the long-term survival of the transplanted organ.

“The addition of azathioprine to standard immunosuppression regimens has been associated with improved graft and patient survival rates in organ transplant recipients.”- Journal of Transplantation

When used as adjunctive therapy, azathioprine is usually started early in the post-transplant period and continued for several months or years. The dose and duration of treatment may vary depending on the individual response of the patient and the specific organ transplanted. To ensure the safety and effectiveness of the drug, it is essential to closely monitor the patient’s blood counts and liver function.

Potential Drug Interactions to Be Aware of When Taking Azathioprine

1. Allopurinol

One of the most notable potential drug interactions of azathioprine is with allopurinol, a medication used to treat gout. When these two medications are taken together, the risk of bone marrow suppression increases, which can lead to decreased blood cell production. This can lead to a higher chance of developing serious infections or bleeding. If you are prescribed azathioprine and allopurinol together, your doctor may need to adjust the dose or closely monitor your blood cell count.

Important: Do not start or stop taking any medication without first consulting your doctor. If you are currently taking allopurinol or are prescribed it in the future, inform your doctor about your use of Azathioprine.

Possible interactions of azathioprine with other medications
Drug Potential interaction
Allopurinol Increased risk of bone marrow suppression
Warfarin Increased risk of bleeding
Aminosalicylates (for example, mesalamine) Increased risk of myelosuppression

2. Warfarin

Warfarin, a commonly prescribed blood thinner, is another medication that can interact with azathioprine. Combining these medications may increase the risk of bleeding. Warfarin works by slowing down the clotting process, while azathioprine can affect the body’s ability to produce blood cells, including those involved in clotting. If you are taking both medications simultaneously, your healthcare professional may need to monitor your blood clotting times more frequently to make sure your treatment is being adjusted appropriately.

3. Aminosalicylates (e. g. mesalamine)

Aminosalicylates are medications used to treat inflammatory bowel disease, such as ulcerative colitis. When taken together with Azathioprine, these medications may increase the risk of myelosuppression, which is a decrease in the production of blood cells. This can lead to increased susceptibility to infections, anemia or bleeding. It is important to closely monitor blood counts if you are prescribed both Azathioprine and aminosalicylates.

Managing Azathioprine Medication: Tips for Optimal Treatment Outcomes

1. Adherence is essential: For azathioprine to be effective, it is essential to take it systematically following the doctor’s instructions. Skipping doses or altering the dosage without medical guidance may compromise the desired therapeutic effect. Consider setting a daily reminder, using a pill organizer, or incorporating medication into your daily routine to help you stay on track.

  1. Avoid interactions: Azathioprine may interact with certain medications, such as allopurinol and warfarin, leading to possible complications. Make sure your doctor knows about all the medications, supplements, and herbal medicines you take to avoid possible interactions. If necessary, they will be able to guide you on appropriate dosage adjustments.
  2. Periodic control: While taking Azatioprina, periodic reviews with your healthcare professional are essential to control your response to the medication, as well as to identify any possible side effect or adverse reaction. Routine blood tests can help evaluate the liver function and blood cell count, which can be affected by azathioprine. This monitoring allows you to intervene in time and adjust the treatment plan in case necessary.
  3. Considerations about lifestyle: It is important to maintain a healthy lifestyle during treatment with azathioprine. This includes following a balanced diet, exercising regularly, quitting smoking and avoiding excessive sun exposure. It is recommended to comment with the doctor any possible modification of the lifestyle to guarantee compatibility with treatment.

Remember that azathioprine is a powerful medication that requires careful treatment. Fulfilling the prescribed treatment plan, avoiding interactions, controlling your health regularly and making adequate lifestyle decisions, can optimize the safety and efficacy of your medication with azathioprine.

Author of the article
Dr.Greenblatt M.
Dr.Greenblatt M.
Medical oncologist at the Robert Larner College of Medicine, MD, at the University of Vermont

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