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AZATHIOPRINE

 

Current indication

For use in patients who are unable to tolerate mycophenolate mofetil.


Dose

Initial

1-2 mg/kg once daily.

Maintenance

1 mg/kg once daily.

Monitoring

No monitoring of drug levels is required.


Preparation

Azathioprine is available as 25 mg and 50 mg tablets. There are both generic and brand (Imuran) forms on the market.


Administration

Virtually exclusively oral although an IV preparation is available.


Contra-indications

Pregnancy

Bone marrow dysfunction, i.e. patients who are known to be leucopaenic or thrombocytopaenic.

Reduce dose if hepatic dysfunction is present.


Drug interactions

Allopurinol and Febuxostat must not be co-prescribed as an inhibition of xanthine oxidase results in potentially fatal accumulation of azathioprine and its metabolites. An alternative uricosuric- benzbromarone is available on a named patient basis. Contact transplant unit pharmacist for further details.


Side Effects

Bone marrow suppression - usually reversible following cessation.

Cholestatis and disturbed liver function - again usually reversible.

Pancreatitis

Dose may require to be altered depending on WCC, ie. reduce if WCC<4.0, stop if WCC <3.0 and re-introduce at a lower doses when WCC>3.0.

 

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This page last modified 05.03.2018 10:34 by Emma Farrell. edren and edrep are produced by the Renal Unit at the Royal Infirmary of Edinburgh and the University of Edinburgh. CAUTIONS and Contact us.