AZATHIOPRINE

(ay za THYE oh preen) Brand: Azasan, Imuran

What is the most significant information I must know about azathioprine?

• Do not use azathioprine if you are pregnant. It could harm the unborn child.

• Some people using azathioprine have developed a rare fast-growing type of lymphoma (cancer). This condition affects the liver, spleen, and bone marrow, and it can be fatal. This has occurred mainly in teenagers and young adults using azathioprine or similar medicines to treat Crohn's malady or ulcerative colitis.

• Call your doctor at once if you have any of the next symptoms: fever, night sweats, itching, loss of appetite, weight loss, tiredness, feeling full after eating only a little amount, pain in your upper stomach that may spread to your shoulder, nausea, light bruising or bleeding, pale skin, feeling light-headed or short of breath, rapid heart course, dark urine, clay-colored stools, or jaundice (yellowing of the skin or eyes).

• Azathioprine can lower blood cells that help your body fight infections. Your blood may need to be tested often. Avoid being around people who are sick or have infections. Avoid activities that may magnify your risk of bleeding injury. Speak your doctor at once if you develop signs of infection.

• If you need to have surgery, speak the surgeon onward of time that you are using azathioprine. You may need to stop using the medication for a short time.

• This medicine can affect fertility (your capacity to have children), whether you are a man or a woman. Conversation with your doctor if you have concerns about this.

• Do not receive a "live" vaccine while you are being treated with azathioprine and avoid coming into contact with anyone who has recently received a live vaccine. There is a chance that the virus could be passed on to you.

What is azathioprine?

• Azathioprine lowers your body's immune system. The immune system helps your body fight infections. The immune system can also fight or "reject" a transplanted organ such as a liver or kidney. This is because the immune system treats the new organ as an invader.

• Azathioprine is used to prevent your body from rejecting a transplanted kidney. It is also used to treat symptoms of rheumatoid arthritis.

• Azathioprine may also be used for purposes not listed in this medicine guide.

What must I discuss with my healthcare provider till taking azathioprine?

• You must not take this medicine if you are allergic to azathioprine.

• However, people with autoimmune disorders (including rheumatoid arthritis, Crohn's malady, ankylosing spondylitis, and psoriasis) may have a higher risk of lymphoma. Conversation to your doctor about your individual risk.

• To create certain you can safely take azathioprine, speak your doctor if you have any of these another conditions:

· liver disease;

· any type of viral, bacterial, or fungal infection; or

· if you have recently received chemotherapy treatments with medications such as cyclophosphamide (Cytoxan), chlorambucil (Leukeran), melphalan (Alkeran).

• FDA pregnancy category D. Do not use azathioprine if you are pregnant. It could harm the unborn child. Use effective birth control, and speak your doctor if you become pregnant during treatment.

• Azathioprine can pass into breast milk and may harm a nursing child. You must not breast-feed while you are using azathioprine.

• This medicine can affect fertility (your capacity to have children), whether you are a man or a woman. Conversation with your doctor if you have concerns about this.

How must I take azathioprine?

• Take exactly as predesigned by your doctor. Do not take in larger or less amounts or for longer than recommended. Follow the directions on your prescription label.

• Take azathioprine with a full glass of water.

• Take azathioprine with food to lessen stomach upset.

• Azathioprine can lower blood cells that help your body fight infections. This can create it easier for you to bleed from an injury or get sick from being near others who are ill. Your blood may need to be tested often. Visit your doctor regularly.

• If you need surgery, speak the surgeon onward of time that you are using azathioprine. You may need to stop using the medication for a short time.

• Store at room temperature away from moisture, heat, and light.

What happens if I miss a dose?

• If you take this medication once daily and you miss a doze, take the missed doze as soon as you remember. Skip the missed doze if it is nearly time for your following scheduled doze. Do not take extra medication to create up the missed dose.

• If you take this medication more than once daily and you miss a doze, take the medication as soon as you remember. If it is nearly time for the following doze, take both doses together, then go back to your regular dosing schedule.

• Call your doctor if you have missed more than one dose.

What happens if I overdose?

• Search abnormal medical attention or call the Poison Help line at 1-800-222-1222.

• Overdose symptoms may include nausea, vomiting, stomach pain, diarrhea, bleeding, fever, chills, and another signs of infection.

What must I avoid while taking azathioprine?

• Avoid being around people who have colds, the flu, or another contagious illnesses. Contact your doctor at once if you develop signs of infection.

• Do not receive a "live" vaccine while using azathioprine, and avoid coming into contact with anyone who has recently received a live vaccine. There is a chance that the virus could be passed on to you. Live vaccines include measles, mumps, rubella (MMR), Bacillus Calmette-Guérin (BCG), oral polio, rotavirus, smallpox, typhoid, yellow fever, varicella (chickenpox), H1N1 influenza, and nasal flu vaccine.

What are the possible side effects of azathioprine?

• Get abnormal medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your person, lips, tongue, or throat.

• Stop using azathioprine and call your doctor right away if you have any of these symptoms of lymphoma:

· fever, night sweats, weight loss, tiredness;

· feeling full after eating only a little amount;

· pain in your upper stomach that may spread to your shoulder;

· light bruising or bleeding, pale skin, feeling light-headed or short of breath, rapid heart course; or

· nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

• Stop using azathioprine and call your doctor at once if you have any of these another serious side effects:

· signs of infection (fever, chills, sore throat, body aches, weakness, muscle pain, flu symptoms);

· severe nausea, vomiting, or diarrhea;

· pain or burning with urination; or

· white patches or sores internal your mouth or on your lips.

• Smaller serious side effects may include:

· mild upset stomach, nausea, diarrhea, loss of appetite;

· hair loss; or

· skin rash.

• This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may message side effects to FDA at 1-800-FDA-1088.

What another drugs will affect azathioprine?

• Till taking azathioprine, speak your doctor if you are taking, have taken, or need to take any of the next medicines:

· allopurinol (Zyloprim);

· mercaptopurine (Purinethol);

· methotrexate (Rheumatrex, Immunex);

· a blood thinner such as warfarin (Coumadin, Jantoven);

· cyclosporine (Gengraf, Neoral, Sandimmune);

· olsalazine (Dipentum), or sulfasalazine (Azulfidine);

· sulfamethoxasole and trimethoprim (Bactrim, Septra, Sulfatrim, SMX-TMP, others); or

· an ACE inhibitor such as benazepril (Lotensin), captopril (Capoten), fosinopril (Monopril), enalapril (Vasotec), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), or trandolapril (Mavik).

• This list is not complete and another drugs may interact with azathioprine. Speak your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal commodity. Do not start a new medicine without telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about azathioprine.

Remember, hold this and all another medicines out of the reach of children, never share your medicines with others, and use this medicine only for the indication prescribed.

Disclaim: Each effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses external of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way must be construed to indicate that the drug or drug combination is safety, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the help of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

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