These medications should not be used together. Taking drugs called aminosalicylates with azathioprine can increase the levels of azathioprine in your body and increase your risk of bleeding disorders.
These are TNF-modifier drugs. They work to reduce inflammation and immune system response. Taking these drugs with azathioprine may increase your risk of infection. Examples of these drugs include:. Using cotrimoxazole with azathioprine can decrease the amount of white blood cells in your body needed to fight an infection.
This increases your risk of infection. Using drugs called angiotensin-converting enzyme ACE inhibitors with azathioprine can increase your risk of blood disorders. Using warfarin with azathioprine can make warfarin less effective for you. Your doctor may closely monitor your levels of warfarin when starting and stopping treatment with azathioprine.
Using ribavirin with azathioprine can increase the levels of azathioprine in your body and increase your risk of side effects. Receiving live vaccines while taking azathioprine may increase your risk of negative side effects from the vaccine. Examples of live vaccines include:. Receiving an inactivated vaccine while taking azathioprine may make the vaccine less effective.
However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking. Taking it again could be fatal cause death. Your doctor may do a test to check the levels of TPMT in your body. For people with low blood cell counts: Azathioprine raises your risk of lowered blood cell counts.
Having certain genetic problems can also increase your risk. Your doctor may do blood tests, lower your dosage of azathioprine, or stop your treatment with the medication.
For people with infections: This medication decreases the activity of your immune system. This may make infections that you have even worse. For people with liver problems: Azathioprine can increase your risk of liver problems, usually in people with kidney transplants.
Your doctor will take blood tests to check how well your liver is working. Liver problems usually happen within 6 months of kidney transplant and usually go away when azathioprine is stopped. For pregnant women: Azathioprine is a category D pregnancy drug.
That means two things:. Azathioprine should be used during pregnancy only if the potential benefit justifies the potential risk. For women who are breastfeeding: Azathioprine passes into breast milk and may cause side effects in a child who is breastfed. All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:. For people with kidney problems: Your dosage of azathioprine may need to be lowered if you have kidney problems that prevent you from urinating regularly.
This enzyme helps to break down the drug. Four RCTs participants compared discontinuation to continuation of azathioprine monotherapy, while two studies participants compared discontinuation of azathioprine from a combination regimen to continuation of combination therapy.
Continuation of azathioprine monotherapy was shown to be superior to withdrawal for risk of clinical relapse. However, it is uncertain if there are any between-group differences in new CD-related complications RR 0. Common adverse events included infections, mild leukopenia, abdominal symptoms, arthralgias, headache and elevated liver enzymes. No differences between azathioprine withdrawal from combination therapy versus continuation of combination therapy were observed for clinical relapse.
The effects on adverse events RR 1. Common adverse events in the combination therapy studies included infections, liver test elevations, arthralgias and infusion reactions. Background Crohn's disease is a serious, chronic, inflammatory disease of the small and large intestine.
Study characteristics We performed a comprehensive literature review and identified six randomized controlled trials an experiment in which participants are randomly assigned to receive two or more interventions and the results are compared that involved a total of participants. Quality of evidence Overall, the quality of evidence for each outcome was low due to a high risk of study bias and small numbers of patients evaluated.
Conclusions The effects of withdrawal of immunosuppressant therapy in people with Crohn's disease in remission are uncertain. Authors' conclusions:. Search strategy:. Selection criteria:. Data collection and analysis:. Using this medicine while you are pregnant can harm your unborn baby.
Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using this medicine, tell your doctor right away. Using these medicines together could cause serious unwanted effects. Using azathioprine after these medicines may increase your risk for unwanted effects. Talk to your doctor if you have questions about this. This medicine may increase your risk of getting certain types of cancer, especially of the skin, lymph system lymphoma , or blood leukemia.
Talk to your doctor if you have concerns about this risk. Use sunscreen or sunblock lotions with a sun protection factor SPF of at least 15 on a regular basis when you are outdoors. Wear protective clothing and hats, and stay out of direct sunlight between the hours of 10 am and 3 pm Avoid sunlamps and tanning beds. While you are being treated with azathioprine, and after you stop treatment with it, do not have any immunizations vaccines without your doctor's approval.
Always follow your doctor's instructions for how to take azathioprine. You'll usually take your tablets once or twice a day. You can take them with or without food. Your dose depends on your body weight and why you need to take azathioprine. Your doctor will tell you how much to take.
From day 2 onwards, you'll take 1mg to 4mg for each kilogram you weigh. You'll usually need to take this medicine long term, probably for the rest of your life. The usual starting dose is 1mg to 3mg each day, for each kilogram you weigh. However, it takes a while for azathioprine to work. You may have to wait a few months to see an improvement.
Taking azathioprine can sometimes affect your liver, kidneys or bone marrow. You will have blood tests to check your liver function, kidney function and blood count before you start taking this medicine. From week 1 to week 8 of your treatment you'll have blood tests every week. This is particularly important if you're taking a high dose, or you have kidney or liver problems.
From week 9 onwards you will have blood tests less often. Your doctor will decide how often you need them. You may only need them every few months.
It's important to have ongoing monitoring for as long as you're taking this medicine. If you forget to take 1 dose, take it as soon as you remember, unless it's almost time for the next dose. In this case, skip the missed dose and take the next one at the usual time. If you forget doses often, it may help to set an alarm to remind you. You could also ask a pharmacist for advice on other ways to help you remember to take your medicine.
If you need to go to hospital, take the medicine packet or leaflet inside it, plus any remaining medicine, with you. Like all medicines, azathioprine can cause side effects, but not everyone gets them.
These common side effects happen in more than 1 in 10 people when you first start treatment or when your dose is increased.
Stop taking your medicine and contact your specialist or a doctor immediately if:. In rare cases, it's possible to have a serious allergic reaction anaphylaxis to azathioprine. You could be having a serious allergic reaction and may need immediate treatment in hospital.
These are not all the side effects of azathioprine. For a full list, see the leaflet inside your medicine packet. You can report any suspected side effect to the UK safety scheme. These side effects are more likely when you first start taking azathioprine or when your dose is increased. You will usually feel better after a week or so. Talk to your doctor if these side effects do not go away or they get worse.
Azathioprine is not recommended in pregnancy by the manufacturer. This appears in the leaflet that comes with your medicine. If you become pregnant, do not stop taking your medicine and speak to your doctor.
For this reason, you will need to keep taking your medicine if you have an autoimmune condition or have had an organ transplant. If your baby is unwell, speak to a doctor, your midwife or health visitor and ask for advice. It is important to tell them that you took azathioprine during pregnancy.
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