Azathioprine

You may experience the following side effects while on Azathioprine. Tell your doctor if you encounter any of them so that adjustments to your therapy may be made to reduce the occu​​rrence of these sid​e effects where possible. These include:

• Nausea and vomiting
• Diarrhoea
• Dizziness or light-headedness
• Hair loss
• Increase risk of infections

Please inform your doctor if you experience any other side effects or if the side effects become severe and bothersome.

There are some potentially serious but rare side effects that may be experienced when you are using Azathioprine. These include:

• ​Hypersensitivity reactions such as rash, swelling in face, breathing difficulties
• Bone marrow suppression, manifested as sore throat, mouth ulcers, unexplained bruising/bleeding, unusual tiredness, prolonged infection or fever​
• Yellowing of skin and/or eye(s), dark-coloured urine

Stop using Azathioprine and inform your doctor immediately if you experience any of the potentially serious side effects.

Do not give your child or yourself any other medications or herbal products without consulting your doctor or pharmacist. Some medication or food may reduce its effectiveness or increase the incidence of side effects where close monitoring is required. These include:

• Immunosuppresants such as Mercaptopurine
• Anti-gout agents such as Allopurinol
• DMARDs such as Penicillamine
• Certain antibiotics such as Co-trimoxazole (Bactrim®)
• Live vaccines such as BCG, MMR and some forms of polio or influenza vaccines

Azathioprine should preferably be taken at the same time every day. For twice daily regimens, a 12 hours interval is preferred.

Azathioprine is available in tablet form.

Azathioprine is usually taken orally once or twice daily with or after food.

Do not stop taking Azathioprine unless you are told to do so by your doctor. Do not take more or less than required unless instructed.

Drugs commonly co-administered:

• Other DMARDs such as Hydroxychloroquine, Methotrexate and Sulphasalazine
• Corticosteroids such as Prednisolone
• Non-steroidal anti-inflammatory drugs (NSAIDs) such as Ibuprofen, Indomethacin and Naproxen
• Biologic agents such as Adalimumab, Etanercept and Infliximab

If you forget a dose, take it as soon as you remember. If it is nearer to the time of your next dose, skip the missed dose. Do not take two doses at the same time.

To minimise drug exposure to other members of the family, the following methods of administration are recommended:

• Place tablets onto a spoon dedicated for use with Azathioprine and administer directly to the mouth. Avoid contact with fingers if possible and wash hands and the spoon thoroughly after taking Azathioprine.
• Pregnant or breastfeeding women are advised to wear gloves as extra precaution where possible.
• For patients who are unable to swallow tablets whole, it is advised to soak the tablets in water for a few minutes before grinding them to minimise the inhalation of medication powder.

Keep away from children;#Keep in a cool, dry place, away from direct sunlight;#Store at room temperature;# Store below 25°C.

Proper Disposal

You are advised to bring Azathioprine to the pharmacy for proper disposal if you are to stop the drug permanently

Compliance to follow up visits

While taking Azathioprine, you should be seeing your specialist doctor regularly to ensure that your treatment is optimized and to address any concerns relating to your treatment.

Regular laboratory tests may be conducted as directed by your doctor.

Supply of Drugs

You are advised not to purchase more Azathioprine than required before your next visit in case of dose changes or discontinuation of therapy.

Caregiver advice

If you are pregnant or breastfeeding, extra precaution should be taken when handling Azathioprine as it may cause harm to the developing foetus or baby. Do not give Azathioprine to anyone else. It has been prescribed for a specific condition, may not be the correct treatment for another person, and would be dangerous if the other person is pregnant or breastfeeding.