Azathioprinum English: azathioprine
Scope of application
Azathioprine® is a drug that inhibits the body’s immune system. Azathioprine therefore belongs to the class of immunosuppressive drugs, and here precisely to the subclass of purine analogues. Azathioprine® is mainly used to suppress the immune system after organ transplants in order to avoid rejection of the new organ by the body’s own immune system.
In addition, Azathioprin® is used in various autoimmune diseases, i.e. diseases in which the immune system attacks the body itself. That is why Azathioprin® is used, among other things, in
- Multiple sclerosis
- Myasthenia gravis
- Lupus erythematosus
- Pemphigus vulgaris
- Various forms of rheumatoid arthritis and
Azathioprine® is also used to treat various chronic inflammatory diseases. These include inflammatory diseases of the gastrointestinal tract, such as Crohn’s disease or ulcerative colitis, and systemic Behçet’s disease.
Azathioprine® is often used when cortisone no longer promises sufficient treatment success. Azathioprin® works by inhibiting DNA synthesis, which particularly affects cells that divide very frequently. These include the T-cells and B-cells of the immune system.
Dose and intake
Azathioprin® can be administered intravenously as a tablet or by infusion. The dose of Azathioprin® is determined individually by the physician and depends on how well the substance can be broken down in the body. In order for the attending physician to know how well the substance is broken down in the body, an appropriate laboratory test should be carried out before therapy.
Most frequently, patients are administered approximately 2 – 2.5 mg Azathioprin® per kilogram of body weight. Since Azathioprine is usually administered in 25mg and 50mg tablets, the doctor should determine in advance exactly how many tablets must be taken per day and whether they should be halved beforehand. It usually takes 12 – 20 weeks before the effects of Azathioprin® are felt, which is why taking the tablets should not be stopped too early.
However, patients often notice an improvement after 4 – 8 weeks, although it can take up to half a year before symptoms improve. If the effects do not appear for a long time, the treating doctor may consider increasing the dose. Before starting the therapy, the attending physician should be informed about all other medications that are currently being taken.
It is particularly important to inform the doctor about medications that are effective against increased uric acid and gout (e.g. allopurinol), as Azathioprine® can cause particularly severe side effects when taken together with these medications. While taking Azathioprin®, vaccinations with live vaccines should be avoided. Since the flu vaccine is not a live vaccine, it is safe to take while taking Azathioprine.
Azathioprine®, like all other drugs, has side effects. Therefore, particularly close monitoring is necessary when Azathioprine® is taken over a long period of time so that any side effects that may occur can be detected early on. The most common side effects of Azathioprine® are gastrointestinal symptoms such as nausea, vomiting and diarrhea.
This can also lead to weight loss. These symptoms can also occur: Black stools should also be reported directly to the treating physician. Furthermore, bleeding in the skin and bruising may occur for which no external cause is known.
Azathioprine may also cause hair loss, joint pain and inflammation of the pancreas (pancreatitis). It is recommended that regular blood tests be carried out during therapy with Azathioprine® so that changes in the liver and kidney can be detected early. Azathioprine® can be used during pregnancy, as current studies show that there is no increased risk of malformation in the unborn child.
However, Azathioprine should not be used during breast-feeding because it can be transmitted to the child through breast milk to a small extent and the long-term consequences for the child cannot be predicted here. The fertility of both men and women is not affected by therapy with Azathioprin®. Furthermore, years of taking Azathioprin® after liver or kidney transplants, for example, considerably increases the risk of skin cancer. – Fever
- Unusually strong gum bleeding and
- Blood in the stool