Before taking azathioprine

Before taking azathioprine make sure your doctor or pharmacist knows:

• If you are pregnant, trying for a baby or breast-feeding.
• If you have liver or kidney problems.
• If you have an infection or have recently recovered from one.
• If you have ever suffered from chickenpox or shingles.
• If you know you have Lesch-Nyhan syndrome (a rare condition that runs in families).
• If you know you have a condition where your body produces too little of the chemical thiopurine methyltransferase (TPMT).
• If you are taking other medicines, including those available to buy without a prescription, herbal or complementary medicines.
• If you have ever had an allergic reaction to this medicine, a medicine called mercaptopurine, or any other medicine.

How to take azathioprine

• Before beginning treatment, read the manufacturer's printed information leaflet.
• Take azathioprine exactly as directed by your doctor. Take the tablets with or immediately after food.
• Try to take azathioprine at the same time each day to avoid missing any doses.
• If you do forget to take a dose, take one as soon as you remember but do not take two doses at the same time to make up for a missed dose.

Getting the most from your treatment

• Keep your regular doctor's appointment so your progress can be monitored. You will need regular blood tests while you are taking azathioprine.
• It is important to try to avoid anyone who is suffering from chickenpox or shingles. Tell your doctor if you come into contact with anyone with these infections.
• While you are taking azathioprine and for a time after you stop treatment, do not have any immunisations (vaccinations) without talking to your doctor first. Azathioprine lowers the body's resistance and there is a chance either that you may get an infection from the vaccine or that the vaccine will not work properly.
• While you are taking azathioprine you may become more sensitive to the harmful effects of sunlight. Avoid sitting out in the sun and use a sun cream of factor 15 or higher.
• If you are having any treatment like an operation or dental treatment, tell the person carrying out the treatment that you are taking azathioprine.
• If you buy any medicines, check with a pharmacist that they are safe to take with your other medicines.

Can azathioprine cause problems?

Along with their useful effects all medicines can cause unwanted side-effects. These usually improve as your body adjusts to the new medicine. Speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

• any unexplained bruising or bleeding
• a high temperature or other sign of an infection
• signs of an allergic reaction such as extreme tiredness, dizziness, being sick, diarrhoea, fever, muscle pain or stiffness, skin rash
• kidney problems such as a change in the amount or colour of your urine

If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.

How to store azathioprine

• Keep all medicines out of the reach and sight of children.
• Store in a cool, dry place, away from direct heat and light.

Important information about all medicines

References

• Manufacturer's PIL, Imuran® Tablets, GlaxoSmithKline UK, electronic Medicines Compendium. Dated February 2009, accessed January 2010.
• British National Formulary; 58th Edition (September 2009) British Medical Association and Royal Pharmaceutical Society of Great Britain, London.