Azathioprine, which goes by brand names Imuran and Azasan, is an immunosuppressant drug often used in lupus patients in addition to or instead of steroid therapy.
Immunosuppresives are potent drugs that help control disease activity in major organs. They may also reduce/eliminate the need for steroids.
Azathioprine is only available by prescription.
Note that mycophenolic acid has been shown to significantly reduce steroid dosage for patients with lupus nephritis or treatment-resistant systemic lupus erythematosus, and is considered a first-line therapy for lupus nephritis, replacing azathioprine.
The immune systems of lupus patients produce autoantibodies at a rapid rate. Azathioprine works by suppressing the cells involved in the hyperactive immune response.
- Pregnant and nursing mothers
- Those planning to get pregnant (both women and men)
- Those taking allopurinol, tubocurarine, penicillamine, captopril, warfarin, cimetidine, indometacin, cytostatic drugs, balsalazide, mesalazine, olsalazine or sulfasalazine
- Those who are suffering from liver or kidney disease
- Those who produce little thiopurine methyltransferase
- Those with Lsech-Nyhan Syndrome
Though dosage varies by patient, most take the drug once a day. Your doctor will determine your regimen.
Contact your doctor immediately if you develop any of the following symptoms:
- Feeling sick and/or being sick
- Diarrhea
- Fever, shivering/chills
- Skin rash
- Muscle and bone pain
- Changes in quantity and color of urine passed (may signal kidney problems)
- Tiredness
- Dizziness
Hair loss is another possible side effect, though it is somewhat rare (1 in 1,000 patients). Hair often returns, even while the drug is still being used.
More serious side effects of azathioprine include:
- Fever
- Chest or other infection
- Unexpected bruising or bleeding
- Bad diarrhea and/or abdominal pain
- Jaundice
- Serious skin reaction
- Lumps on the body or patches on the skin
Azathioprine goes by brand names Azasan, made by the pharmaceutical company Salix, and Imuran, produced by GlaxoSmithKline.
Sources:
Imuran. GlaxoSmithKline. Our Products
Azathioprine. MedlinePlus Drug Information. U.S. National Library of Medicine. National Institutes of Health.
Immune Suppressants. Lupus Foundation of America.
Glomerular DiseasesNational Kidney and Urological Diseases Information Clearinghouse. NIH Publication No. 07–4358. April 2006.
