azathioprine
| Uses | • renal transplantation • rheumatoid arthritis • Crohn's disease • ulcerative colitis • dermatomyositis • polymyositis • immune thrombocytopenia |
| Contraindications, drug interactions or cautions | Contraindications • hypersensitivity to azathioprine, pregnancy, patients with rheumatoid arthritis and a history of treatment with alkylating agents (e.g., cyclophosphamide, chlorambucil, melphalan) Drug interactions • angiotensin-converting-enzyme inhibitor, allopurinol, mercaptopurine, natalizumab,rivavirin, sulfamethoxazole, tacrolimus, trimethoprim, warfarin Cautions • patients with rheumatoid arthritis and a history of treatment with alkylating agents (cyclophosphamide, chlorambucil, melphalan) may have a prohibitive risk of malignancy with azathioprine treatment |
| Adverse Effects (common and severe) | • malaise • nausea • vomiting • leukopenia • neolasia • thrombocytoenia • hepatotoxicity • increased susceptibility to infection • myalgia • fever |
| Instructions and dose (initial; typical) | indication-specific dosing (usual initial dose for patients with rheumatoid arthritis: 50 to 100 mg once daily) |
| Monitoring | • complete blood count • total bilirubin • liver function tests • creatinine clearance • thiopurine methyltransferase genotyping or phenotyping • symptoms of infection |
| Source of Suggestion | WHO Model List of Essential Medicines (Added on August 2016) |