Azathioprine is an immunosuppressant drug. It is used for immune system suppression to those experiencing over activity of the immune system or those who require inhibiting the immune system for some reason. Azathioprine is available in the brands Imuran and Azasan. It is also a precursor, which is converted to mercaptopurine, an active form of azathioprine.
Uses of Azathioprine
Azathioprine suppresses the proliferation of B lymphocytes and T lymphocytes in the blood. T and B lymphocytes are important components of the immune system that help the body fight infections. Because of its effects in suppressing the immune system, it is used for the following conditions:
Kidney transplantation – Kidney transplantation requires azathioprine to prevent the organ rejection brought by the immune system’s reaction to the foreign kidney.
Autoimmune diseases – Autoimmune diseases such as rheumatoid arthritis may also require immunosuppressant drugs like azathioprine to prevent the action of the immune system against its own body cells. The use in rheumatoid arthritis prevents further inflammation and joint damage.
Others – Other indications include Multiple sclerosis, Myasthenia gravis, Crohn’s disease, Ulcerative colitis, and Autoimmune hepatitis.
Azathioprine Side effects
There are lot of side effects of azathioprine including:
1. Reduces white blood cell count
The reduction in white blood cell count leads to possible infections. Presence of recurrent sore throat may be a sign of lowered levels of the white blood cells. Reduced white blood cell count may be reversed upon discontinuation or lowering the dose.
2. Nausea and Vomiting
Nausea and vomiting are other Azathioprine side effects. These azathioprine side effects result from the affectation of the gastrointestinal system. Nausea and vomiting usually occur during the first months of azathioprine therapy. Nausea and vomiting may also be associated with hypersensitivity pancreatitis.
3. Loss of appetite
It may also lead to loss of appetite because of the potential gastrointestinal symptoms brought by azathioprine.
4. Liver toxicity
Azathioprine is a potential hepatotoxic drug, which may lead to increased liver enzymes as a sign of liver damage. Liver toxicity usually results in azathioprine side effects such as jaundice, abdominal pain, liver enlargement and cirrhosis.
5. Hypersensitivity reactions
Hypersensitivity reactions are also possible azathioprine side effects. These may result from the decreased immune system; thereby there are excessive reactions to other substances. Hypersensitivity reactions may include erythema, itching, skin rash and more severe forms such as erythema nodosum.
Fatigue may also be experienced as a result of blood dyscrasia such as anemia. Anemia may be reversed by discontinuing or reducing the dosage of the drug.
7. Hair loss
Hair loss is also an azathioprine side effect because of induced damage to the hair follicles.
Arrhythmias are cardiovascular side effects of azathioprine that have been observed in patients taking the drug. Hypotension may also be apparent. Arrhythmias and hypotension are possible effects of hypersensitivity reactions.
Due to the decreased immune system, opportunistic infections may also proliferate in the gut leading to diarrhea as azathioprine side effect. This can be avoided by avoiding potential sources of infection.
10. Joint pains
The joints may also be affected leading to arthralgias as azathioprine side-effects.
11. Interstitial pneumonitis
This respiratory azathioprine side effect is traced to the effects of the restrictive pulmonary disorders as a result of intake of immunosuppressant drugs.
12. Renal problems
Renal problems such as renal failure, acute nephritis and glomerulonephritis may be experienced by patients taking azathioprine. Problems in the kidneys may manifest as increased creatinine and BUN, with oliguria or anuria or the absence of urination.
The presence of azathioprine side effects may never outweigh the potential benefits for people undergoing kidney transplant and those who have autoimmune disorders, thereby the use of azathioprine is still considered.
- Overactive Bladder – Symptoms, Medications, Treatment, Causes
- Inositol Side Effects (Top 8)