Azathioprine 50mg Tablet

Azathioprine – Purine Analogue Immunosuppressant / DMARD

Azathioprine contains Azathioprine, a purine analogue immunosuppressant / dmard for rheumatoid arthritis (dmard), organ transplant rejection prevention, ibd (crohn’s, uc), autoimmune hepatitis, sle, myasthenia gravis. ACR-recognised DMARD; ECCO guideline first-line for Crohn’s disease steroid-sparing; established transplant immunosuppressant since 1960s.

Product Information

How It Works

Metabolised to 6-mercaptopurine (6-MP) and 6-thioguanine nucleotides — incorporated into DNA blocking purine synthesis and lymphocyte proliferation, suppressing T and B cell-mediated immunity.

People Also Ask

How long does azathioprine take to work?

Azathioprine’s immunosuppressive effect develops over 3–6 months as active metabolites accumulate in lymphocytes. For IBD steroid-sparing, significant benefit is often not apparent until month 3–4. For RA, clinical improvement takes similarly long. This slow onset means azathioprine should be started early in parallel with faster-acting treatments (steroids, NSAIDs) while awaiting the full DMARD effect.

What is TPMT testing before azathioprine?

Thiopurine methyltransferase (TPMT) is the enzyme metabolising azathioprine. Patients with low or absent TPMT activity accumulate toxic metabolites causing severe bone marrow suppression at standard doses. TPMT genotyping or phenotyping before starting azathioprine guides dosing: normal TPMT — standard dose; intermediate — reduce dose by 50%; deficient — azathioprine is contraindicated.

What blood tests are required during azathioprine treatment?

Full blood count (CBC) weekly for the first month, every 2 weeks for 3 months, then monthly. Liver function tests (LFTs) every 3 months. Sudden reduction in white blood cells or platelets requires immediate dose reduction or cessation. Annual skin cancer check is recommended as azathioprine increases skin malignancy risk with long-term use.

Is azathioprine the same as methotrexate for RA?

Both are DMARDs but methotrexate is generally preferred as first-line due to faster onset, better tolerability profile, and superior RA trial evidence. Azathioprine is used when methotrexate is contraindicated (renal impairment, hepatic disease) or has failed. For IBD (where methotrexate is used less commonly), azathioprine is typically first-line steroid-sparing therapy.

Can azathioprine cause cancer?

Long-term azathioprine use increases risk of non-melanoma skin cancer and lymphoma — due to sustained immunosuppression impairing tumour immune surveillance. Lifetime sun protection is essential for patients on long-term azathioprine. Annual skin checks are recommended. The absolute risk is small but increases with duration; this is a class effect of all immunosuppressants.

Storage

Store at 15–30°C away from sunlight and moisture. Keep out of reach of children.