Precautions and Warnings With Azathioprine

Understanding azathioprine warnings and precautions can help ensure a safe treatment process. For example, the drug should be avoided by people who have taken certain chemotherapy medications in the past. Precautions and warnings also include being aware that azathioprine may cause certain types of cancers and may decrease the body's ability to produce blood cells that are important for the immune system.

Azathioprine: What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking azathioprine (Imuran®) if you have:
  • Taken chemotherapy medications in the past
  • A blood disorder
  • Any infection.
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
Be sure to tell your healthcare provider about all of the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Specific Precautions and Warnings With Azathioprine

Warnings and precautions to be aware of prior to taking azathioprine include the following:
  • The medication can decrease the body's ability to produce blood cells, including blood cells that are important for the immune system. It is recommended that you have blood tests frequently (weekly for the first month, twice a month for the next two months, and then at least monthly) to check for these problems.
  • Azathioprine works by suppressing the immune system. While this is helpful for preventing kidney transplant rejection or for treating rheumatoid arthritis, it also puts you at higher risk for infection. Your body may not be able to fight off infection as well as it should. Let your healthcare provider know if you have any signs of an infection during treatment.
  • The medication can increase your risk of certain types of cancers, especially skin cancer or lymphomas. Let your healthcare provider know if you have any unusual skin changes or other unusual symptoms while taking the drug.
  • You could develop a serious brain infection called progressive multifocal leukoencephalopathy (PML) during treatment with azathioprine. PML can cause severe disability and death. Contact your healthcare provider right away if you experience problems with vision, movement, or thinking.
  • Azathioprine can decrease sperm production in men. This is usually temporary and corrects itself once the medication is stopped.
  • Azathioprine is considered a pregnancy Category D medication. This means that it is probably not safe for pregnant women, although the full risks are not known. Be sure to talk to your healthcare provider about the risks and benefits of using the drug while pregnant (see Imuran and Pregnancy).
  • Azathioprine passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider before taking the drug (see Imuran and Breastfeeding).
  • Azathioprine can interact with certain medications (see Drug Interactions With Azathioprine).
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Azathioprine (Imuran) Information

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