Azathioprine
Azapress, Imuran
Granskad av Sid DajaniSenast uppdaterad av Michael Stewart, MRPharmSSenast uppdaterad 15 Sept 2022
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Azathioprine will be prescribed for you by a specialist doctor.
Swallow the tablets whole with plenty of water, after a meal. Do not crush or break the tablets.
Azathioprine may reduce your body's resistance to infections. Try to keep away from people who you know are ill. It is important to protect yourself from serious illness by having any vaccinations your doctor offers you.
Överblick
Azathioprine is an immunosuppressant medicine that suppresses your immune system.
It is used to prevent organ rejection and to treat long-term inflammatory and autoimmune conditions.
Take tablets after food or with a snack and do not drink milk with your dose.
You will need regular blood tests whilst taking this medicine.
Avoid strong sunlight and use sun cream with a high SPF due to an increased risk of skin cancer.
Tell your doctor straight away if you get signs of infection or unexpected bruising/bleeding.
About azathioprine
Typ av medicin | An immunosuppressant |
Används för | To prevent organ rejection following transplant operations To treat chronic inflammatory and autoimmune conditions |
Även kallad | Azapress®; Imuran® |
Tillgänglig som | Tabletter, flytande medicin och injektion |
Azathioprine is an immunosuppressant, which simply means that it suppresses your immune, or defence, system. It is used to help prevent rejection following organ transplant operations and also to treat a variety of long-term (chronic) inflammatory and autoimmune conditions, such as reumatoid artrit, systemisk lupus erythematosus, och Crohns sjukdom.
Following organ transplant operations, it is natural for your body to try to reject the new tissue as it regards it as 'foreign'. By suppressing your defence system, azathioprine helps to prevent your body from fighting the new organ.
In chronic inflammatory and autoimmune conditions your immune system attacks part of your own body as if it were foreign. Azathioprine reduces inflammation and the symptoms it causes because it suppresses your immune system.
Before taking azathioprine
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking azathioprine it is important that your doctor or pharmacist knows:
Om du är gravid, försöker bli gravid eller ammar.
Om du har lever- eller njurproblem.
If you have any infection.
If you have ever had chickenpox or shingles.
If you have been told you have a rare, inherited metabolic disorder called Lesch-Nyhan syndrome or you have a lack of an enzyme called TPMT.
Om du tar eller använder några andra läkemedel. Detta inkluderar alla läkemedel du tar som finns att köpa utan recept, samt växtbaserade och komplementära läkemedel.
If you have ever had an allergic reaction to a medicine. It is particularly important that you tell your doctor if you are allergic to a medicine called mercaptopurine.
How to take azathioprine
Before you start this treatment, read the manufacturer's printed information leaflet from inside your pack. The leaflet will give you more information about azathioprine, how to take it, and a full list of side-effects which you may experience from taking it.
Your doctor will prescribe a dose for you which is tailored to your weight and the reason why you are taking it. Make sure you take the tablets exactly as your doctor has told you - your dose will be on the label of the pack to remind you.
Take the tablets after eating a meal or with a snack. This will help to stop any feelings of queasiness or nausea. Drink plenty of water as you take the tablets.
Do not drink milk or eat dairy products (such as yoghurt) at the same time as taking your azathioprine dose. Dairy products contain an enzyme which can break down azathioprine making your treatment less effective.
Try to take your doses at the same time of day each day, as this will help you to remember to take them. If you forget to take a dose at the usual time, take one as soon as you remember, but do not take two doses together to make up for a missed dose.
Your doctor will tell you how long your treatment is expected to continue. Keep taking azathioprine until your doctor tells you otherwise.
Få ut det mesta av din behandling
Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress. Your doctor will want you to have regular blood tests during this treatment, to monitor for unwanted side-effects.
This medicine lowers your natural protection against infection. It is important to protect yourself from serious illness by having any vaccinations your doctor offers you. If you live with other people they can also help protect you by having their own vaccinations.
Some vaccines may not be suitable for people with lowered immune systems. Always let the person vaccinating know that you are taking this medicine.
It is important to try to avoid anyone who has chickenpox or shingles. Tell your doctor if you come into contact with anyone with these infections.
Your doctor will have discussed with you the possibility of a slightly increased risk of cancer (particularly skin cancer) associated with immunosuppressants like azathioprine. Do not use sunbeds, and avoid strong sunlight or use a sun cream with a high sun protection factor (SPF of at least 15).
You should avoid becoming pregnant while you or your partner are taking azathioprine. Make sure you have discussed with your doctor which types of contraception are suitable for you and your partner.
If you are having an operation or any dental treatment, tell the person carrying out the treatment that you are taking azathioprine.
If you buy any medicines, check with your doctor or a pharmacist that they are suitable for you to take with your other medicines.
Can azathioprine cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with azathioprine. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.
Azathioprine side-effects | What should I do if I experience this? |
Feeling extremely tired or dizzy, being sick (vomiting), loose or watery stools (diarrhoea), a high temperature (fever), muscle pain or stiffness, skin rash, kidney problems (such as a change in the amount or colour of your urine) | These may be signs of an allergic reaction. Let your doctor know straightaway |
Feeling unwell, a high temperature, a sore throat or symptoms of an infection | Let your doctor know straightaway. This is especially important if you have been near anyone with chickenpox or shingles |
Unexpected bruising or bleeding | These are symptoms of bone marrow suppression. Let your doctor know about this straightaway |
Loss of hair | This may resolve on its own, but speak with your doctor if it becomes troublesome |
If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist for advice.
How to store azathioprine
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Förvara på en sval, torr plats, borta från direkt värme och ljus.
Viktig information om alla läkemedel
Viktig information om alla läkemedel
Ta aldrig mer än den föreskrivna dosen. Om du misstänker att du eller någon annan kan ha tagit en överdos av denna medicin, gå till akutmottagningen på ditt lokala sjukhus. Ta med behållaren, även om den är tom.
Denna medicin är för dig. Ge den aldrig till andra människor även om deras tillstånd verkar vara detsamma som ditt.
Behåll inte föråldrade eller oönskade mediciner. Ta dem till ditt lokala apotek som kommer att ta hand om dem åt dig.
Om du har några frågor om denna medicin, fråga din apotekare.
Rapportera biverkningar av ett läkemedel eller vaccin
Om du upplever biverkningar kan du rapportera dem online via Yellow Card webbplats.

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Vanliga frågor
What is azathioprine, and why does it suppress my immune system?
Azathioprine is an immunosuppressant medicine. It works by reducing the activity of your body's immune system. This suppression is beneficial to prevent organ rejection after a transplant, as your body would naturally see the new organ as 'foreign'. It also helps treat chronic inflammatory and autoimmune conditions where your immune system mistakenly attacks your own body tissues.
Are there any specific medical conditions or previous illnesses I need to tell my doctor about before starting azathioprine?
Yes, it is important to inform your doctor or pharmacist if you have liver or kidney problems, any active infection, or if you've ever had chickenpox or shingles. You should also mention if you have a rare inherited metabolic disorder called Lesch-Nyhan syndrome or a lack of the enzyme TPMT.
Why do I need regular blood tests while taking azathioprine?
Regular blood tests are essential to monitor your progress and check for potential unwanted side-effects. These tests help your doctor ensure that the medicine is working effectively and safely, and to detect any issues early.
What should I do if I come into contact with someone who has chickenpox or shingles while I'm on azathioprine?
Your natural protection against infection is lowered while taking azathioprine, so it is important to try to avoid anyone with chickenpox or shingles. If you do come into contact with someone who has these infections, you should tell your doctor straightaway.
If I am planning to have an operation or dental work, do I need to inform the medical staff about taking azathioprine?
Yes, you must tell the person carrying out the operation or any dental treatment that you are taking azathioprine. This is important for them to be aware of your current medication regimen.
What are the common side-effects of azathioprine that I should be aware of?
Some common side-effects include feeling extremely tired or dizzy, vomiting, diarrhoea, a high temperature, muscle pain or stiffness, skin rash, and kidney problems. Some people may also experience hair loss. While many of these improve as your body adjusts, you should speak with your doctor or pharmacist if they persist or become troublesome.
Should I be concerned about an increased risk of cancer when taking azathioprine?
Your doctor will have discussed that immunosuppressants like azathioprine can be associated with a slightly increased risk of certain cancers, particularly skin cancer. To mitigate this, you should avoid sunbeds, strong sunlight, and always use a sun cream with a high sun protection factor (at least SPF 15).
Vidare läsning och referenser
- Manufacturer's PIL, Imuran® 25 mg and 50 mg Tablets; Aspen Pharma Trading Ltd. The electronic Medicines Compendium. Dated June 2021.
- Mediciner Komplett BNF 89:e Utgåvan; Brittiska Läkarföreningen och Kungliga Farmaceutiska Sällskapet i Storbritannien, London.
Om författarenVisa fullständig biografi

Michael Stewart, MRPharmS
Ansvarig för granskning av medicinbroschyrer – Konsult, Apotekare
BPharm (Hons), MRPharmS
Michael är en apotekare som arbetar i Midlands och South Yorkshire med mer än 20 års erfarenhet av att ge råd om läkemedel och medicinska tillstånd. Han har en stark bakgrund inom vårdutbildning och har producerat och levererat utbildningskurser för apoteksteam och personal inom vårdboenden, inklusive sjuksköterskor. Han har också bidragit till apoteksrådgivande styrelser för hantering av mindre allvarliga tillstånd i samhället.
Om recensenten

Sid Dajani
Sultan Dajani tog examen vid London School of Pharmacy 1994 och blev den yngsta valda medlemmen i Royal Pharmaceutical Society-rådet sedan dess grundande 1842.
Artikelhistorik
Informationen på denna sida är skriven och granskad av kvalificerade kliniker.
Artikeln finns också på Engelska, Tyska, Spanska, Franska, Italienska, Portugisiska, Hindi, Hebreiska, Arabiska, och Svenska.
Next review due: 13 Mar 2027
15 Sept 2022 | Senaste versionen

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