What does it do?

Azathioprine is an immunosuppressant used with other medicines to prevent transplant rejection.

Before you start

• You will need a blood test to check if azathioprine is suitable for you.
• Azathioprine weakens your immune system, making it harder for your body to fight infections. You may need tests before you start to make sure you don't have any infections like tuberculosis (TB), HIV, or hepatitis B and C.
• Ask your doctor what vaccines you might need before you start and while you are taking azathioprine. You should not have a live vaccine while taking azathioprine.
• If you plan to become pregnant, or find you are pregnant, discuss this with your doctor. Tell your doctor if you are breastfeeding.

How should you take it?

Take azathioprine regularly as directed with a glass of water. Swallow the tablets whole – do not break, crush or chew.

What if you forget a dose?

Take the missed dose as soon as possible. If it is close to the time for your next dose, skip the missed dose and carry on as normal. Do not take two doses at the same time.

Can you take other medicines?

Some medicines available without a prescription may react with azathioprine including:

• trimethoprim

Tell your pharmacist or doctor about all medicines or treatments that you may be taking, including vitamins, herbal products (e.g. echinacea) or recreational drugs.

What side effects might you notice?

Side Effects	Recommended action
Reduced number of blood cells that fight infections or help your blood to clot - symptoms include: fever, chills, sore throat or generally feeling unwell, or easy or unusual bruising or bleeding Severe stomach pain Symptoms of liver problems including: yellow skin or eyes, itching, dark urine, pale bowel motions, abdominal pain	Tell your doctor immediately
Skin rash	Tell your doctor
Vomiting, diarrhoea	Tell your doctor if troublesome
Nausea	Take with food

If you notice any other effects, discuss them with your doctor or pharmacist.

Other information:

• Allopurinol (a medicine sometimes prescribed for gout) can cause a serious reaction with azathioprine. Discuss with your doctor.
• Do not stop taking azathioprine unless your doctor at the transplant clinic tells you to. You may have to take azathioprine for the rest of your life.
• You will need regular blood tests while you are taking azathioprine to check if it is causing problems with your liver or blood, and to make sure you are on the right dose.
• Protect yourself from too much sunlight while taking immunosuppressant medicines (they may increase your risk of skin cancer). Always cover up and apply a thick layer of broad spectrum sunscreen (at least SPF30) when outside. Do not use sunbeds.
• Women using azathioprine for a long time may need cervical screening more often. Discuss with your doctor.
• It is important to tell anyone who gives you medical or dental treatment that you are taking azathioprine.