Warnings
Azathioprine Risks, Warnings, and Complications
Azathioprine can cause serious adverse reactions in certain people. Talk to your doctor about alternative treatments if you are at a high risk of complications from azathioprine use. Some of the potential risks of taking azathioprine include:
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Precautions Before Starting Azathioprine
Tell your doctor if you have ever had an allergic reaction to azathioprine, any of the active or inactive ingredients in azathioprine tablets, or any other drugs. Your pharmacy can give you a list of ingredients.
Give your doctor a complete medical history. Azathioprine may not be right for people with certain health conditions, such as kidney disease or infections.
Give your doctor or pharmacist a complete list of your other medications, including prescription drugs, over-the-counter medicines, vitamins, supplements, and herbal products. This can help avoid possible interactions between azathioprine and your other medications.
Tell your doctor if you are pregnant, could be pregnant, or are planning a pregnancy. Also tell your doctor if you are breastfeeding.
Precautions During Use of Azathioprine
Keep all your healthcare appointments during treatment with azathioprine. Your doctor may want to perform certain blood tests to keep an eye on your blood cells and liver function.
Use birth control to ensure you or your partner do not become pregnant while you are on this medicine. Tell your doctor if you or your partner become pregnant while taking azathioprine.
Talk to your doctor before getting any vaccinations while on azathioprine.
Tell your doctor you are on azathioprine before any surgery, including dental procedures.
Azathioprine Drug Interactions
Certain other medicines can affect azathioprine if administered concomitantly. Azathioprine and other medicines taken together can also increase the risk of severe adverse reactions. Your doctor may change the doses of your medications and/or monitor you carefully for adverse effects if there are known interactions between azathioprine and your other medicines.
The following medications can have possible interactions with azathioprine:
- Alkylating agents for cancer such as chlorambucil (Leukeran), cyclophosphamide (Cytoxan), or melphalan (Alkeran)
- Blood pressure medications called angiotensin converting enzyme (ACE) inhibitors such as captopril, benazepril (Lotensin), enalapril (Vasotec), lisinopril (Prinivil, Zestril), fosinopril, moexipril (Univasc), quinapril (Accupril), perindopril (Aceon), trandolapril (Mavik), and ramipril (Altace)
- Other drugs that weaken the immune system and increase the risk of infection (such as rituximab, tofacitinib)
- Antibiotics like trimethoprim and sulfamethoxazole (Septra, Bactrim)
- Antiviral drugs like ribavirin (Rebetol, Copegus, Virazole)
- Medications used to treat gout such as allopurinol (Zyloprim) and febuxostat
- Anti-inflammatory medications called aminosalicylates such as mesalamine (Asacol, Apriso, Pentasa, others), sulfasalazine (Azulfidine), and olsalazine (Dipentum)
- Anticoagulants or blood thinners like warfarin (Coumadin)
The above list may not include all the possible interactions with azathioprine. Give your doctor or pharmacist a complete list of your medications, including prescription drugs, over-the-counter medicines, dietary supplements, and herbal remedies. Also, tell your healthcare provider if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause a serious reaction when used with prescription and over-the-counter medicines.
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