Product Details

What you need to know before you take Azathioprine

Do not take Azathioprine if: • You are allergic to Azathioprine, 6−mercaptopurine (a derivative of Azathioprine) or any of the other ingredients of this medicine (see section 6 “Contents of the pack and other information”) Warnings and precautions Talk to your doctor before taking Azathioprine: • If you are going to have a vaccination (see “Other medicines and Azathioprine” section) • If you are currently taking ribavirin (see “Other medicines and Azathioprine” section) • If you suffer from kidney or liver problems • If you have had Hepatitis B, a liver disease caused by a virus • If you suffer from Lesch−Nyhan Syndrome, a rare hereditary disorder caused by a deficiency of the enzyme HPRT (hypoxanthine-guanine-phosphoribosyltransferase) • If you have, have been exposed to or have ever suffered from chickenpox or shingles (varicella zoster virus infection) as the infection can become severe if you are taking immunosuppressants • If you are showing signs or symptoms (headache, loss of co-ordination, clumsiness, loss of speech, memory loss, vision problems, weakness of the legs and arms that gets worse) of having Progressive Multifocal Leukoencephalopathy [PML] (a rare infection caused by a virus that damages the material covering and protecting nerves in the brain) as treatment with Azathioprine should be withheld (see section 4 “Possible side effects, Very rare side effects…”) • If you have an inherited mutation in the NUDT15 gene (a gene which is involved in the breakdown of Azathioprine in the body) • If you suffer from an inherited condition where your body produces too little of the enzyme thiopurine methyltransferase (TPMT) • If you or your partner are pregnant or planning to become pregnant (see section “Pregnancy, breast-feeding and fertility”) • If you are receiving immunosuppressive therapy, taking Azathioprine could put you at greater risk of: tumours, including skin cancer. Therefore, avoid excessive exposure to sunlight and UV light, wear protective clothing and use a sunscreen with a high protection factor • If you are receiving treatment with multiple immunosuppressants (including thiopurines) as this may increase the risk of a type of cancer called lymphoproliferative disorder and disorders of the lymph system due to a viral infection (Epstein-Barr virus (EBV)-associated lymphoproliferative disorders) • If you suffer with autoimmune conditions such as inflammatory bowel disease (IBD), as this could put you at greater risk of developing a life-threatening disorder called Macrophage Activation Syndrome (excessive activation of white blood cells associated with inflammation) Other medicines and Azathioprine Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines, including those obtained without a prescription. This includes herbal medicines. Medicines which may interact with or be affected by Azathioprine: Before a surgical procedure tell the anaesthesiologist that you are taking azathioprine because muscle relaxants used during anaesthesia may interact with Azathioprine • Medicines used to treat gout such as allopurinol, oxipurinol, thiopurinol or other xanthine oxidase inhibitors, such as febuxostat. If these medicines are given concomitantly with Azathioprine, the dose of Azathioprine must be reduced to a quarter of the original dose • Muscle relaxants such as atracurium, rocuronium, cisatracurium or suxamethonium (also known as succinylcholine) and tubocurarine (neuromuscular blocking agents) • Medicines used to treat chronic inflammatory bowel diseases such as olsalazine, mesalazine, sulfasalazine (aminosalicylate derivatives) as lower doses of Azathioprine may need to be considered when given concomitantly • Medicines used to thin the blood such as warfarin, acenocoumarol (anti−coagulants) • Medicines used to treat high blood pressure or heart failure e.g. captopril (Angiotensin−Converting Enzyme [ACE] Inhibitors) • Medicines used to treat infections such as trimethoprim, sulphamethoxazole also known as cotrimoxazole (antibiotics) • Medicines used to treat stomach ulcers such as cimetidine (H2-receptor antagonist) • Medicines used to treat certain rheumatic disorders such as indomethacin (Non-Steroidal Anti−Inflammatory Drugs [NSAIDs]) • Cytostatic medicines (used to treat cancer) • Medicines which may have a myelosuppressive effect (decrease in bone marrow activity resulting in fewer red and white blood cells and platelets) such as penicillamine (mainly used in the treatment of rheumatoid arthritis) • Live vaccines and also inactive vaccines such as hepatitis B (see section 2 “Warnings and precautions”) • Ribavirin, used to treat chronic hepatitis C • Methotrexate, used to treat auto-immune conditions and cancers • Infliximab, mainly used in the treatment of ulcerative colitis and Crohn’s disease Taking Azathioprine with food and drink • Azathioprine may be taken with food or on an empty stomach. • Azathioprine should be taken 1 hour before or 2 hours after milk or dairy products. Pregnancy, breast-feeding and fertility • If you are pregnant or breast−feeding, think you may be pregnant or are planning to have a baby, ask your doctor for advice before taking this medicine. • Women of childbearing potential should use effective contraceptive measures while being treated with Azathioprine and for one month following completion of treatment. • Men should use effective contraceptive measures and not father a child while being treated with Azathioprine and for three months following completion of treatment. Pregnancy Do not take Azathioprine if you are pregnant, trying to become pregnant or think you may be pregnant. Breast-feeding It is recommended that women receiving Azathioprine should avoid breast-feeding (unless the benefits outweighs the potential risks) as 6-Mercaptopurine, a derivative of Azathioprine is passed into breast milk. Fertility The specific effect of Azathioprine on fertility is unknown. Adequate contraceptive precautions should be used when either partner is taking Azathioprine. Driving and using machines Azathioprine is not known to affect your ability to drive or use machinery. If you experience any side effect from this medicine, you may not be able to drive or operate machinery. Azathioprine contains lactose If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicine.