How to use
Azathioprine should be taken orally, once or twice a day, at approximately the same time every day. Take Azathioprine with food to avoid a stomach upset.

Your doctor will determine which dosage is best for you, depending on various factors, such as your height, weight, age, general health and the condition being treated.

Overdose
If you suspect you have taken too much of this medication, please contact your local poison control center or emergency medical services immediately.

Missed dose
If you take Azathioprine once daily and miss a dose, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not try to make up for a missed dose by doubling up.

If you take Azathioprine more than once a day and miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, take both doses together, then go back to your usual dosing schedule.

If you miss more than one dose, you should contact your doctor. He may need to adjust your dosing schedule.

Notes
Azathioprine decreases the normal amount of blood cells in your body, so your doctor may want to perform regular medical tests to see how you are responding to the medication and if you are suffering from any side effects.

Do not share this medication with others, as they may have a problem that is not effectively treated by this drug.

If you’ve recently had an organ transplant, it is highly recommended you attend a transplant education class or support group.

Storage
Store Azathioprine at room temperature, between 59 and 86 degrees F (15 and 30 degrees C), away from heat and moisture. KEEP THIS AND ALL OTHER MEDICATION OUT OF REACH OF CHILDREN.

Important note
The above information is intended to supplement, not substitute for, the expertise and judgement of your physician, pharmacist or other healthcare professional. It should not be construed that the taking of this medication is safe, appropriate or effective for you.

 * Illustrations are for graphic purposes only and the ordered medication may differ in appearance.

Precautions
Before taking Azathioprine, inform your doctor if you suffer or have suffered from any of the following:

• A kidney or liver disease
• Blood disorders
• Decreased bone marrow function
• Cancer
• Active infections
• A certain enzyme disorder (TPMT deficiency)
• Low blood pressure
• Lesch-Nyan Syndrome
• Any allergies or a history of allergic reactions

Azathioprine is classed as FDA Pregnancy Category D, which means it can potentially harm an unborn baby. Inform your doctor immediately if you are pregnant or become pregnant during treatment with Azathioprine.

Do not use this medication while breastfeeding. Azathioprine passes into breast milk and could potentially harm a nursing infant. If you are breastfeeding and want to start treatment with Azathioprine, contact your doctor immediately.

Azathioprine may lower the effectiveness of intrauterine forms of birth control (which are placed inside the womb) and this could result in pregnancy. Discuss alternative forms of birth control with your physician.

Azathioprine reduces the actions of your immune system and can therefore cause serious infections. Make sure you maintain a good personal hygiene while taking Azathioprine.

Patients who take immunosuppressive medication in the long term are at increased risk of skin cancer. Avoid exposure to strong sunlight and wear a good sunscreen or protective clothing.

Drug Interactions
Before taking Azathioprine, you should inform your doctor if you take any of the following:

• Blood thinners (e.g. warfarin, heparins)
• Allopurinol
• Drugs affecting bone marrow (e.g. cotrimoxazole, numerous anti-cancer drugs)
• Alkylating type cancer drugs (e.g. chlorambucil, melphalan, cyclosporine)
• ACE inhibitors (e.g. lisinopril)
• Aminosalicylates (e.g. olsalazine, sulfasalazine)
• Febuxostat
• Mercaptopurine
• Natalizumab

The above is only a partial list and other medications may interact with Azathioprine. Inform your doctor of all other prescription and over-the-counter medicines you use, including vitamins, nutritional supplements, herbal pills and medication prescribed by another doctor. Do not change medications without talking to your doctor first.

The use of Azathioprine may cause the following common side effects:

• Nausea
• Vomiting
• Diarrhea
• Loss of appetite

If these effects persist or worsen, notify your doctor immediately.

More severe but unlikely side effects of Azathioprine are also possible. Notify your doctor promptly if you experience any of the following:

• Severe stomach or abdominal pain
• Loss of air
• Unusual fatigue
• Joint or muscle pain
• Changes in vision
• Weakness or muscle loss
• Hair loss
• Coldness or numbness in the fingers
• Mouth sores
• Difficult or painful swallowing
• Greasy stools

Seek emergency medical attention if any of the following rare but very serious side effects occur:

• Yellowing eyes or skin (jaundice)
• Swelling or extra fluid around the abdomen
• Vomit that contains blood or looks like coffee grounds
• Black stools

Also seek immediate medical attention if you experience any of the following symptoms of a serious allergic reaction:

• Severe stomach/intestinal symptoms
• Fever
• Shakes and chills
• Rash, itching
• Swelling of the face, tongue or throat
• Severe dizziness
• Trouble breathing
• Cough
• New or worsening joint or muscle aches
• Dark urine

This is only a partial list of possible side effects and others may occur. Contact your healthcare provider immediately if any other side effects occur than the ones listed above or if they are especially bothersome.