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Updated February 2023
Azathioprine is a medication used to treat certain childhood rheumatic conditions (diseases which may affect kidneys, joints, muscles, skin, gut or eyes). This can include lupus (also known as SLE), inflammatory bowel disease, uveitis and scleroderma. People who have had organ transplants also use it.
Azathioprine is a medication that works by suppressing your immune system. It reduces the damage done by inflammation, rather than just reducing pain.
Azathioprine is a medication that works slowly. You can expect your child to gradually start feeling better, but it might take one to three months.
Azathioprine is available as oral tablets.
This depends on the weight of your child. It is usually started at a low dose, which is then increased. The final dose is adjusted according to response and side effects. It is taken either once or twice a day.
People stay on azathioprine for long periods (several years) to help keep their disease under control.
Azathioprine is usually very effective in improving your child’s condition but, like all medications, side effects can occur. Some are common, and some are rare. Most people don’t have any problems when they take azathioprine. Regular blood tests are important to monitor side effects.
Most common side effects
Treatment
Nausea (feeling sick) vomiting, loss of appetite & diarrhoea
Skin rash / sun sensitivity
Mouth ulcers Sore gums
Sore throat
Rare side effects
Disturbance in the blood counts (change in blood tests results)
Upset liver function
Pancreatitis (felt as very bad stomach pain)
Allergic reactions and serious skin reactions
What to do if your child is sick Normal coughs and colds are okay. Don’t give azathioprine if your child:
If you’re not sure, talk to your doctor, and get your child checked if necessary before giving the azathioprine.
Interactions Azathioprine can interact with other medications. Talk to your doctor before your child takes any prescription medications, natural medications and any medications that you can buy over the counter.
Immunisations Most immunisations are safe to have (flu vaccine, cervical cancer vaccine, killed polio vaccine (IPV) etc) when taking this medication. Live virus vaccines (such as mumps, measles, rubella (MMR), polio (OPV)), varicella (chicken pox) and some travel vaccines should not be used.
Infections Patients on azathioprine are at increased risk of infection, because of immune suppression. Azathioprine can make chickenpox infections more serious. A blood test can be done to see if your child is already immune to the virus. If your child is in contact with chickenpox or shingles, call your doctor. Alcohol Azathioprine and alcohol are both broken down by the liver. Drinking alcohol while you are on this medication can put extra strain on the liver. It is not known how much is safe, so it is suggested that anyone on azathioprine should avoid drinking alcohol. Sexual health and pregnancy Having been on azathioprine in the past does not change your chances of having babies when you are older. Azathioprine appears to be relatively safe in pregnancy and breastfeeding.
Myths and misconceptions You may hear a lot of different information about azathioprine from friends, pharmacists or people that you know. If you are worried about anything, please talk to your child’s doctor or nurse.
If your child is taking azathioprine they should see their paediatric rheumatologist regularly to make sure the treatment is working and to minimise any possible side effects.