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Azathioprine

Medical and Pharmacy Editor:

Brand Name: Azasan, Imuran

Generic Name: Azathioprine

Drug Class: Immunosuppressants; DMARDs, Immunomodulators

What Is Azathioprine and How Does It Work?

Azathioprine is an immunosuppressive antimetabolite that lowers the body's immune system used to prevent the body from rejecting a transplanted kidney. Azathioprine is also used to treat symptoms of rheumatoid arthritis.

Azathioprine is available under the following different brand names: Azasan, and Imuran.

Dosages of Azathioprine:

Dosage Forms and Strengths

Capsule

  • 50 mg
  • 75 mg
  • 100 mg

Powder for injection

  • 100 mg/vial

Dosage Considerations – Should be Given as Follows:

Kidney Transplantation

  • Prevention of transplant rejection
  • 3-5 mg/kg/day intravenously/orally initially on day of transplant or 3 days before transplant (rare)
  • Maintenance: 1-3 mg/kg/day intravenously/orally

Rheumatoid Arthritis

  • 1 mg/kg/day intravenously/orally initially in single daily dose or divided every 12 hours; may be increased by 0.5 mg/kg/day after 6-8 weeks, then by 0.5 mg/kg/day every 4 weeks; not to exceed 2.5 mg/kg/day
  • Maintenance: Reduce daily dose by 0.5 mg/kg every 4 weeks until lowest effective dosage is reached

Transplantation, Pediatric (Off-label)

  • Prevention of transplant rejection
  • 3-5 mg/kg/day intravenously/orally initially on day of transplant or 3 days before transplant (rare)
  • Maintenance: 1-3 mg/kg/day intravenously/orally

Lupus Nephritis (Off-label)

  • Induction and maintenance therapy for lupus nephritis (2012 American College of Rheumatology guidelines)
  • Adult: 2 mg/kg/day orally with or without low-dose corticosteroids
  • Induction and maintenance therapy for lupus nephritis (2012 American College of Rheumatology guidelines)
  • Children under 12 years: Safety and efficacy not established
  • Children over 12 years: 2 mg/kg/day orally with or without low-dose corticosteroids

Crohn's Disease (Off-label)

Ulcerative Colitis (Off-label)

  • Maintenance, remission, or reduction of steroid
  • 1.5-2.5 mg/kg orally once daily

Chronic Refractory Thrombocytopenic Purpura (Off-label)

  • 1-2 mg/kg orally once daily to maximum daily dose of 150 mg for at least 3-6 months before typical response is observed
  • Dosing considerations
    • Lower dosage (100 mg/day) is reported effective in some patients
    • Longer treatment duration (up to 84 months) is reported in some patients

Juvenile Idiopathic Arthritis

  • 1 mg/kg/day intravenously/orally initially in single daily dose or divided every 12 hours; may be increased by 0.5 mg/kg/day after 6-8 weeks, then by 0.5 mg/kg/day every 4 weeks; not to exceed 2.5 mg/kg/day
  • Maintenance: Reduce daily dose by 0.5 mg/kg every 4 weeks until lowest effective dosage is reached
Medically Reviewed by a Doctor on 8/11/2017



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