Azathioprine (AZA), sold under the brand name Imuran among others, is an immunosuppressive medication. It is used in rheumatoid arthritis, granulomatosis with polyangiitis, Crohn's disease, ulcerative colitis, systemic lupus erythematosus, and in kidney transplants to prevent rejection. It is taken by mouth or injected into a vein. Azathioprine is sometimes used in systemic lupus erythematosus who require a maintenance dose of 15 mg or higher of prednisone and those who experience recurrent flares.
It is used as an add on therapy when steroid therapy is given by mouth for pemphigus and myasthenia gravis, as a "steroid-sparing" agent. Azathioprine is also used to maintain remission in people who have granulomatosis with polyangiitis.
It was shown to be very effective in eczema and atopic dermatitis in researches, even though it is not commonly used. The British National Eczema Society lists it as a third-line treatment for severe to moderate cases of these skin diseases.
Common side effects include bone marrow suppression and vomiting. Bone marrow suppression is especially common in people with a genetic deficiency of the enzyme thiopurine S-methyltransferase. Other serious risk factors include an increased risk of lymphoma. Use during pregnancy may result in harm to the baby. Azathioprine is in the purine analogue and antimetabolite family of medication. It works via 6-thioguanine to disrupt the making of RNA and DNA by cells.
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