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Azathioprine is an immunosuppressant, which is used to prevent rejection of an organ transplant (e.g kidney transplant). It is also used to treat symptoms of rheumatoid arthiritis. It is also used for certain types of  intestinal diseases ( colitis) like Crohn’s disease and ulcerative colitis.

How it works

Azathioprine belongs to class of medications called immunosuppressant’s and acts by reducing the function of the body's immune system response. By suppressing body’s defence system, azathioprine helps to prevent the  body from fighting and rejecting  the newly transplanted organ. In chronic inflammatory and autoimmune conditions like rheumatoid arthiritis, the immune system attacks part of own body as if it were foreign. Azathioprine helps prevent this by interfering with a substance, which is needed for cells to grow and divide.

Common side effects

Nausea, Pancreatic infection, Post renal transplant infection, Liver failure, Allergic reaction, Decreased blood pressure, Dizziness, Infection, Joint inflammation, Increased white blood cell count, Decreased white blood cell count, Malignancy, Reduced blood platelets, Skin rash, Vomiting, Loss of appetite


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Expert advice

  • Azathioprine can cause birth defects so avoid pregnancy while using it or consult your doctor if you are pregnant or breast feeding. 
  • While taking Azathioprine, your body is more prone  to infections; so be sure to wash your hands often and keep distance from with people who are sick.
  • Avoid excessive exposure to sun and wear a sunscreen, sunglasses and appropriate clothing wile going out in the sun.
  • Do not start or continue azathioprine and consult your doctor:if you are allergic to azathioprine.

Frequently asked questions


Q. Is azathioprine / Imuran safe?
Azathioprine is safe if used at prescribed doses for the prescribed duration as advised by your doctor.
Q. Is azathioprine a biologic or chemotherapy or steroid or corticosteroid or blood thinner or enema?
No. Azathioprine is an immunosuppressant, which suppresses your immune or defence system.
Q. Can I take azathioprine with Pentasa or antibiotics or vitamins?
No. All of these drugs interact with azathioprine. Avoid the concomitant use of this drug along with azathioprine. Please consult your doctor before taking all these drugs with Azathioprine. 
Q. Can I take azathioprine with ibuprofen or paracetamol (Tylenol) or vitamins or Benadryl or doxycycline or prednisone or Aleve or melatonin?
No results found for any interaction of these medicines with azathioprine, but please consult with your doctor before taking this medication.
Q. Does azathioprine cause cancer?
Yes, azathioprine administration may increase your risk of developing certain types of cancer (especially skin cancer and lymphoma). This increased risk is dependent on other factors also including dose, duration and indication of use.
Q. Does azathioprine make you tired?
It can make sleepy or dizzy.
Q. Does azathioprine cause macrocytosis?
Yes. Red blood cell macrocytosis is a well-known complication of azathioprine therapy.
Q. Does azathioprine work in colitis?
Yes, azathioprine is recommended in the treatment of certain type of colitis such as Crohn's disease and ulcerative colitis.
Q. Does azathioprine cause weight gain?
No studies found. 
Q. Does azathioprine cause acne?
Q. Does azathioprine cause high blood pressure? 
In some patients azathioprine may cause low blood pressure. Contact your doctor immediately if you develop such symptom.
Q. Does azathioprine affect fertility?
This medication can affect fertility (your ability to have children), whether you are a man or a woman. Talk with your doctor if you have concerns about this.
Q. Does azathioprine cause constipation or depression or bruising or dry skin or headaches?
No studies found. However, consult your doctor immediately if you develop such symptom.
Q. Does azathioprine cause diarrhea or hair loss or anemia?
Yes. All these are the side effect of azathioprine.

Content on this page was last updated on 30 September, 2016, by Dr. Varun Gupta (MD Pharmacology)