Azathioprine Side Effects

What does his Rheumy say? I mean there are too many variables to hazard a guess what could be going on but he seems to need a work up to figure it out. There are a lot of potential side effects to this drug shown in drugs.com online. But that’s true of most if not all autoimmune drugs. Its primary use seems to be anti rejection for scenarios like transplants. So it sounds like a broad and strong immune suppressant. So of course it could suppress autoimmune disorders like RA. But it doesn’t sound targeted to RA like several biologics are.

Sorry I can’t add much more -

Hi @grrranny, While you wait for members with experience to respond to your questions. I thought I would share this reference article on the adverse effects of Azathioprine: https://www.ncbi.nlm.nih.gov/books/NBK542190/#article-18065.s5.

I thought you might also be interested in these discussions:
--- Naltrxone vs Azathioprine: https://connect.mayoclinic.org/discussion/naltrxone-vs-azathioprine/
--- Has anyone been on azathioprine (Imuran) for a very long time?: https://connect.mayoclinic.org/discussion/has-anyone-been-on-azathioprine-imuran-for-a-very-long-time/

HI,

I have a small suggestion for symptoms. I have found it is easier on my guts to take the pills far apart in time, like 9 hours (pharmacist suggested it.) Also, I take the pill with a lot of food- a full meal. I still get a little nauseous sometimes about 1/2 hour afterwards, but I don't get the diarrhea. I think it helps my arthritis.

It's great that you are helping your husband! Blessings to you both!

Hello,I have been on 50 mg of azathioprine for nearly 29 years. I was placed on it by Dr. William Tremaine of Mayo. I had severe chronic pancolitis and was possibly looking a having to have a colectomy. He asked that we try one thing before moving on to life changing surgery. Every new GI doctor questions the dosage at 50 mg as it is the lowest dose available - this is what I started on and it has never changed. Many tests over the years to verify 50 mg is a therapeutic dose for me. Only within the last decade I have started to have some precancerous and recently cancerous skin conditions as a result of the azathioprine. All have been treated properly and I see a dermatologist annually. I would ask your prescribing doctor if you could back off for a bit and see if you improve. Azathioprine is an immunosuppressant and long term use does have its problems. It is not for everyone and it might be beneficial to really discuss options with your provider. I have had mild hair thinning due to the azathioprine but I am now 69 so this is expected. I do hope you find something workable because quality of life is very important as well. I wish you the best.

Thanks for sharing your experience, Jgkc.
At 83, hubby's hair has also thinned, but I don't know if it's due to anything other than his wearing a golf cap all the time....

Thanks for sharing! After just a couple of days of cutting the dose in half and taking 25mg Azathioprine after breakfast and dinner instead of the full dose before breakfast as prescribed by his Rheumy, hubby's feeling better!

I was diagnosed with autoimmune hepatitis in June 2021. I was whined off prednisone and put on 50MG Azathioprine 2X/day in August 2021. Fortunately, I have not had any side effects taking this drug and my blood work has remained stable for the past 2+ years. I am now being gradually whined off this medication.

I posted my side effects a while ago on another thread. I had several infections during the time I was treated. Since then I also have had a couple squamous cell skin cancers.
Something else happened to me that I suspect had something to do with the treatment- cognitive problems. I also had trouble parking the car correctly in a parking spot in addition to forgetting how to hit tennis balls( I had played tennis for years).
I started doing crossword puzzles to exercise the brain and also focus on how I approach a parking spot. I succeeded with both. I also recovered the ability to play tennis.
I don’t understand why this happened to me- there was no other signs of neurological illness- and actually scared me.

I would urge you to get regular yearly at least dermatology checks. My derm told my neurologist who put me on azathioprine find something else because it was causing skin cancers.

So what drugs are you on now? The only thing I can find (with a quick search) that looks safe is Plaquinil.