What should be monitored while taking azathioprine?
What should be monitored while taking azathioprine?
Patients receiving azathioprine with ribavirin should have complete blood counts, including platelet counts, monitored weekly for the first month, twice monthly for the second and third months of treatment, then monthly or more frequently if dosage or other therapy changes are necessary.
What is the antidote for azathioprine?
There is no specific antidote for azathioprine. In the event of overdose, blood count and hepatic function in particular should be monitored. Azathioprine is known to be dialysable and in severe cases dialysis may be used.
How is azathioprine eliminated?
In humans, azathioprine is catabolized to a variety of oxidized and methylated derivatives, which are excreted by the kidneys; very little azathioprine or 6-mercaptopurine are excreted intact. At least 11 different metabolites have been identified, with the major one, 6-thiouric acid, found in urine.
What should I check before starting azathioprine?
A further 10% of people have lower than normal TPMT and are likelier than people with normal activity to develop bone marrow suppression. Testing TPMT activity before starting azathioprine can identify people who are TPMT deficient and who should not receive the drug.
Can azathioprine be stopped suddenly?
If you stop taking it suddenly: If you’re taking this drug for a kidney transplant and you stop taking it suddenly, you may experience transplant rejection and kidney failure. If you’re taking this drug for rheumatoid arthritis and you stop taking it suddenly, your symptoms of rheumatoid arthritis may come back again.
How does azathioprine affect the liver?
We need to regularly monitor your blood because azathioprine can suppress normal bone marrow function and white blood cell production, and may also cause problems with your liver function. If your liver is affected, it can take time for it to recover, even after you stop taking azathioprine.
What is the conversion factor of azathioprine to Aza?
Azathioprine is 55% 6-MP by molecular weight. Thus a conversion factor of 2.08 will convert a dose of 6-MP to AZA. Clinicians often over dose 6-MP or under dose AZA because they fail to take this conversion into account. The second question clinicians must ask is what dose of AZA or 6-MP to use?
When to increase azathioprine dose to prevent rejection?
Use: Adjunctive therapy for prevention of rejection in renal homotransplantation. -Dose may be increased by 0.5 mg/kg/day (or approximately 25 mg/day), after 6 to 8 weeks of starting treatment and thereafter at 4 week intervals if necessary. -Gradual dose reduction is recommended to reduce the risk of toxicities.
What are the side effects of azathioprine over time?
Further dose reduction or alternative therapies should be considered for patients with low or absent TPMT activity. -Chronic immunosuppression with azathioprine increases the risk of malignancy. -Post-transplant lymphoma and hepatosplenic T-cell lymphoma (HSTCL) has been reported in patients with inflammatory bowel disease.
How much azathioprine should I take for concomitant TPMT?
Concomitant allopurinol: Azathioprine dose should be reduced to 25% to 33% of the usual dose. Further dose reduction or alternative therapies should be considered for patients with low or absent TPMT activity.