Azathioprine (previously determine TPMT activity)

Commercial name

Azafalk®, Azaimun®

Before therapy

Blood count, (if leukocytes <3x103/μl: differential blood count), kidney values, liver values, Hep B/ C/ HIV serology, TPMT determination prior to start of therapy

Administration

p.o.

Dosage

1 mg/kg bw/d, within 3 - 4 weeks gradual increase to 1.5- 3 mg/kg bw/d maintenance dose

Median effect of action

At the earliest 4 - 6 weeks, usually after 2 - 3 months

Be careful

Kidney/ liver disease (dose adjustment), with simultaneous administration of allopurinol: reduction of azathioprine to 1/4 of the dose, combination with succinylcholine, tubocurarin, cytostatics, no live vaccines, with SS: max 2 mg/kg bw/d, annual flu and pneumococcal vaccination recommended, with HIV infection: individual risk assessment, TPMT-development (myelotoxicity). Cutaneous carcinogenesis

Contraindications

Bone marrow diseases (cytopenia), chronic Hep B (pos HbsAG), breastfeeding; SS (relative contraindication) and breastfeeding period

Anamnesis points, selected side effects and measures

Stomatitis, gastrointestinal side effects, drug fever, infection, leukopenia (<3x103/μl), thrombopenia (<100x103/μl) -> interruption and/or termination. Ex- anthem, hair loss -> dose reduction, possibly interruption. Pancreatitis, hepatitis, cholestasis -> abortion. Pneumonitis -> abortion

Duration of theraphy

Not limited

Format

Tbl.

Application

systemic