Azasan is administered orally as a tablet. Dosage and frequency depend on the disease being treated and the patient’s individual response to the drug. Generally, Azasan is administered once or twice a day.

Autoimmune Diseases (such as rheumatoid arthritis, Crohn’s disease, or lupus):

The usual starting dose is 1 to 3 mg/kg body weight per day, which should be adjusted according to the patient’s response and tolerance.

For Organ Transplantation (e.g., kidney or liver transplant):

It is usually started at a dose of 1 to 3 mg/kg body weight per day and might be adjusted according to the type of transplant, patient condition, and blood tests.

Azasan should be taken strictly at the same time daily. One is advised not to change anything from his prescription dosage otherwise he is prone to other serious illnesses like susceptibility to an infection or organ rejection due to increased sensitivity.

Azasan works by inhibiting the synthesis of purines, which are essential building blocks of DNA and RNA. Specifically, azathioprine is converted in the body to 6-mercaptopurine (6-MP), a compound that interferes with the purine metabolism required for the synthesis of nucleic acids in rapidly dividing cells, including those in the immune system.

Immunosuppression: The drug primarily suppresses the proliferation of T-lymphocytes and B-lymphocytes, which are main cells involved in immune response. This action reduces inflammation and prevents the immune system from attacking the body’s own cells in autoimmune diseases or transplant settings.

Inhibition of DNA/RNA Synthesis: By preventing the synthesis of purines, azathioprine will prevent the synthesis of DNA and RNA within the immune cells, essentially reducing the number of active immune cells capable of producing an immune response.

Effect on T-and B-Cells: There is a specific effect of the Azasan on T-cells, which forms an important part of graft rejections and autoimmune diseases. Thus, by inhibiting those cells, azathioprine prevents the immune mechanism of attacking the transplanted organs or healthy tissues.

Like any medication, Azasan has side effects. Some of the most common and serious are:

• Nausea, vomiting, or loss of appetite
• Fatigue or general malaise
• Hair thinning
• Mild rash

Bone marrow suppression: Azasan can cause reduced blood cells production in a patient and may lead to anemia, low white blood count, or low platelet count. All these increases the chances of infections and bleeding.

Increased risk of infections: Because it suppresses the immune system, Azasan increases the likelihood of serious infections, including bacterial, fungal, and viral infections.

Liver toxicity: Azasan can affect liver function, so liver enzyme levels should be regularly monitored during treatment.

Blood Monitoring: Because Azasan can suppress the bone marrow and lead to liver toxicity, it is essential to monitor the blood of a patient with regular blood tests, including low blood cell counts and liver function, during the treatment period.

 Doctors usually order blood tests once every 1-2 weeks upon initiation of the treatment, then once every month upon stabilization.

Increased Risk of Infections: Since Azasan suppresses the immune system, patients have a higher risk of infection. Patients should avoid people with infections, and the presence of infection signs must be reported immediately.

Pregnancy and Breastfeeding: Azasan is contraindicated in pregnancy because it may cause harm to the fetus, including birth defects and other complications. It should also be avoided in breastfeeding because it can pass into breast milk and affect the infant.

Liver Disease: Azasan should be used with caution in patients with liver disease because it can further compromise liver function.

Allopurinol: Taking Azasan with allopurinol (a medication for gout) can increase the levels of azathioprine in the body, increasing the risk of side effects like bone marrow suppression. A lower dose of Azasan is often needed when used together.

Warfarin: Azasan may interact with warfarin, a blood thinner, altering its effects. This can increase the risk of bleeding or clotting. Your healthcare provider will likely monitor your blood clotting levels (INR) more closely when these medications are combined.

Live Vaccines: Azasan suppresses the immune system, so it is advised to avoid live vaccines (e.g., measles, mumps, rubella, yellow fever) while using this medication. Live vaccines could cause infections in individuals on immunosuppressive therapy.

The dosing of Azasan (azathioprine) is usually calculated based on the patient’s body weight and the diagnosis. A usual starting dose is 1 to 3 mg/kg/day; however, this dose is often titrated based on the patient’s response to the medication.

For example:

Autoimmune diseases: A general dose of about 1-2.5 mg/kg/day is commenced and altered according to results from various blood tests, along with the patient’s response.

Transplant organ: In most transplant cases, it begins from 2-3 mg/kg/day; this dosing can also be readjusted with regard to the type of transplant undertaken, risk level for the rejection, and monitoring values.

Azasan is a prescription drug; that is, it needs a prescription from a health professional. It is usually prescribed by specialists, such as a rheumatologist, gastroenterologist, or transplant surgeon, depending on the kind of condition being treated. Azasan is not a drug that can be taken over the counter; thus, it should be administered only under medical care for the possibility of dangerous side effects and the requirement of monitoring.

1. What is Azasan?

   • Azasan is an immunosuppressant medication that contains azathioprine, primarily used to prevent organ transplant rejection and treat autoimmune disorders.

2. How does Azasan work?

   • Azasan works by inhibiting the production of DNA and RNA in cells, particularly affecting rapidly dividing immune cells, thereby dampening the immune response.

3. What conditions are treated with Azasan?

   • It is used to treat conditions such as rheumatoid arthritis, lupus, Crohn’s disease, and ulcerative colitis, as well as to prevent transplant rejection.

4. What is the typical dosage of Azasan?

   • The dosage varies based on the condition being treated, but it typically starts low (around 1 to 3 mg/kg per day) and is adjusted according to the patient’s response and tolerance.

5. Are there any common side effects of Azasan?

   • Yes, common side effects include nausea, vomiting, diarrhea, liver enzyme elevations, increased risk of infections, and skin rash.

6. What should I do if I miss a dose of Azasan?

   • If you miss a dose, take it as soon as you remember. If it’s almost time for your next dose, skip the missed dose and continue with your regular schedule. Never double up doses.

7. Can Azasan be taken during pregnancy?

   • Azasan may pose risks during pregnancy. It is crucial to discuss with your healthcare provider before using it if you are pregnant or planning to become pregnant.

8. Can I drink alcohol while taking Azasan?

   • It’s advised to limit alcohol consumption, as it can increase the risk of liver issues and may worsen side effects.

9. What are the risks associated with long-term use of Azasan?

   • Long-term use can increase the risk of certain cancers, infections, liver damage, and marrow suppression. Regular monitoring by a healthcare provider is essential.

10. What precautions should I take when using Azasan?

    • Avoid live vaccines, regularly monitor blood counts, report any signs of infection, and have routine liver function tests while on this medication.

11. Can Azasan interact with other medications?

    • Yes, Azasan can interact with various medications, including allopurinol, warfarin, and certain antibiotics, potentially altering their effectiveness or increasing side effects.

12. How should Azasan be stored?

    • Store Azasan at room temperature, away from heat, moisture, and light. Keep it out of reach of children.

13. What will happen if I overdose on Azasan?

    • Overdosing on Azasan can lead to severe side effects like liver damage or bone marrow suppression. Seek emergency medical attention if an overdose is suspected.

14. Is there a specific diet I should follow while on Azasan?

    • While there’s no specific diet, a balanced diet rich in nutrients, staying hydrated, and limiting alcohol and raw foods are recommended to support overall health.

15. How often will I need to see my doctor while on Azasan?

    • Regular follow-up appointments are typically required every few weeks to monitor blood counts and liver function until stabilized, then less frequently.

16. Can Azasan cause allergic reactions?

    • Yes, some individuals may experience allergic reactions, which can manifest as rash, itching, or difficulty breathing. Seek medical attention if these occur.

17. Can I stop taking Azasan suddenly?

    • Discontinuing Azasan abruptly is not recommended without consulting your healthcare provider, as it may lead to flare-ups of the underlying condition.

18. Are there alternatives to Azasan?

    • Yes, alternatives may include other immunosuppressants like methotrexate, mycophenolate mofetil, or biologics, depending on the condition being treated.

19. What should I do if I experience serious side effects?

    • If you experience serious side effects such as jaundice (yellowing of the skin/eyes), unusual bleeding, or persistent infections, contact your doctor immediately.

20. Is regular lab testing necessary while on Azasan?

    • Yes, regular lab tests are necessary to monitor liver function and blood counts to detect any early signs of complications from the medication.