What is azathioprine?

What is azathioprine (‘aza’)?

  • Type of drug: purine synthesis blocker (antimetabolite)
  • Use: immunosuppressant after kidney transplant; other autoimmune disease
  • Dose: 25-150 mg once a day (1-2 mg/kg)
  • Side-effects: gastrointestinal disorders; liver dysfunction; bone marrow suppression (causing low haemoglobin, white cells and platelets)
  • Monitor: FBC and liver enzymes.

Note 1. It is an alternative drug to mycophenolate, with similar side-effects
Note 2. As with all immunosuppression, skin protection (against skin cancer) is important
Note 3. Can be given IV, at the same dose of oral azathioprine
Note 4. Do NOT use azathioprine with allopurinol. It can lead to fatal bone marrow suppression.

Other resources

CKD drug side-effects
CKD patient information (CKD Explained 30+ core articles)
Azathioprine (BNF)
Renal transplantation (UHCW patient information)
This is a review article: Mohammadi, 2023

Last Reviewed on 5 May 2024

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