Information for Patients
Patients being started on Azamun tablets should be informed of the necessity of periodic blood counts while they are receiving the drug and should be encouraged to report any unusual bleeding or bruising to their physician. They should be informed of the danger of infection while receiving Azamun tablets and asked to report signs and symptoms of infection to their physician. Careful dosage instructions should be given to the patient, especially when Azamun tablets are being administered in the presence of impaired renal function or concomitantly with allopurinol (see Drug Interactions subsection and DOSAGE AND ADMINISTRATION). Patients should be advised of the potential risks of the use of Azamun tablets during pregnancy and during the nursing period. The increased risk of malignancy following therapy with Azamun tablets should be explained to the patient.
A Azamun and Mycophenolate Mofetil
Azamun and mycophenolate mofetil are frequently used in combination with calcineurin-phosphatase inhibitors and glucocorticoids after transplantation. Nieszporek et al. found suppressed serum testosterone levels in combination with a blunted LH response to gonadotropin-releasing hormone after renal transplantation in patients receiving Azamun in combination with prednisone . Other investigators reported normal testosterone levels in patients receiving glucocorticoids and Azamun after kidney transplantation . Animal studies do not suggest any significant testicular toxicity as a result of Azamun or mycophenolate mofetil treatment. Furthermore, short-term studies in rats showed no effect of either Azamun or mycophenolate mofetil on bone volume when administered as single agents .
What are some things I need to know or do while I take Azamun Tablets?
- Tell all of your health care providers that you take this medicine (Azamun tablets). This includes your doctors, nurses, pharmacists, and dentists.
- You may have more of a chance of getting an infection. Wash hands often. Stay away from people with infections, colds, or flu. Some infections have been very bad and even deadly.
- You may bleed more easily. Be careful and avoid injury. Use a soft toothbrush and an electric razor.
- If you have a thiopurine methyltransferase deficiency, talk with your doctor.
- Have blood work checked as you have been told by the doctor. Talk with the doctor.
- The chance of skin cancer may be raised. Avoid lots of sun, sunlamps, and tanning beds. Use sunscreen and wear clothing and eyewear that protects you from the sun.
- You may need to have your skin checked while you take this medicine (Azamun tablets). Talk with your doctor.
- Use birth control that you can trust to prevent pregnancy while taking this medicine (Azamun tablets).
- This medicine may cause harm to the unborn baby if you take it while you are pregnant. If you are pregnant or you get pregnant while taking this medicine (Azamun tablets), call your doctor right away.
Nausea and vomiting may occur within the first few months of therapy with IMURAN, and occurred in approximately 12% of 676 rheumatoid arthritis patients. The frequency of gastric disturbance often can be reduced by administration of the drug in divided doses and/or after meals. However, in some patients, nausea and vomiting may be severe and may be accompanied by symptoms such as diarrhea, fever, malaise, and myalgias (see PRECAUTIONS). Vomiting with abdominal pain may occur rarely with a hypersensitivity pancreatitis. Hepatotoxicity manifest by elevation of serum alkaline phosphatase, bilirubin, and/or serum transaminases is known to occur following Azamun use, primarily in allograft recipients. Hepatotoxicity has been uncommon (less than 1%) in rheumatoid arthritis patients. Hepatotoxicity following transplantation most often occurs within 6 months of transplantation and is generally reversible after interruption of IMURAN. A rare, but life-threatening hepatic veno-occlusive disease associated with chronic administration of Azamun has been described in transplant patients and in one patient receiving IMURAN for panuveitis. 21,22,23 Periodic measurement of serum transaminases, alkaline phosphatase, and bilirubin is indicated for early detection of hepatotoxicity. If hepatic veno-occlusive disease is clinically suspected, IMURAN should be permanently withdrawn.
Can Azamun cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with Azamun. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.
By Lynn Marks | Medically Reviewed by Robert Jasmer, MD
Latest Update: 2015-03-30 Copyright © 2014 Everyday Health Media, LLC
Blood thinning drug
Using warfarin with Azamun can make warfarin less effective for you. Your doctor may closely monitor your levels of warfarin when starting and stopping treatment with Azamun.
Getting the most from your treatment
- Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress. Your doctor will want you to have regular blood tests during this treatment, to monitor for unwanted side-effects.
- It is important to try to avoid anyone who has chickenpox or shingles. Tell your doctor if you come into contact with anyone with these infections.
- While you are taking Azamun, and for a while after you stop treatment, do not have any immunisations (vaccinations) without talking to your doctor first. Azamun lowers your body's resistance and there is a chance that you may get an infection from the vaccine. Also, some vaccines may be less effective.
- Your doctor will have discussed with you the possibility of a slightly increased risk of cancer (particularly skin cancer) associated with immunosuppressants like Azamun. Do not use sunbeds, and avoid strong sunlight or use a sun cream with a high sun protection factor (SPF of at least 15).
- You should avoid becoming pregnant while you or your partner are taking Azamun. Make sure you have discussed with your doctor which types of contraception are suitable for you and your partner.
- If you are having an operation or any dental treatment, tell the person carrying out the treatment that you are taking Azamun.
- If you buy any medicines, check with your doctor or a pharmacist that they are suitable for you to take with your other medicines.
Azamun for Dogs and Cats
Azamun may be used in dogs to treat certain conditions such as the following:
- Hemolytic anemia
- Arthritis and skin disease caused by an immune problem
- Chronic liver, kidney, or stomach diseases
- Thrombocytopenia (low blood platelet count)
The drug may also be used in very low doses to treat cats with certain skin disorders caused by an immune disorder.
Azamun can increase the risk of infection in a pet, so owners should monitor their animals for unusual symptoms.
Possible risks and s >
Most people don’t have any side effects, and for those who do, they aren’t usually serious. However, if you do have severe side effects, or are concerned about your symptoms, contact one of the healthcare professionals in charge of your care.
Azamun may cause:
- nausea or feeling sick
- loss of appetite
- hair loss
- skin rashes
- sensitivity to sunlight.
Because Azamun affects the immune system, it can make you more likely to develop infections. It can also affect your blood count or liver. So you’ll need to have blood tests before and during your course of Azamun.
You may be asked to keep a record of your blood test results in a booklet, and you should take it with you when you visit your GP or the hospital.
You should tell your doctor or nurse specialist straight away if you develop any of the following after starting Azamun:
- a sore throat, fever or any other signs of infection
- unexplained bruising or bleeding
- yellowing of the skin or eyes, this is known as jaundice
- any new symptoms that concern you.
Contact your rheumatology team if you get chickenpox or shingles, or if you come into come into contact with someone who has them and you’ve never had chickenpox before.
These illnesses can be worse than usual if you’re on Azamun. You may need treatment for them, and your Azamun may be stopped until you’re better.
Leukopenia and/or thrombocytopenia are dose-dependent and may occur late in the course of therapy with Azamun tablets. Dose reduction or temporary withdrawal may result in reversal of these toxicities. Infection may occur as a secondary manifestation of bone marrow suppression or leukopenia, but the incidence of infection in renal homotransplantation is 30 to 60 times that in rheumatoid arthritis. Anemias, including macrocytic anemia and/or bleeding have been reported.
TPMT genotyping or phenotyping can help >CLINICAL PHARMACOLOGY, WARNINGS and PRECAUTIONS: Laboratory Tests). Death associated with pancytopenia has been reported in patients with absent TPMT activity receiving Azamun. 6, 20