{"id":1657,"date":"2023-06-25T17:29:05","date_gmt":"2023-06-25T17:29:05","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/azathioprine\/"},"modified":"2023-06-25T19:49:36","modified_gmt":"2023-06-25T19:49:36","slug":"azathioprine","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/azathioprine\/","title":{"rendered":"Azathioprine"},"content":{"rendered":"

<\/p>\n

Azathioprine<\/h1>\n

CLINICAL USE<\/h3>\n

Immunosuppressive:<\/p>\n

  • Prophylaxis of transplant rejection<\/li>\n
  • Treatment of various auto-immune conditions
    \n

    DOSE IN NORMAL RENAL FUNCTION<\/h3>\n

    1\u20135 mg\/kg\/day<\/p>\n

    PHARMACOKINETICS<\/h3>\n<\/li>\n
  • Molecular weight                           :277.3<\/li>\n
  • %Protein binding                           :<30<\/li>\n
  • %Excreted unchanged in urine     : <2<\/li>\n
  • Volume of distribution (L\/kg)       :0.55\u20130.8<\/li>\n
  • half-life \u2013 normal\/ESRD (hrs)      :3\u20135\/Increased
    \n

    DOSE IN RENAL IMPAIRMENT<\/h3>\n

    GFR (mL\/MIN)<\/h4>\n<\/li>\n
  • 20 to 50     : Dose as in normal renal function<\/li>\n
  • 10 to 20     : 75\u2013100%<\/li>\n
  • <10           : 50\u2013100%
    \n

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES<\/h3>\n<\/li>\n
  • CAPD                :Dialysed. Dose as in normal renal function<\/li>\n
  • HD                     :Dialysed. Dose as in normal renal function<\/li>\n
  • HDF\/high flux   :Dialysed. Dose as in normal renal function<\/li>\n
  • CAV\/VVHD      :Dialysed. Dose as in normal renal function
    \n

    IMPORTANT DRUG INTERACTIONS<\/h3>\n

    Potentially hazardous interactions with other drugs<\/li>\n

  • Allopurinol: enhances effect with increased toxicity. Reduce azathioprine dose by 50\u201375% if administered concomitantly<\/li>\n
  • Antibacterials: increased risk of haematological toxicity with co-trimoxazole<\/li>\n
  • Anticoagulants: possibly reduced anticoagulant effect of coumarins<\/li>\n
  • Antipsychotics: avoid concomitant use with clozapineCiclosporin: ?decreased ciclosporin absorption and bioavailability<\/li>\n
  • Cytotoxic agents may be additive or synergistic in producing toxicity, particularly on the bone marrow
    \n

    ADMINISTRATION<\/h3>\n

    Reconstition<\/h4>\n

    Add 5 mL water for injection to each vial (50 mg)<\/p>\n

    Route<\/h4>\n

    Oral, IV<\/p>\n

    Rate of Administration<\/h4>\n

    Over not less than 1 minute<\/p>\n

    Comments<\/h4>\n<\/li>\n
  • Some units dilute to 100 mL sodium chloride or glucose 5% and infuse over 1 hour.<\/li>\n
  • IV bolus peripherally, preferably in the side arm of a fast-running infusionVery irritant to veins. Flush with 50 mL sodium chloride 0.9% after administration<\/li>\n
  • Take tablets with or after food
    \n

    OTHER INFORMATION<\/h4>\n

    Extensively metabolised to mercaptopurine<\/li>\n

  • 1 mg by IV injection is equivalent to 1 mg by oral route<\/li>\n
  • 6-mercaptopurine levels can be monitored in patients with low urate clearance<\/li>\n
  • Monitor white cell and platelet counts<\/li>\n
  • Cytotoxic Drug \u2013 Do Not Handle Can be given as an intermittent infusion (up to 250 mg in 100 mL)<\/li>\n
  • About 40\u201360% is removed by haemodialysis.<\/li>\n","protected":false},"excerpt":{"rendered":"

    Azathioprine CLINICAL USE Immunosuppressive: Prophylaxis of transplant rejection Treatment of<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-1657","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1657","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=1657"}],"version-history":[{"count":1,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1657\/revisions"}],"predecessor-version":[{"id":2885,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1657\/revisions\/2885"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=1657"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=1657"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=1657"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}