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Read time: 17 mins
Last updated: 06 May 2020
Published: 24 Jul 2020

4.1 Therapeutic indications

Azathioprine is an antimetabolite which is used as an immunosuppressant, either as monotherapy or more often in combination with other drugs (mainly corticosteroids) and procedures which modulate the immune response. Therapeutic effect may be apparent only after weeks or months. Combination therapy with Azathioprine and corticosteroids may allow the dosage of corticosteroids to be reduced, resulting in a reduction of the toxicity associated with chronic use of corticosteroids at high doses.

Azathioprine, in combination with corticosteroids and/or other immunosuppressive drugs and procedures, is indicated to improve the survival of organ transplants, including renal, cardiac and hepatic transplants and to reduce the requirement for corticosteroids in renal transplant recipients.

Azathioprine tablets, either as a monotherapy or more usually in combination with corticosteroids and/or other drugs and procedures, may have a significant therapeutic effect in a proportion of patients suffering from auto-immune chronic active hepatitis, severe rheumatoid arthritis, systemic lupus erythematosus (SLE), chronic refractory idiopathic thrombocytopenic purpura, auto-immune haemolytic anaemia, pemphigus vulgaris, polyarteritis nodosa, dermatomyositis and polymyositis.

Clinical benefit may include a reduction in the dosage of corticosteroids or discontinuation of corticosteroid therapy.

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Drugs appearing in this section are approved by UK Medicines & Healthcare Products Regulatory Agency (MHRA), & the European Medicines Agency (EMA).