Azathioprine

• Do not take Azathioprine if you are allergic to any immunosuppressant medicines or Azathioprine.
• Let your doctor know before using Azathioprine if you have liver or kidney problems, serious blood disorders, immune system problems, bone marrow problems, serious infections, immunodeficiency syndrome, or if you have a condition where your body produces too little of a natural chemical called thiopurine methyltransferase (TPMT), or if you have received any vaccinations.
• Do not take Azathioprine if you are pregnant or planning for pregnancy, as Azathioprine is a Pregnancy category risk D medicine, which can cause serious congenital disabilities to the unborn baby.
• Azathioprine should not be taken by breastfeeding mothers as it passes into breast milk.
• While taking Azathioprine, avoid contact with anyone who has had shingles, chickenpox, or measles. If you accidentally come in contact with any person having them, please inform your doctor immediately, as it requires special treatment if you have not had these illnesses.
• Azathioprine causes dizziness and drowsiness, so drive with caution.
• Azathioprine should not be given to children as safety and efficacy have not been established.
• Avoid consuming alcohol along with Azathioprine as it could lead to increased dizziness. Your doctor may advise you to undergo regular blood tests, kidney and liver tests to monitor your condition.
• Using Azathioprine for a long time can increase your chance of getting certain types of cancer, such as lymphoma (cancer of the spleen, thymus gland, and bone marrow), leukaemia (blood cancer), and skin cancer.
• Avoid excessive exposure to sunlight, wear protective clothing, and use protective sunscreen with a high protection factor while using Azathioprine.

Drug-Drug Interaction: Azathioprine may have interaction with other immunosuppressant medicines (tacrolimus), anti-gout (allopurinol, oxypurinol, thiopurine), angiotensin-converting enzyme (ACE) inhibitors (benazepril, captopril, enalapril, fosinopril, moexipril, perindopril, quinapril, ramipril), blood thinner (warfarin, phenprocoumon), medicines used to treat inflammation of the bowels (infliximab), medicines used to treat ulcers (cimetidine, olsalazine, mesalazine, sulfasalazine), diuretics (furosemide), medicines used to treat bacterial infections (trimethoprim, sulfamethoxazole), pain killers (indomethacin), medicines used as muscle relaxants (d-tubocurarine, pancuronium, succinylcholine).

Drug-Food Interaction: Avoid alcohol consumption while taking Azathioprine as it may increase dizziness.

Drug-Disease Interaction: Azathioprine may cause interactions with certain disease conditions, including leukopenia (low levels of white blood cells), infections, unusual bleeding or bruising, liver dysfunction, and kidney dysfunction.

• Physical activity helps in strengthening muscles and relieves joint stiffness. Gentle activities like 20-30minutes of walking or swimming would be helpful.
• Practising yoga may also help improve joint flexibility and manage pain.
• Maintain a healthy weight by performing regular low-strain exercises and eating healthy food.
• Get adequate sleep, as resting the muscles can help in reducing inflammation and swelling.
• Follow heat or cold therapy, apply a cold or hot compress on the joints for 15-20minutes regularly.
• De-stress yourself by meditating, reading books, taking a warm bubble bath, or listening to soothing music.
• Acupuncture, massage, and physical therapy may also be helpful.
• Eat food rich in antioxidants such as berries, spinach, kidney beans, dark chocolate, etc.
• Foods containing flavonoids help in reducing inflammation. These include soy, berries, broccoli, grapes, and green tea.
• Avoid smoking and alcohol consumption.

• Use sunscreen while taking Azathioprine, as it can make your skin more sensitive to sunlight and may cause skin cancer.
• Long-term use of Azathioprine may increase your risk of developing cancers like blood cancer, skin cancer and immune system cancer (lymphoma).