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AZATHIOPRINE: It has marked effect on Tlymphocytes, suppreses cell mediated immunity (CMI) and is used primarily as immunosuppressant in organ transplantation, rheumatoid arthritis Azathioprine acts by inhibiting DNA syntheses and thus prevents the proliferation of lymphocytes that occurs in response to the newly introduced antigen (in the cause of transplant)

Indications: Renal transplantations Autoimmune disease. Severe rheumatoid arthritis unresponsive to other drugs.

Dosage: Renal transplantations : Initially 3-5 mg/kg bidy-wt followd by 1-3 mg/kg bodywt daily as maint dose Rheumatoid arthritis initially 1mg/kg body wt as a single dose. If required increase after 6-8 wks by 0.5 mg/kg body wt at 4 week intervals to max of 2.5 mg/kg bodywt Reduce tominium effective dose. Chronic active hepatitis : 1-5 mg/kg bodywt. daily other conditions : 2-2.5 mg/kg bodywt daily.

Contra indications: Pregnancy.

Special Precautions: Renal or hepatic dysfunction Avoid exposure to sun. Monitor blood counts regularly watch for infections & toxic effects.

Pediatrics: Safety not established
Pregnancy: Should not be used.
Lactation: Should not be used.
Elderly: Use with caution.

Side effects: G.I. disturbances, hepatotoxicity Rashes, Myelosuppresison.

Drug Interactions: Potentiation of other myleotoxic drugs Reverses effects of tubocurarine Enhances effects of succinylacholine Avoid concmitant use of gold antimalarials pencilamine.