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Azasan is a prescription medication approved by the Food and Drug Administration (FDA) in 1968 to help prevent rejection in people who had kidney transplants. More recently, it has been used to treat autoimmune diseases including rheumatoid arthritis. Azasan can reduce damage to joints and decrease the risk for disability. Azasan is often prescribed to be taken with a corticosteroid such as Prednisone. Azasan makes it possible to take lower doses of the steroid, and to withdraw it more quickly, thereby sparing worse side effects. Azasan may be referred to by its drug name, Azathioprine. Azathioprine is also sold under the brand name Imuran.

Azasan is an immunomodulator, or in other words, a drug that modulates the immune system. Azasan is also considered a disease-modifying antirheumatic drugs (DMARD). It is an antimetabolite which blocks the synthesis of purine, a protein the body needs in order to produce lymphocytes. Lymphocytes are a type of white blood cell active in the immune system. Azasan is believed to work by blocking the synthesis of lymphocytes, decreasing their numbers, and preventing them from attacking the joints.

How do I take it?
Azasan is taken orally in tablet form. It is usually prescribed to be taken once or twice daily. Taking Azasan with meals may decrease some side effects. Your doctor may start you on a low dose at first to gauge any side effects, and then slowly increase the dosage. However, some doctors begin immediately with the full dosage. It is important to note that while you may see results after only two weeks of taking Azasan, it usually requires three to four months to begin working, and may take as long as six or 12 months.

Your doctor may order regular complete blood count (CBC) and liver function tests while you are taking Azasan in order to monitor your risk for serious side effects.

It is important for both men and women to use effective birth control while taking Azasan. Also note that Azasan can lower the effectiveness of intrauterine devices (IUDs).

Azasan raises your risk for developing skin cancer. Wear protective clothing and sunblock with a high protection factor while taking Azasan.

For answers to frequently asked questions about exposure to Azathioprine during pregnancy and breastfeeding, visit the experts at

Side effects
Common side effects of Azasan include nausea, vomiting, loss of appetite and diarrhea.

Tell your doctor if you experience rare but serious side effects such as hair loss, muscle loss, greasy-looking stools, mouth sores, sensations of cold or numbness in the fingers, or pain or difficulty when swallowing.

Seek immediate medical attention if you experience signs of liver problems including yellowing of the skin or eyes, swollen or painful abdomen, black stools, or vomit that contains blood or a substance that looks like coffee grounds.

Azasan can weaken your immune system, making it less able to fight off infections. Inform your doctor if you experience signs of infection such as fever, chills and aches. Ask your doctor before receiving any vaccination or immunization while taking Azasan.

In rare cases, chronic use of Azasan has contributed to the development of cancers including lymphoma and skin cancer.

Another rare but serious side effect of taking Azasan is an increased risk of developing a brain infection called progressive multifocal leukoencephalopathy (PML). Seek immediate medical attention if you begin experiencing seizures, problems speaking or moving, vision changes, confusion or difficulty concentrating.

Many drugs can cause allergic reactions which, in the most serious cases, can result in death. Seek immediate medical help if you experience signs of a severe allergic reaction such as difficulty breathing or swelling in the face, throat, eyes, lips or tongue.

Azasan (Azathioprine) for Rheumatoid Arthritis Questions

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