What is Azamun used for?
Azamun tablets 50mg contain azathioprine, an immunosuppressant medication that is used to treat autoimmune diseases to relieve painful symptoms, and to prevent the body from rejecting a transplant. Azamun can be used on its own but is mostly used in addition to other medication such as corticosteroids, which are also immunosuppressive drugs, and Azamun can reduce the amount of steroids needed.
The immune system is your body’s defensive barrier that protects you from invasion with harmful organisms such as bacteria and viruses. It is a complex structure consisting of cells, proteins and chemicals that destroys foreign microorganisms recognised as non-self, also foreign cells such as in an organ transplant.
When working well, the immune system keeps you safe from harmful pathogens and recognises the difference between the invaders and your own cells. However, sometimes the immune system attacks the body’s own cells for no apparent reason, and this causes a variety of autoimmune disorders.
Organ transplant
Organ transplant is a final solution if you have organ failure such as liver, heart or kidney. You will need to be tested to make sure that your tissues have a close enough match to the organ you are receiving to prevent rejection. The Major Histocompatibility Complex (MHC) is a code for a group of genes known as the HLA (Human Leukocyte Antigen) system. The HLA proteins are found on all cells of the body and help the body’s immune system tell the difference between self and non-self. If the HLA proteins on the cells of the transplanted organ do not closely match, then the immune system identifies the transplant as non-self and attacks the healthy transplanted organ cells. This results in rejection and failure of the transplant. Azamun tablets 50mg weaken the immune system, which improves the transplant’s chances of survival.
Autoimmune disease
An overactive immune system that mistakes the body’s own cells as foreign is the cause of autoimmune disease. The immune system attacks otherwise healthy tissue causing its destruction. Antibodies are proteins produced by specialised cells of the immune system that recognise unique markers on the surface of foreign cells. This helps to assist other immune cells in destroying those foreign cells. Autoantibodies are produced when the immune system attacks the body’s own cells, and these can clog up the affected tissue or organ and ultimately lead to its destruction.
Symptoms of autoimmune disease range from moderate to severe, depending on which part of the body the disease targets and can include pain, inflammation, stiffness in the joints, swelling, skin rash, hair loss, fever, and fatigue. Azamun tablets 50mg are used to treat a range of autoimmune diseases
Types of autoimmune disease
Azamun tablets 50mg are used to manage the following autoimmune disease:
- Rheumatoid Arthritis is a chronic progressive disease of the joints in which the immune system attacks the lining the joints causing inflammation and swelling that results and deformity of the joints.
- Systemic Lupus Erythematosus (SLE) is a connective tissue disease that can affect many parts of the body like the skin, joints, blood vessels and various organs like the kidney.
- Ulcerative Colitis and Crohn's Disease are both inflammatory bowel disorders caused by the immune system attacking the lining of the intestines
- Dermatomyositis and polymyositis are both autoimmune inflammatory diseases of the muscles that cause muscle weakness
- Auto-immune chronic active hepatitis occurs when healthy liver cells are attacked by the immune system causing liver damage
- Pemphigus vulgaris is an autoimmune disease of the skin and mucous membranes causing blistering
- Polyarteritis nodosa is inflammation of the artery wall of small and medium arteries causing swelling and damage
- Auto-immune haemolytic anaemia occurs when red blood cells are targeted and destroyed resulting in insufficient numbers of oxygen-carrying cells in the blood
- Chronic refractory idiopathic thrombocytopenic purpura is the result of blood platelets being targeted and destroyed by the immune system, causing excessive bleeding and bruising
How does Azamun work?
An immunomodulator affects the way the immune system works. Azathioprine in Azamun tablets 50mg is an immunomodulator and acts as an immunosuppressant, which means that it dampens down and weakens the immune system.
Many specialised cell types make up the immune system, including white cells (leukocytes) called lymphocytes, and these comprise T-cells that recognise antigens on foreign cells and B cells that produce antibodies to these antigens. Once immune cells have been activated, they divide rapidly to amplify the immune response. A complex interaction between cells of the immune system causes the destruction of foreign cells.
If the foreign cell is harmful, that is the job of the immune system. However, if it is the body’s own cells that have been mistakenly identified by the immune system as foreign or is a much-needed transplant, this causes serious problems.
Azathioprine in Azamun tablets 50mg is classed as an antimetabolite drug because it interferes with the cell’s metabolic processes. Antimetabolites work by blocking access of a metabolite involved in a specific metabolic process. Azathioprine is a purine analogue, a molecule known as a nucleotide that is used to make DNA. If the immune cell incorporates azathioprine instead of purine to synthesise DNA, this blocks the cell from using purine which means that it cannot divide and replicate.
Antimetabolites like Azathioprine in Azamun tablets target rapidly dividing cells like activated T-cells and B-cells. It blocks their DNA synthesis and prevents them from replicating and producing autoantibodies directed against the body’s own cells. These autoantibodies can be specific to a single tissue such as joints in rheumatoid arthritis, or the whole body as in SLE. Transplants are also protected from harmful antibodies by the same mechanism.
The way that azathioprine in Azamun works means that it may take several weeks or months to become fully effective.
What does Azamun contain?
Azamun tablets 50mg contain the active ingredient azathioprine, an immunosuppressant medication used to treat autoimmune diseases and to prevent transplant rejection. They also contain cellulose microcrystalline, mannitol, povidone, maize starch, croscarmellose sodium, sodium stearyl fumarate in the tablet core. The tablet coating contains Opadry clear OY7240 (macrogol 400 and hypromellose).
What are the side effects of Azamun?
Most medications have some side effects, but they are not experienced by everyone. Some side effects that are commonly experienced when taking Azamun include nausea, increased bleeding and bruising, increased risk of infection.
When should Azamun not be used?
Have a talk with your primary healthcare physician before taking Azamun so that you have a full understanding of what this medicine is for and how to use it. There are some reasons for not taking a medication; these are called contraindications, and you should consider the following before taking Azamun:
- Have you ever had a reaction or an allergy when taking Azamun?
- Are pregnant or are breastfeeding?
- Do you have any disease of the kidneys or liver?
- Do you have or have you had a viral infection such as have chickenpox, shingles or Hepatitis B?
- Have recently had any vaccination, as azathioprine can affect how the vaccine works
What medications interact with Azamun?
Some medicines interact with Azamun and may affect the way it works, be affected by Azamun, or increase side effects. You should discuss possible interactions with your primary care physician, who may advise that you do not take Azamun or adjust the dose you take.
These may include: allopurinol, oxipurinol or thiopurinol for gout, succinylcholine used during anaesthesia, the anticoagulant warfarin, penicillamine for rheumatoid arthritis, the antibiotic co-trimoxazole, captopril for high blood pressure and heart failure, mesalazine, olsalazine or sulphasalazine for ulcerative colitis, methotrexate for cancer chemotherapy, the antiviral ribavirin for respiratory infection, frusemide for oedema, some non-steroidal anti-inflammatories like diclofenac and indomethacin.
If other medications may interact with Azamun, your doctor will discuss these with you.
How should Azamun be taken and for how long?
You should take your Azamun tablets 50mg swallowed whole with a glass of water at least one hour before or three hours after eating food or drinking milk. The dose you take and for how long depends on what you are being treated for, how well you respond and your doctor’s recommendation. Your doctor will keep a careful eye on you while you are taking Azamun and may adjust your dose.
You should continue to take your Azamun tablets 50mg for as long as recommended by your doctor, which may be long term or indefinitely for preventing transplant rejection.
Missed dose of Azamun
If you miss a dose of Azamun take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose. Do not take a double dose.
How should Azamun be stored?
You should store your Azamun below 25°C in a cool, dry place.