Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes Imuran (Azathioprine). If you are concerned about side effects, discuss the risks and benefits of Imuran (Azathioprine) with your doctor.

The following side effects have been reported by at least 1% of people taking Imuran (Azathioprine). Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• hair loss
• nausea
• tiredness

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• feeling dizzy or faint when rising from a sitting or lying position
• feeling tired, dizzy, or generally unwell
• Fever or chills
• nausea
• new marks or change in marks on your skin
• signs of clotting problems (e.g., unusual nosebleeds, bruising, blood in urine, coughing blood, bleeding gums, cuts that don’t stop bleeding)
• signs of infection (symptoms may include fever or chills, severe Diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness)
• symptoms of a lung infection (e.g., shortness of breath, cough, chest pain)
• symptoms of a urinary tract infection (e.g., pain when urinating, urinating more often than usual, low back or flank pain, strong odour)
• vomiting

Stop taking the medication and seek immediate medical attention if any of the following occur:

• muscle or bone pain
• severe skin reaction such as redness or blisters on skin or peeling skin
• severe nausea, vomiting, diarrhea, or stomach pain
• dizziness or faintness especially when you stand up
• signs of kidney problems (e.g., increased urination at night, decreased urine production, blood in the urine, change of urine colour)
• signs of a Anaphylaxis (severe allergic reaction), e.g.:
• difficulty breathing
• Hives
• swelling of the face, mouth, throat, or tongue

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Imuran (Azathioprine).

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Imuran (Azathioprine).

50 mg tablet
Each pale yellow, peanut-shaped tablet, engraved "AZ 50" on one side and score lines on the other, contains 50 mg of Imuran (Azathioprine). Nonmedicinal ingredients: lactose, magnesium stearate, microcrystalline cellulose, and starch.

Injection
Each 17 mL vial contains 50 mg of Imuran (Azathioprine) sodium. Nonmedicinal ingredient: sodium hydroxide to adjust pH.

Do not use Imuran (Azathioprine) if you are allergic to Imuran (Azathioprine) or any ingredients of the medication.

There may be an interaction between Imuran (Azathioprine) and any of the following:

• 5-ASA medications (e.g., Mesalamine, Olsalazine, Sulfasalazine)
• Adalimumab
• Allopurinol
• angiotensin-converting enzyme (ACE) inhibitors (e.g., Enalapril, Ramipril)
• Baricitinib
• certolizumab
• Cladribine
• cotrimoxazole
• Cyclophosphamide
• Denosumab
• echinacea
• Etanercept
• Febuxostat
• Fingolimod
• Golimumab
• Infliximab
• Leflunomide
• Mercaptopurine
• Natalizumab
• Nivolumab
• Ocrelizumab
• Pimecrolimus
• ribavirin
• Roflumilast
• siponimod
• sulfamethoxazole
• Tacrolimus
• Tofacitinib
• Trastuzumab
• Trimethoprim
• upadacitinib
• vaccines
• Warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Imuran (Azathioprine). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking.

Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Medications other than those listed above may interact with Imuran (Azathioprine). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin taking a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Imuran (Azathioprine).

Cancer: Imuran (Azathioprine) may increase your risk of developing certain types of cancer, specifically hepatosplenic T-cells lymphoma, a particularly severe cancer of the immune cells, and Skin Cancer.

To reduce the risk of skin cancer, limit your exposure to sunlight and ultraviolet light, wear protective clothing, and use sunscreen with a high sun protection factor. Report any unusual growths on your skin to your doctor as soon as possible.

Bleeding: Imuran (Azathioprine) can decrease the number of platelets (component of the blood that helps blood to clot). Your doctor will monitor your platelet levels regularly while you are taking Imuran (Azathioprine). If you notice any unusual signs of bruising or bleeding (e.g., bleeding gums, blood in urine, dark-tarry stools), contact your doctor immediately or get immediate medical attention.

Infection: Imuran (Azathioprine) reduces the number of white blood cells that fight infection in the body and can increase the risk of bacterial, fungal, and viral infections. If you notice any signs of infection (e.g., fever, chills, cough, painful urination) or any other unusual symptoms, contact your doctor. Contact your doctor immediately if you come into contact with someone who has Chickenpox or Shingles. Your doctor will monitor your white blood cell levels regularly while you are taking Imuran (Azathioprine).

Kidney function: Imuran (Azathioprine) may be removed from the body more slowly in people with reduced kidney function. If you have reduced kidney function discuss with your doctor how Imuran (Azathioprine) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Imuran (Azathioprine), and whether any special monitoring is needed.

Liver function: Liver damage or reduced liver function may cause Imuran (Azathioprine) to build up in the body, causing side effects. If you have liver disease, discuss with your doctor how Imuran (Azathioprine) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Imuran (Azathioprine), and whether any special monitoring is needed.

Imuran (Azathioprine) may reduce liver function and can cause liver failure. If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.

Pregnancy: Imuran (Azathioprine) can cause harm to the baby when taken by pregnant women. Imuran (Azathioprine) should not be used during pregnancy unless the benefits outweigh the risks. Effective birth control should be practiced while using Imuran (Azathioprine). If you become pregnant while you are taking Imuran (Azathioprine), contact your doctor at once.

Breast-feeding: Imuran (Azathioprine) may pass into breast milk. If you are a breast-feeding mother and are taking Imuran (Azathioprine) it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using Imuran (Azathioprine) have not been established for children.

Seniors: The safety and effectiveness of using Imuran (Azathioprine) have not been established for people over the age of 65. Discuss the risks and benefits of taking Imuran (Azathioprine) with your doctor.