FM1997

Disease Modifying Drugs > Azathioprine (Imuran)

 
Dosage: Start 25mg  - 50mg twice daily orally
Increase to 50mg tds if no response in 3 months

Several important drug interactions.
Check BNF before co-prescribing.

Investigations before starting treatment performed by rheumatologist

Monitoring of treatment by primary health care team

Monitoring of Methotrexate treatment by primary health care team

 
Investigation Frequency Action required
FBC Weekly for THREE months,
then Monthly
STOP if: WBC <4 x 109/L
neutrophils <2 x 109/L
platelets <150 x 109/L
OR if: sequential fall of >10% in 3 counts
    Check B12 and folate if macrocytosis

 
LFT Every 2 Months STOP if: >twofold rise in AST or ALT or Alk Phos
U&E Every 4 Months  

Please note that in addition to absolute values for haematological indices a rapid fall
or consistent downward trend  in any values should prompt caution and extra vigilance.

Side effects
Mouth ulcers, rash STOP
Nausea Split or reduce dose - get advice if persistent

 

These guidelines have been with permission from the department of rheumatology, Gwent Rheumatology Service.

 

 
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Francisco Machado 1997