Epidemiology

• Used to treat both neoplastic and non-neoplastic conditions

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Dosing and Administration

• PO: 2.5 mg/kg/day -> start at 50 mg/day (max: 200 mg/day)
  • Maximal effects may not be seen for 6-9 months
  • Better side effect profile than cyclophosphamide
  • May be used long-term
• Monitor: LFT’s, CBC

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Pharmacology

• Metabolized to 6-mercaptopurine (which is known to have pulmonary toxicity)

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Adverse Effects

Pulmonary Adverse Effects

• Interstitial Lung Disease (see Interstitial Lung Disease-Etiology)
  • Epidemiology: several case reports of Azathioprine-associated pneumonitis
• Diffuse Alveolar Hemorrhage (see Diffuse Alveolar Hemorrhage)
  • Diagnosis: absence of pulmonary capillaritis

GI Adverse Adverse Effects

• Acute Pancreatitis (see Acute Pancreatitis)
• Elevated Liver Function Tests

Hematologic Adverse Effects

• Myelosuppression

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References

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