Nausea with Azathioprine

[Investigator1]

Hi all, I was diagnosed with GPA last December and after being on Prednisolone and Cyclophosphomide for 4 months the Steroids are greatly reduced and I have moved onto Azathioprine (Imuran) I have been on it 5 weeks and all is ok apart from the fact that I am struggling with Nausea. It comes on about an hour after I have taken the tablets with food and is only bad for about 2 hours but it’s a swine. I don’t want to come of it because my blood tests are showing it’s doing it’s job. Has anybody had a similar experience......please share.

[AndrewT]

Dear Investigator1,

I can only 'speak' as I found, for the roughly Fifteen years, that I was on Azathioprine. I was on 150mg per day, along with Prednisolone, Amlodipine, Ramipril and 'other drugs' that varied, a little, over the years. However I was also prescribed 'Omeprazole' a 'Proton Pump Inhibitor'- which reduce the amount of acid, your stomach, produces. It was Specifically Prescribed, to me, 'In Order To stop Drug Interactions'.

Even though my Medication has changed a fair bit, I had a Kidney Transplant- in July 2013- both Prednisolone and Omeprazole have remained. I have had no Problems, with Omeprazole, and it has VERY Definitely 'helped' me to avoid Sickness/ Nausea, often caused by other Drugs.

If you are not currently 'Taking' this Drug it might, well be, worth your asking for it. There ARE admittedly, quite a few, 'Side Effect' listed however the Only one, that I have heard of directly, was someone who found his 'Mineral' levels dropping. 'They' will, in any case, perform Regular blood tests, to ensure that this is Safe, for you to take.

Don't be Put Off though, please Do ask.

AndrewT

[Investigator1 in reply to AndrewT]

Thanks AndrewT that’s good advice, I have a prescription of Lansazrapole which is in the same group of medicines. I will check with my specialist. Thanks again.

[Main1234]

If you have a look under “related posts” you can see that over the years people have discussed nausea and AZA . Andrews suggestion might be worth following up , do you split your dose? Hope you find an answer.

Take care and stay safe

[Investigator1 in reply to Main1234]

Hi thanks for replying I want to split the dose but it’s getting hold of somebody to authorise it! It’s because it’s early days with the drug but Covid19 is rife at my hospital, so getting hold of my specialist is hard. Will keep trying.

[jojod78]

My advice is take them of a night as thats what i was told and you should sleep through the nausea. I was also on anti sickness which helped.

[sorefeetsoldier]

Hi

I also take 200mg Azathrioprine for 5yrs now.

I take at bed time with omeprazole seems to work.

🖖

[Borderblue]

I take 200 mg at night after my evening meal and have no issues but I also take omeprazole which has been prescribed instead of ranitidine. My consultant did say that if I suffered with nausea I could split the dose. Good luck.

[jane1964]

Hello I had nausea when I first started azathioprine I would get a sudden feeling of nausea an hour or two after the dose.I found having more to eat when I took them helped so I changed to taking with a bigger breakfast and that helped.Now I don't have any problems.But if your feeling bad I would give your doctor a call to help.Jane

[Chris-Bromsgrove]

Hi Investigator. If you find you really can't get on with Azathioprine (I couldn't) there are other alternatives. I've been on Mycophenolate for many years now without any problems. Hope you get it sorted. Chris

[Investigator1]

Hi All. A big thank you to all those people who replied and you all gave me some fantastic advice. Since starting the Lansaparazole things have improved and my specialist called today and said she was so pleased with my progress that she wants to reduce my Azarathropine to 100mg from 150mg and to split the dose, she also told me (as some of you have pointed out) there are plenty of alternatives. Let’s see how we go. Thanks again.

[Katiz]

I take azathioprine together with prednisone and have done for over 18 months, on a reducing amount. I avoid the nausea by taking at bed time as I find I can sleep through it. Worth a try? I can’t take omeprazole because the vasculitis attacked my kidneys.

[ns69]

Hi there, I was diagnosed in 2010 with Wegeners and by the sound of it have also had the same medication as yourself. I had a reaction to Imuran, it temporarily paralysed me from the neck down. I was taken off of it and put back on steroids. I have since had 4 years of Retuximab infusions. I am back on track but lost my right eye. Things will get better with time.

Nick