Best time to take Azathioprine?

[Happy43]

Can anyone help me with when to take Azathioprine? Is morning or evening better?

Thanks 😊

[happytulip]

When I started aza I had side effects for the first four days which were headache and nausea.

From my experience I found it best to take it in the evening and then go straight to bed. This meant that I slept through the side effects and after four days they went. Eventually I then went on to taking it morning and evening with no problems.

Good luck.

[Happy43 in reply to happytulip]

Thank you 😊

[Happy43 in reply to happytulip]

Just read the information leaflet, it says take during a meal. Did you take it before bed or with evening meal? Sorry for questions, just want to minimise any effects!

[happytulip in reply to Happy43]

No problem, ask away. That's how I learnt!

I was suffering a lot of fatigue at the time so I ate between 6pm-7pm, took it immediately after food. Sat upright for about 30 mins either relaxing on the sofa or in bed and then drifted off to sleep.

When I took it for the first 4 days it gave me an almost instant low grade headache so I took my evening dose of paracetamol at the same sort of time. Unless specified otherwise, I always try to take my medication with food.

Let us know how you get on with it. It does take a while to work.

[Happy43 in reply to happytulip]

Thank you so much, that's very helpful. I'm starting it tonight, I hope it works 🤞.

[happytulip in reply to Happy43]

Hope it goes ok for you. It takes time to work, let's hope it suits you!

[studiomaster1 in reply to Happy43]

Hi Happy 43,

I have been on Azothioprine now for around 5 months. I take mine with my steroids after breakfast and so far have not had any issues. Of course it may differ from person to person. I suffer from PMR and have had no side effects doing it this way. I'm not sure it matters what time it is taken but should always be taken with or shortly after food. I hope it works for you.

[Happy43 in reply to studiomaster1]

Hi studiomaster1 thanks for your reply. Have you started to feel better on it yet?

[studiomaster1 in reply to Happy43]

If i'm honest I don't know that I am taking the Azothioprine other than the fact that I have been able to reduce the amount of Pred that i'm on without major flare ups. I'm still at a level of Pred that is causing me problems . That was my reason for agreeing to try Azothioprine as a steroid sparer, to try and get the steroid dose low enough to improve things for me. I'm not there yet. Having read up on the limited info on Azothioprine though i'm going to rethink what i am doing. I don't like what I am hearing about the lont term use of Azo.

[Happy43 in reply to studiomaster1]

That was my understanding, that Azathioprine is a better option than steroids long term. I have not been offered steroids but I did have a steroid injection last year which helped and the Rheumatologist suggested Azathioprine based on the fact I had responded well to that.

I've not heard anything regarding long term use of Azathioprine, many people on here have taken it long term I think?

[happytulip in reply to Happy43]

Essentially it's a mild form of chemotherapy in a tablet and that comes with risks, but all drugs do. You have to weigh up if taking the drug and it's potential benefits of managing your lupus (if it works for you), outweighs the risks of long-term medications.

Many transplant patients take aza for life to prevent rejection.

If it were me I would give it a go with aza but talk to your rheumie nurse or doctor about any concerns regarding long term risks. If you can get your steroid dose down that will benefit your body as long term steroids have so many risk factors. I've been trying to get off them for 5 years 😭

[Happy43 in reply to happytulip]

I'm ok with trying the Azathioprine, things have progressed over the last six months symptoms wise and after my last telephone appointment two weeks ago with Rheumatology they were keen to get me started asap as they feel something is brewing as they put it!

I've been having severe nose bleeds and head pain with recurrent sinusitis, they mentioned Vasculitis as I am also ANCA/MPO positive aswell as UCTD/Lupus.

I'm not on steroids which is good, I read a lot about people trying very hard to taper off them and it sounds awful. Are you still on Azathioprine aswell as the steroids?

I've done two nights now and so far so good, no headaches or sickness 🤞.