Azathioprine 175mg/5ml oral suspension
Requires a prescription from a doctor or prescriber
Drugs affecting the immune response
Official documents, adverse reaction reporting, and safety monitoring
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Official medicine documents
Safety monitoring data
Yellow Card reports
The MHRA Yellow Card scheme collects reports of suspected side effects from healthcare professionals and patients. View the Drug Analysis Profile (iDAP) for real-world adverse reaction data.
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Suspected adverse reactions reported for Azathioprine
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Submit a Yellow Card report to the MHRA
Data from the MHRA Yellow Card scheme. A reported reaction does not necessarily mean the medicine caused it. Contains public sector information licensed under the Open Government Licence v3.0.
EudraVigilance
The European Medicines Agency (EMA) collects suspected adverse reaction reports from across the EU/EEA through the EudraVigilance system. Search for safety data on this medicine.
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Suspected adverse reactions reported for Azathioprine
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EudraVigilance data is published by the European Medicines Agency (EMA). A suspected adverse reaction is not necessarily caused by the medicine.
1 branded products available
WHO defined daily dose (DDD)
150 mg
Not a recommended dose. The DDD is the assumed average maintenance dose per day for a drug used for its main indication in adults. It is a statistical measure used for research and comparison purposes only.
Source: WHO Collaborating Centre for Drug Statistics Methodology, distributed via NHS dm+d BNF mapping files. Contains public sector information licensed under the Open Government Licence v3.0.
Therapeutically similar medicines
Similarity based on WHO Anatomical Therapeutic Chemical (ATC) classification and NHS BNF section grouping. Source data: NHS dm+d via TRUD (OGL v3.0), WHO ATC/DDD Index.
NHS prescribing volume and spending trends
Clinical guidelines and formulary information
British National Formulary
Azathioprine
Source: British National Formulary, NICE. Joint Formulary Committee. Contains public sector information licensed under the Open Government Licence v3.0.
NICE clinical guidance(13)
Crohn's disease: management (NG129)
Avacopan for treating severe active granulomatosis with polyangiitis or microscopic polyangiitis (TA825)
Ulcerative colitis: management (NG130)
Immunosuppressive therapy for kidney transplant in children and young people (TA482)
Infliximab, adalimumab and golimumab for treating moderately to severely active ulcerative colitis after the failure of conventional therapy (TA329)
Everolimus for preventing organ rejection in liver transplantation (TA348)
Alitretinoin for the treatment of severe chronic hand eczema (TA177)
Idiopathic pulmonary fibrosis in adults: diagnosis and management (CG163)
Immunosuppressive therapy for kidney transplant in adults (TA481)
Certolizumab pegol for treating rheumatoid arthritis after inadequate response to a TNF-alpha inhibitor (TA415)
Rituximab in combination with glucocorticoids for treating anti-neutrophil cytoplasmic antibody-associated vasculitis (TA308)
Dupilumab for treating moderate to severe atopic dermatitis (TA534)
Romiplostim for the treatment of chronic immune thrombocytopenia (TA221)
Source: National Institute for Health and Care Excellence (NICE). Contains public sector information licensed under the Open Government Licence v3.0.
Check stock at pharmacies and supply information
Pharmacy stock checkers
Search for this medicine at major UK pharmacy chains. These links open the retailer's own website — results depend on their current online catalogue.
Supply & product information
Official product databases and supply status monitoring
Pharmacy links redirect to the retailer's own search and do not represent real-time stock levels. emc (electronic medicines compendium) is operated by Datapharm Ltd. Shortage information sourced from NHS Specialist Pharmacy Service (SPS), sps.nhs.uk.
Codes for healthcare professionals and prescribing systems
These codes are used by healthcare IT systems and prescribers to identify this medicine.
NHS UK identifiers
Browse tools
SNOMED CT and dm+d codes from NHS TRUD (Technology Reference data Update Distribution), licensed under the Open Government Licence v3.0. BNF codes from NHS Business Services Authority (NHSBSA). ATC codes from the WHO Collaborating Centre for Drug Statistics Methodology (whocc.no).
Active and completed clinical studies from ClinicalTrials.gov
Source: ClinicalTrials.gov, a database of the U.S. National Library of Medicine (NLM), National Institutes of Health (NIH). Data accessed via ClinicalTrials.gov API v2. Trial information is provided for research purposes and does not constitute medical advice.
Pharmacology and chemical data from DrugBank
Key facts
Drug status
Approved
Major interactions
27 found
Half-life
5 hours
Mechanism
Azathioprine's mechanism of action is not entirely understood but it may be rela…
Food interactions
1 warning
Human targets
2 targets
Data: DrugBank · CC BY-NC 4.0
Pharmacokinetics at a glance
Absorption
1-2h
[L11214]
Further data regarding the absorption of azathioprine is not readily available.
[A189657][A189663]…
Half-life
5 hours
[L11214]
Protein binding
30%
[A189603]
Volume of distribution
[A189657][A189663]
Metabolism
[A14289]…
Elimination
8 hours
[L11214]…
Clearance
[A189657][A189663]
Pharmacokinetic data: DrugBank · CC BY-NC 4.0
Azathiprine was granted FDA approval on 20 March 1968.[L11214]
[L11214]
Known interactions with other medications. Always consult a healthcare professional.
Showing 50 of 1298 interactions
[L11214]
Patients experiencing an overdose may present with bone marrow hypoplasia, bleeding, and infection, which may progress to death.
[L11214]
Patients should be treated with supportive and symptomatic treatments. 8 hour hemodialysis may remove 45% of a dose from serum.
[L11214]
6-thioguanine triphosphate, a metabolite of azathioprine, modulates activation of rac1 when costimulated with CD28, inducing T cell apoptosis.[A19872] This may be mediated through rac1's action on mitogen-activated protein kinase, NF-kappaB.[A19872]
How the body processes this drug — absorption, distribution, metabolism, and elimination
[L11214]
Further data regarding the absorption of azathioprine is not readily available.
[A189657][A189663]
[L11214]
[A189603]
[A189657][A189663]
[A14289]
6-mercaptopurine is then metabolized to 6-methylmercaptopurine by thiopurine methyltransferase, 6-thiouric acid by xanthine oxidase, or 6-thiosine-5'-monophosphate by hypoxanthine phosphoribosyltransferase.
[A14289]
6-thiosine-5'-monophosphate is metabolized to 6-methylthiosine-5'-monophosphate by thiopurine methyltransferase or 6-thioxanthylic acid by inosine monophosphate dehydrogenase.
[A14289]
6-thioxanthylic acid is metabolized by guanosine monophosphate synthetase to 6-thioguanine monophosphate, the first of the 6-thioguanine nucleotides.
[A14289]
6-thioguanine monophosphate is phosphorylated to produce the remaining 6-thioguanine nucleotides, 6-thioguanine diphosphate and 6-thioguanine triphosphate.
[A14289]
[L11214]
Further data regarding the route of elimination of azathioprine are not available.
[A189669]
[A189657][A189663]
Proteins and enzymes this drug interacts with in the body
PMID:1643658 PMID:22843693 PMID:23512198 PMID:28886345
Rac1 p21/rho GDI heterodimer is the active component of the cytosolic factor sigma 1, which is involved in stimulation of the NADPH oxidase activity in macrophages. Essential for the SPATA13-mediated regulation of cell migration and adhesion assembly and disassembly.
Stimulates PKN2 kinase activity .
PMID:9121475
In concert with RAB7A, plays a role in regulating the formation of RBs (ruffled borders) in osteoclasts .
PMID:1643658
In podocytes, promotes nuclear shuttling of NR3C2; this modulation is required for a proper kidney functioning. Required for atypical chemokine receptor ACKR2-induced LIMK1-PAK1-dependent phosphorylation of cofilin (CFL1) and for up-regulation of ACKR2 from endosomal compartment to cell membrane, increasing its efficiency in chemokine uptake and degradation. In neurons, is involved in dendritic spine formation and synaptic plasticity (By similarity).
In hippocampal neurons, involved in spine morphogenesis and synapse formation, through local activation at synapses by guanine nucleotide exchange factors (GEFs), such as ARHGEF6/ARHGEF7/PIX .
PMID:12695502
In synapses, seems to mediate the regulation of F-actin cluster formation performed by SHANK3. In neurons, plays a crucial role in regulating GABA(A) receptor synaptic stability and hence GABAergic inhibitory synaptic transmission through its role in PAK1 activation and eventually F-actin stabilization (By similarity). Required for DSG3 translocation to cell-cell junctions, DSG3-mediated organization of cortical F-actin bundles and anchoring of actin at cell junctions; via interaction with DSG3 .
PMID:22796473
Subunit of the phagocyte NADPH oxidase complex that mediates the transfer of electrons from cytosolic NADPH to O2 to produce the superoxide anion (O2(-)) PMID:38355798
Enzymes involved in drug metabolism — important for understanding drug interactions
Proteins that transport this drug across cell membranes
PMID:10722669 PMID:12527552 PMID:12590919 PMID:16214850 PMID:21795683 PMID:9396714 PMID:9478986
Functions as a Na(+)-independent, passive transporter .
PMID:9478986
Involved in the transport of nucleosides such as inosine, adenosine, uridine, thymidine, cytidine and guanosine .
PMID:10722669 PMID:12527552 PMID:12590919 PMID:16214850 PMID:21795683 PMID:9396714 PMID:9478986
Also able to transport purine nucleobases (hypoxanthine, adenine, guanine) and pyrimidine nucleobases (thymine, uracil) .
PMID:16214850 PMID:21795683
Involved in nucleoside transport at basolateral membrane of kidney cells, allowing liver absorption of nucleoside metabolites .
PMID:12527552
Mediates apical nucleoside uptake into Sertoli cells, thereby regulating the transport of nucleosides in testis across the blood-testis-barrier .
PMID:23639800
Mediates both the influx and efflux of hypoxanthine in skeletal muscle microvascular endothelial cells to control the amount of intracellular hypoxanthine available for xanthine oxidase-mediated ROS production (By similarity)
PMID:11032837 PMID:15861042 PMID:16446384 PMID:17140564 PMID:21998139
Involved in the homeostasis of endogenous nucleosides .
PMID:11032837 PMID:15861042
Exhibits the transport characteristics of the nucleoside transport system cib or N3 subtype (N3/cib) (with marked transport of both thymidine and inosine) .
PMID:11032837
Employs a 2:1 sodium/nucleoside ratio .
PMID:11032837
Transports uridine .
PMID:21795683
Also able to transport gemcitabine, 3'-azido-3'-deoxythymidine (AZT), ribavirin and 3-deazauridine PMID:11032837 PMID:17140564
PMID:2897240 PMID:35970996 PMID:8898203 PMID:9038218 PMID:35507548
Catalyzes the flop of phospholipids from the cytoplasmic to the exoplasmic leaflet of the apical membrane. Participates mainly to the flop of phosphatidylcholine, phosphatidylethanolamine, beta-D-glucosylceramides and sphingomyelins .
PMID:8898203
Energy-dependent efflux pump responsible for decreased drug accumulation in multidrug-resistant cells PMID:2897240 PMID:35970996 PMID:9038218
PMID:26455426 PMID:32339528
May regulate fatty acid (FA) transport in adipocytes, acting as a positive regulator of FA efflux and as a negative regulator of FA uptake (By similarity)
Proteins that carry this drug through the body
PMID:19021548
Major calcium and magnesium transporter in plasma, binds approximately 45% of circulating calcium and magnesium in plasma (By similarity).
Potentially has more than two calcium-binding sites and might additionally bind calcium in a non-specific manner (By similarity). The shared binding site between zinc and calcium at residue Asp-273 suggests a crosstalk between zinc and calcium transport in the blood (By similarity). The rank order of affinity is zinc > calcium > magnesium (By similarity).
Binds to the bacterial siderophore enterobactin and inhibits enterobactin-mediated iron uptake of E.coli from ferric transferrin, and may thereby limit the utilization of iron and growth of enteric bacteria such as E.coli .
PMID:6234017
Does not prevent iron uptake by the bacterial siderophore aerobactin PMID:6234017
Involved compounds
Involved compounds
ATC L04AX01
Chemical identifiers
CAS, UNII, InChI Key and database cross-references
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Chemical identifiers
CAS, UNII, InChI Key and database cross-references
Linked compound data from DrugBank Open Data (CC BY-NC 4.0)
Azathioprine
Additional database identifiers
Drugs Product Database (DPD)
10128
ChemSpider
2178
BindingDB
50373919
ZINC
ZINC000004258316
HUGO Gene Nomenclature Committee (HGNC)
HGNC:9238
GenAtlas
PPAT
GeneCards
PPAT
GenBank Gene Database
D13757
GenBank Protein Database
219459
UniProt Accession
PUR1_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:9801
GenAtlas
RAC1
GeneCards
RAC1
GenBank Gene Database
M29870
GenBank Protein Database
190824
UniProt Accession
RAC1_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:5157
GenAtlas
HPRT1
GeneCards
HPRT1
GenBank Gene Database
M31642
GenBank Protein Database
306885
UniProt Accession
HPRT_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:23063
GeneCards
NUDT15
UniProt Accession
NUD15_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:12805
GenAtlas
XDH
GeneCards
XDH
GenBank Gene Database
D11456
GenBank Protein Database
10336525
Guide to Pharmacology
2646
UniProt Accession
XDH_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:12014
GenAtlas
TPMT
GeneCards
TPMT
GenBank Gene Database
S62904
GenBank Protein Database
386420
UniProt Accession
TPMT_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:4626
GenAtlas
GSTA1
GeneCards
GSTA1
GenBank Gene Database
M15872
GenBank Protein Database
306809
UniProt Accession
GSTA1_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:4627
GenAtlas
GSTA2
GeneCards
GSTA2
GenBank Gene Database
M16594
GenBank Protein Database
306811
UniProt Accession
GSTA2_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:4632
GenAtlas
GSTM1
GeneCards
GSTM1
GenBank Gene Database
X08020
GenBank Protein Database
31924
UniProt Accession
GSTM1_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:6052
GenAtlas
IMPDH1
GeneCards
IMPDH1
GenBank Gene Database
J05272
GenBank Protein Database
307067
Guide to Pharmacology
2624
UniProt Accession
IMDH1_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:6053
GenAtlas
IMPDH2
GeneCards
IMPDH2
GenBank Gene Database
J04208
GenBank Protein Database
307066
Guide to Pharmacology
2625
UniProt Accession
IMDH2_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:4378
GenAtlas
GMPS
GeneCards
GMPS
GenBank Gene Database
U10860
GenBank Protein Database
595410
UniProt Accession
GUAA_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:6176
GeneCards
ITPA
UniProt Accession
ITPA_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:2596
GenAtlas
CYP1A2
GeneCards
CYP1A2
GenBank Gene Database
Z00036
Guide to Pharmacology
1319
UniProt Accession
CP1A2_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:399
GenAtlas
ALB
GeneCards
ALB
GenBank Gene Database
V00494
GenBank Protein Database
28590
UniProt Accession
ALBU_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:11004
GeneCards
SLC29A2
UniProt Accession
S29A2_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:16484
GeneCards
SLC28A3
GenBank Gene Database
AF305210
GenBank Protein Database
10732815
Guide to Pharmacology
1116
UniProt Accession
S28A3_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:40
GenAtlas
ABCB1
GeneCards
ABCB1
GenBank Gene Database
M14758
GenBank Protein Database
307180
Guide to Pharmacology
768
UniProt Accession
MDR1_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:17466
GeneCards
SLC43A3
UniProt Accession
S43A3_HUMAN
International reference pricing
Reference pricing from DrugBank. Prices are indicative and may not reflect current UK costs.
Source: DrugBank. Used under CC BY-NC 4.0 academic licence for non-commercial purposes.
DrugBank citations
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