Azathioprine treatment for respiratory conditions. Information for patients Respiratory Medicine

Transcription

1 Azathioprine treatment for respiratory conditions Information for patients Respiratory Medicine

2 What is azathioprine? Azathioprine (also known as Imuran) is a treatment for the immune system. It is used in many inflammatory diseases such as rheumatoid arthritis, bowel diseases, skin conditions and some cancers. Although not licensed for use in asthma or interstitial lung diseases, it is being used more widely and with increasing success in these conditions. How does azathioprine work? Azathioprine acts on certain cells in your immune system to try to damp down the inflammation which causes your lung disease. How do I take azathioprine? Azathioprine is taken as a tablet, preferably with meals, and with at least a glass of water. At first, you will be given a small dose which will be increased as your body gets used to it. As a guideline, we aim for approximately two milligrams of azathioprine to one kilogram of body weight. How often do I take azathioprine? Azathioprine is taken once or twice daily, depending on the dose. This will be clearly shown on the box. How long will I need to take azathioprine? Azathioprine is an ongoing treatment and the length of time you take it will be decided by your doctor and your response to the treatment. Will I still need my other treatments? Yes. Azathioprine is used to help improve your disease and reduce the amount of steroids you need. You will be given clear guidance regarding any treatment changes. page 2 of 8

3 How will I know if the azathioprine is working? You should begin to need less steroid therapy for your respiratory condition. In asthma, your attacks should become less frequent and less severe. In interstitial or scarring lung disease, your breathing tests will monitor the effects of treatment. Are there any side effects? As with any medication, azathioprine can have side effects. The most common include feelings of nausea and tiredness but this usually settles once your body gets used to it. It can also cause hair thinning, and studies suggest that one in ten people may experience this reaction. Less common side effects include an increased risk of some infections. It can also upset your liver, your lung or your blood count but these can be detected through regular blood monitoring. Some people (1 in 50 to 1 in 100) experience a nasty flu-like reaction. If you feel very unwell you should seek urgent medical attention and stop the treatment. Sun exposure can increase the risk of some skin cancers and should be avoided or use high factor sun screen preferably above factor 15. It is important that you discuss any changes in your day to day health after you have started azathioprine as everyone is different and may react differently to the treatment. This will also enable us to keep you as well as possible whilst taking the treatment. page 3 of 8

4 What are the benefits of taking azathioprine? The reason for taking azathioprine is to reduce or even stop the need for steroid medication such as prednisolone. This is important as steroids have numerous side effects which cannot always be detected. Are there any other ways to treat my condition? The most effective way to treat your condition is to suppress your immune system. However, azathioprine is not the only drug available which achieves this. If you do not respond well to it, your consultant will discuss any other options with you. Will I need any special tests whilst taking azathioprine? Yes. You will need to have regular blood tests to see how well the azathioprine is working and to be sure it is not causing any harm. Usually this is weekly for four weeks, two weekly for four weeks and monthly thereafter. Can I take other medicines whilst taking azathioprine? Yes, but it is very important that you tell your doctor, pharmacist and/or dentist that you are taking azathioprine. Always check that any drugs you buy over the counter are safe to take with azathioprine. Drugs you should not take with azathioprine include: Some anti epileptic drugs, again speak to your doctor if you need these. Certain heart drugs should also be reviewed before taking azathioprine, but again speak to your doctor. You should not have any live vaccines without speaking to your doctor first. You also need to avoid people who have chicken pox or shingles, especially if you have not had these illnesses yourself. page 4 of 8

5 What should I do if I forget my medication? If you forget to take your medication, just miss the dose for that day and carry on as usual when you remember. Never double up on your treatment. If you forget your treatment for a number of days you should contact your doctor or specialist nurse for further advice. What should I do if I take more medication than I should? You should contact your GP, Hospital Support or NHS 111 (if out of hours) urgently as you may need special treatment to prevent the drug causing any harm. See Useful contact numbers on page 7. How should I store my azathioprine? Store at room temperature and keep out of the reach of children. Do not use after the expiry date printed on the box. How do I get a repeat prescription? Azathioprine should be prescribed by your hospital consultant and dispensed by the hospital pharmacy. Once you are settled on the treatment, we may be able to arrange shared care with your local surgery. What if my partner and I want to start a family? Azathioprine can cause birth defects, whether it is the father or mother who takes it. All patients and their partners must take extremely reliable contraceptive precautions during treatment and for at least three months after treatment has been stopped. page 5 of 8

6 Can I drink alcohol whilst taking azathioprine? Alcohol can damage your liver and azathioprine can increase the risk of this. We recommend you have no more than five units per week whilst taking the treatment. What if I want more information? This booklet is meant as a brief introduction to azathioprine treatment. You are advised to read the manufacturer's leaflet for a more detailed review. Any concerns or questions should be discussed with your doctor or nurse specialist. No question is too trivial. If you have internet access you may find these following web sites useful: page 6 of 8

7 Useful contact numbers Dawn Weston and Carly Straw - Interstitial Lung Disease Nurse Specialists Clare Daniel - Asthma Nurse Specialist Claire Copeland - Secretary to Professor Sabroe and Professor Renshaw Theresa Ainsworth - Secretary to Dr Bianchi and Dr Barber Medicines Helpline These numbers are only answered Monday to Friday during office hours, however they do have an answer machine service. For support outside of office hours please contact NHS 111: 111 (freephone telephone advice) page 7 of 8

8 Produced with support from Sheffield Hospitals Charity Working hard to fund improvements that make life better for patients and their families Please donate to help us do more Registered Charity No Alternative formats may be available on request. Please Sheffield Teaching Hospitals NHS Foundation Trust 2016 Re-use of all or any part of this document is governed by copyright and the Re-use of Public Sector Information Regulations 2005 SI 2005 No Information on re-use can be obtained from the Information Governance Department, Sheffield Teaching Hospitals. PD5341-PIL1757 v4 Issue Date: April Review Date: April 2018