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Azathioprine is a purine-antagonist anti-metabolite that primarily is used as an immunosuppressant in dogs. It competes with purine in the synthesis of nucleic acids. It also inhibits the synthesis of T-lymphocyte-dependent antibodies and cyclo-oxygenase. Azathioprine is absorbed from the GI tract and metabolized to mercaptopurine. The incidence of bone marrow suppression is thought to be related to levels of one of the important enzymes involved in the metabolism of azathioprine-thiopurine methyltransferase (TMPT). Cats have low TMPT activity and are prone to azathioprine toxicity. Humans with low TMPT-levels are more likely to experience bone marrow suppression. There is conflicting research regarding TMPT activity in dogs and the incidence of myelotoxicity. Metabolites of azathioprine and mercaptopurine are excreted by the kidneys.
Azathioprine is used in dogs to treat inflammatory bowel disease, immune mediated anemia, colitis and skin disease; and Myasthenia Gravis. Azathioprine frequently is used with corticosteroids (prednisolone), with the goal of reducing the dose of both drugs and moving towards alternate day therapy. Azathioprine has a delayed onset of action of about three weeks and clinical response may take as long as six weeks. Azathioprine should be given with food to minimize GI side effects.
Azathioprine occasionally is used in the horse to treat autoimmune skin disease.
If overdose is recognized promptly, proceed with gut emptying protocols.
May Be Prescribed by Veterinarians for:
Inflammatory bowel disease; immune-mediated anemia, colitis, skin disease; Myasthenia Gravis.
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Barbara Forney, VMD
She began to develop her interest in client education and medical writing in 1997. Recent publications include portions of The Pill Book Guide to Medication for Your Dog and Cat, and most recently Understanding Equine Medications published by the Bloodhorse.
Dr. Forney is an FEI veterinarian and an active member of the AAEP, AVMA, and AMWA.
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This content is intended for counseling purposes only. This content is informational/educational and is not intended to treat or diagnose any disease or patient. No claims are made as to the safety or efficacy of mentioned preparations. The compounded medications featured in this content have been prescribed and/or administered by prescribers who work with Wedgewood Pharmacy. You are encouraged to speak with your prescriber as to the appropriate use of any medication. Wedgewood Pharmacy’s compounded veterinary preparations are not intended for use in food and food-producing animals. All product and company names are trademarks™ or registered® trademarks of their respective holders. Use of them does not imply any affiliation with or endorsement by them.
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