Drug Eruption and Interactions - PHARMACEUTICAL REVIEW

54 AZATHIOPRINE
AZATHIOPRINE
Trade names: Azamedac; Azamune; Azasan; Azatrilem; Imuprin;
Imuran (Prometheus); Imurek; Imurel; Thioprine
Indications: Lupus nephritis, psoriatic arthritis, rheumatoid
arthritis, autoimmune diseases, kidney transplant patients
Category: Antimetabolite; Disease-modifying antirheumatic;
Purine anaolog
Half-life: 12 minutes
Clinically important, potentially hazardous interactions
with: allopurinol, chlorambucil, cyclophosphamide, cyclosporine,
hemophilus B vaccine, mycophenolate, olsalazine, vaccines,
warfarin
Reactions
Skin
Acanthosis nigricans
(1980): L’Eplattenier JL+, Schweiz Med Wochenschr (German)
110, 1307 (0.5%)
Acne
(1983): Schmoeckel C+, Hautarzt (German) 34, 413
Acute febrile neutrophilic dermatosis (Sweet’s syndrome)
(2007): Ammar D+, Ann Dermatol Venereol 134(2), 151
(2004): Paoluzi OA+, Dig Liver Dis 36(5), 361
Acute generalized exanthematous pustulosis (AGEP)
(2007): Elston GE+, Clin Exp Dermatol 32(1), 52
Allergic granulomatous angiitis (Churg–Strauss syndrome)
(1998): Dietz A+, Laryngorhinootologie 77(2), 111
Allergic reactions (sic)
(1996): Parnham AP+, Lancet 348, 542
Angioedema
(1988): Saway PA+, Am J Med 84, 960 (passim)
Basal cell carcinoma
(2001): Otley CC+, Arch Dermatol 137, 459
Carcinoma
(2001): Austin AS+, Eur J Gastroenterol Hepatol 13, 193
(1992): Taylor AE+, Acta Derm Venereol 72(2), 115
Cicatricial pemphigoid
(2000): Burgess MJA+, Arch Dermatol 136, 1274
Dermatitis
(2006): Patel AA+, JAmAcadDermatol55(3), 369
(2001): Lauerma AI+, Contact Dermatitis 44, 129
(1996): Soni BP+, Am J Contact Dermat 7, 116
(1992): Burden AD+, Contact Dermatitis 27, 329
Erythema
(2004): Mori H+, JDermatol31(9), 731
Erythema gyratum repens
(2002): Gunther R+, Med Klin 97(7), 414
(2002): von Rainer Gunther ZB+, Med Klin 97(12), 759
Erythema multiforme
(1995): Knowles SR+, Clin Exp Dermatol 20, 353 (passim)
(1988): Saway PA+, Am J Med 84, 960 (passim)
Erythema nodosum
(2007): de Fonclare AL+, Arch Dermatol 143(6), 744
(1995): Knowles SR+, Clin Exp Dermatol 20, 353 (passim)
(1988): Saway PA+, Am J Med 84, 960 (passim)
Exanthems
(1995): Knowles SR+, Clin Exp Dermatol 20, 353 (passim)
(1990): Jeurissen ME+, Ann Rheum Dis 49, 25 (4%)
(1988): Bergman SM+, AnnInternMed109, 83
(1988): Saway PA+, Am J Med 84, 960
Exfoliative dermatitis
(1997): Hermanns-Le T+, Dermatology 194, 175
Fixed eruption
(1990): Black AK+, Br J Dermatol 123, 277 (observation)
Formication
(1992): Shelley WB+, Advanced Dermatologic Diagnosis WB
Saunders, 1042 (passim)
Fungal dermatitis
(1980): L’Eplattenier JL+, Schweiz Med Wochenschr (German)
110, 1307 (42%)
Herpes simplex
(1980): L’Eplattenier JL+, Schweiz Med Wochenschr (German)
110, 1307 (27%)
Herpes zoster
(2006): Patel AA+, JAmAcadDermatol55(3), 369
(2003): Lemyze M+, Rev Mal Respir 20(5), 773
(2001): Vergara M+, Gastroenterol Hepatol 24, 47
(1991): Callen JP+, Arch Dermatol 127, 515
(1982): Speerstra F+, Ann Rheum Dis 41, Suppl 37
(1980): L’Eplattenier JL+, Schweiz Med Wochenschr (German)
110, 1307 (27%)
Kaposi’s sarcoma
(2006): Patel AA+, JAmAcadDermatol55(3), 369
(1997): Aebischer MC+, Dermatology 195, 91
(1997): Halpern SM+, Br J Dermatol 137, 140
(1997): Lesnoni-La-Parola I+, Dermatology 194, 229
(1997): Vandercam B+, Dermatology 194, 180
(1996): Ozen S+, NephrolDialTransplant11, 1162
(1991): Almog Y+, Clin Exp Dermatol 9, 285
(1984): Luderschmidt C+, Klin Wochenschr (German) 62, 803
(1982): Weiss VC+, Arch Dermatol 118, 183
(1980): Iversen OH+, Scand J Urol Nephrol 14, 125
Keratoacanthoma
Lichenoid eruption
Lymphoma
(2005): Hon C+, Leuk Lymphoma 46(2), 289
Neoplasms
(2003): Li AC+, Eur J Gastroenterol Hepatol 15(2), 185
Nevi
(2006): Bovenschen HJ+, Br J Dermatol 154(5), 880
Non-Hodgkin’s lymphoma
(2000): Lewis JD+, Gastroenterology 118, 1018
Pemphigus foliaceus
(2000): Elston DM, Cutis 66(5), 332, 375
Peripheral edema
(1996): Oakley A, Hamilton, New Zealand (from Internet)
(observation)
Photosensitivity
Pigmentation (sun-exposed skin)
Porokeratosis
(1997): Matsushita S+, JDermatol24, 110 (disseminated
superficial actinic)
(1988): Neumann RA+, Br J Dermatol 119, 375 (disseminated
superficial actinic)
(1987): Tatnall FM+, JRSocMed80, 180 (Mibelli)
Pruritus
(2005): Appelman M+, Dermatology 210(4), 366
Purpura
Pyoderma gangrenosum
Rash (sic) (1–10%)
(2005): Bajaj JS+, Am J Gastroenterol 100(5), 1121
(2005): Heckmann JM+, JNeurolSci231(1-2), 71
(2004): Gearry RB+, Pharmacogenetics 14(11), 779
(1997): Lavaud F+, Dig Dis Sci 42, 823
(1990): Jeurissen ME+, Ann Rheum Dis 49, 25
Raynaud’s phenomenon
Sarcoma
(1996): Csuka ME+, Arch Intern Med 156, 1573
Scabies
(2006): Patel AA+, JAmAcadDermatol55(3), 369
(1980): L’Eplattenier JL+, Schweiz Med Wochenschr (German)
110, 1307 (1%)