硫唑嘌呤

硫唑嘌呤，有时以其他名称（例如Imuran或Azapress）而闻名，是disease-modifying anti-rheumatic drug (DMARD)。它通过减少人体免疫系统的活性来起作用，这在某些情况下可能过度活跃。

硫唑嘌呤isn’t apainkiller, but it can reduce the damage and effects caused by your condition. Your symptoms should start to improve 6–12 weeks after you start taking it.

硫唑嘌呤can be prescribed by a顾问风湿病学家为了：

• 狼疮
• myositis
• Crohn’s disease
• rheumatoid arthritis.

硫唑嘌呤is usually given as tablets, taken once or twice daily. They should be swallowed whole and taken with or after food.

Your doctor will advise you about the correct dose, which will depend on how much you weigh. But you’ll usually start on a low dose of about 50mg, your doctor may increase this if necessary.

硫唑嘌呤可能不会立即起作用，因此，即使起初似乎没有工作，继续服用它也很重要。

当您的症状改善并开始感觉更好时，您还应该继续按照规定的规定进行服用，因为这将使您的病情受到控制。

对于许多关节炎患者来说，硫唑嘌呤是一种非常有效的药物。但这并不适合所有人。

在开处方硫唑嘌呤之前，您的医生将订购一种称为TPMT的酶，也称为硫嘌呤甲基转移酶（硫代蛋白 - 蛋白 - 蛋白甲基 - 甲基蛋白 - 蛋白质反射率）。酶是您体内的蛋白质，可以帮助分解某些物质或化学物质。

TPMT有助于分解并去除体内的硫唑啉。TPMT水平较低可能意味着硫唑嘌呤的副作用风险略有增加，因此您的医生可能建议较低剂量。

If the TPMT result is very low, azathioprine may not be the right medication for you, and your doctor will discuss other treatment options.

如果：

• 你有严重的肝或肾脏问题
• you have bone marrow problems
• you have infections that repeatedly come and go.

Before starting azathioprine you might need to be checked for previous hepatitis B or C infections, as this drug can increase the risk of these infections starting up again. If the tests are positive you may need antiviral treatment first.

在开始硫唑嘌呤之前，您还需要使用胸部X射线。如果您有任何长期肺部疾病，例如纤维化或肺气肿，则需要测试，以查看肺部如何检查硫唑嘌呤是否适合您。

如果您吸烟，则值得减少或理想放弃，因为吸烟会增加病情并发症及其治疗的风险。

大多数人没有任何副作用，对于那些这样做的人来说，他们通常并不认真。但是，如果您确实有严重的副作用，或者担心自己的症状，请联系一名负责您护理的医疗保健专业人员。

硫唑嘌呤may cause:

• nausea or feeling sick
• vomiting
• 腹泻
• 食欲不振
• 脱发
• skin rashes
• 对阳光的敏感性。

Because azathioprine affects the immune system, it can make you more likely to develop infections. It can also affect your blood count or liver. So you’ll need to have blood tests before and during your course of azathioprine.

可能会要求您在小册子中保留血液检查结果的记录，当您访问GP或医院时，您应该随身携带。

你应该告诉医生或护士专家straight away if you develop any of the following after starting azathioprine:

• a sore throat, fever or any other signs of infection
• unexplained bruising or bleeding
• yellowing of the skin or eyes, this is known as jaundice
• any new symptoms that concern you.

联系您风湿病团队if you get chickenpox or shingles, or if you come into come into contact with someone who has them and you’ve never had chickenpox before.

These illnesses can be worse than usual if you’re on azathioprine. You may need treatment for them, and your azathioprine may be stopped until you’re better.

Tips to reduce your risk of infection

• Try to avoid close contact with people you know have an infection.
• Wash your hands regularly and carry around a small bottle of antibacterial hand gel.
• Keep your mouth clean by brushing your teeth regularly.
• 如果您是吸烟者，请停止吸烟。
• 确保您的食物存储并准备好。
• Try to keep your house clean and hygienic, especially the kitchen, bathrooms and toilets.

硫唑嘌呤可以与用于治疗的药物相互作用痛风, such asallopurinol和febuxostat。It’s also known to interact with some medications used to control high blood pressure, such as warfarin. So make sure to discuss what medications you’re on with your风湿病团队, as they might suggest starting you on an alternative DMARD.

Check with your doctor or pharmacist before starting any new medications. And remember to mention you’re on azathioprine if you’re treated by anyone other than your usual rheumatology team.

你可以继续non-steroidal anti-inflammatory drug (NSAID)或者止痛药如果需要，除非您的医生另有建议。

Don’t take over the counter preparations or herbal remedies without discussing this first with your doctor or pharmacist as some of them could react badly with azathioprine.

The pneumonia (new-mow-nee-uh) vaccine and yearly flu vaccines don’t affect azathioprine and are perfectly safe to have while you’re taking it. It’s very important to have these to reduce your risk of infection.

避免有活疫苗，例如MMR（麻疹，腮腺炎和风疹）或黄热气。水痘疫苗也可以使用，如果您使用硫唑嘌呤，则应避免使用。

Zostavax带状疱疹疫苗是一种现场疫苗，通常不建议使用硫唑嘌呤的人，尽管如果您使用的硫唑嘌呤剂量低，则可以使用它。另外，可以使用非叶木瓦疫苗（Shingrix），因此您可以使用此疫苗。您的医疗团队将能够就此提供建议。

如果您不确定是否应该接受疫苗，请先与风湿病团队聊天。

If you’re due to have surgery, you might need to stop taking azathioprine or other drugs beforehand. You should speak to your doctor and surgeon about this first.

Alcohol and azathioprine can both affect your liver, so it’s important you don’t drink more alcohol than the government’s recommended limits.

Government guidelines say both men and women should have no more than 14 units of alcohol a week, and that you should spread these through the week rather than having them all in one go.

您可以在www.drinkaware.co.uk。

Some风湿病学家可能建议更严格的限制。如果您担心，请与您的医疗团队讨论您的酒精摄入量。

如果您正在计划一个家庭或在服用硫唑嘌呤时怀孕，则应尽快与您的医生讨论。

当前的准则说，如果尝试婴儿，即使怀孕或母乳喂养，也可以采用硫唑嘌呤。

Men are also fine to continue taking it when trying for a baby.