Azathioprine (children)

What is it?

Azathioprine (brand name: Imuran, Azamun, Azapin) is a medicine used to treat certain childhood rheumatic conditions (diseases which may affect kidneys, joints, muscles, skin, gut or eyes). This can include lupus (also known as SLE), inflammatory bowel disease, uveitis and scleroderma. People who have had organ transplants also use it. Azathioprine is a medicine that works by suppressing your immune system. It reduces the damage done by inflammation, rather than just reducing pain.

How will it help?

Azathioprine is a medicine that works slowly. You can expect your child to gradually start feeling better, but it might take one to three months.

How is Azathioprine given?

Azathioprine is given as a tablet. When should it be given? It is taken either once or twice a day.

What is the dose?

This depends on the weight of your child. It is usually started at a low dose, which is then increased. The final dose is adjusted according to response and side effects.

How long will it be used for?

People stay on azathioprine for long periods (several years) to help keep their disease under control.

Are there any side effects?

Azathioprine is usually very effective in improving your child’s condition but, like all medicines, side effects can occur. Some are common, and some are rare. Most people don’t have any problems when they take azathioprine.

Things you need to know when your child’s taking this medicine

What to do if your child is sick

Normal coughs and colds are okay. Don’t give azathioprine if your child:

  • Has a high fever
  • Has had vomiting/ diarrhoea
  • Has been in contact with chickenpox, shingles or herpes zoster
  • Is sick and you’re not sure why

If you’re not sure, talk to your doctor, and get your child checked if necessary before giving the azathioprine.


Azathioprine can interact with other medicines. Talk to your doctor before taking any prescription medicines, natural medicines and medicines that you can buy over the counter.


Most immunisations are safe to have (flu vaccine, cervical cancer vaccine, inactivated polio vaccine (IPV) etc) when taking this medicine. Live virus vaccines (such as mumps, measles, rubella (MMR), polio (OPV)), varicella (chicken pox) and some travel vaccines should not be used.


Azathioprine can make chickenpox infections more serious. A blood test can be done to see if your child is already immune to the virus. If your child is in contact with chickenpox or shingles, call your doctor.


Azathioprine and alcohol are both broken down by the liver. Drinking alcohol while you are on azathioprine can put extra strain on the liver. It is not known how much is safe, so it is suggested that anyone on azathioprine should avoid drinking alcohol.

Sexual health

Having been on azathioprine in the past does not change your chances of having babies when you are older.

Myths and misconceptions

You may hear a lot of different information about azathioprine from friends, pharmacists or people that you know. If you are worried about anything, please talk to your child’s doctor or nurse. If your child is taking azathioprine they should see their paediatric rheumatologist regularly to make sure the treatment is working and to minimise any possible side effects.

This medicine suppresses the immune system. Keep it in a safe place as accidental overdose can be serious.

This Information Sheet has been prepared using materials obtained from various sources which have been reviewed by the Australian Rheumatology Association (ARA). It contains general information only and does not contain a complete or definitive statement of all possible uses, actions, precautions, side effects or interactions of the medicines referenced. This information is not intended as medical advice for individual conditions nor for making an individual assessment of the risks and benefits of taking a particular medicine. Decisions regarding the assessment and treatment of patients are the sole responsibility of the treating medical professional, exercising their own clinical judgment and taking into account all of the circumstances and the medical history of the individual patient. ARA has used all reasonable endeavours to ensure the information on which this Information Sheet is based is accurate and up to date. However, the ARA accepts no responsibility or liability for the accuracy, currency, reliability and/or completeness of the information contained in this Information Sheet.  To the maximum extent permitted by law, the ARA expressly disclaims any liability for any injury, loss, harm or damage arising from or in connection with use of and reliance on the information contained in this Information Sheet. This information sheet is copyright and may be reproduced in its entirety but may not be altered without prior written permission from the ARA.Page updated September 2023