AZAFRINE

*Severe acute Crohns disease, Maintenance of remission of Crohns disease, Maintenance of remission of acute ulcerative colitis:* Adult: 2-2.5 mg/kg daily, some patients may respond to lower doses. *Rheumatoid arthritis, Severe systemic lupus erythematosus and other connective tissue disorders, Polymyositis:* Adult: Initially up to 2.5 mg/kg daily in divided doses, adjusted according to response, rarely more than3 mg/kg daily; maintenance 1-3 mg/kg daily, discontinue if no improvement within 3 months. *Autoimmune conditions:* Adult: 1-3 mg/kg daily, adjusted according to response, Discontinue if no improvement within3 months. *Suppression of transplant rejection:* Adult: 1-2.5 mg/kg daily, adjusted according to response. *Severe refractory eczema:* Adult: 1-3 mg/kg daily (with normal or high TPMT activity), 0.5-1.5 mg/kg daily (with intermediate TPMT activity). *Generalized myasthenia gravis:* Adult: Initially 0.5-1 mg/kg daily, then increased to 2-2.5 mg/kg daily, dose is increased over 3-4 weeks.

Biliary stasis, toxic hepatitis, absent or very low thiopurine methyltransferase (TPMT) activity

Monitor for toxic effects, perform regular blood counts, impaired renal function, infection, pregnancy, exposure to sunlight, reduce dose in elderly

Allopurinol, cytostatics, muscle relaxants.

Arthralgia, cholestatic jaundice, diarrhoea, dizziness, dose-related bone marrow suppression, fever, hair loss, herpes zoster infection, hypersensitivity reactions, hypotension, interstitial nephritis, liver impairment, malaise, myalgia, nausea, neutropenia, rash, rigors, thrombocytopenia, vomiting. Rare: Hepatic veno-occlusive disease, lymphoma, pancreatitis, pneumonitis, red cell aplasia