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Azathioprine is used for:

Preventing kidney transplant rejection along with other medicine. It may also be used to treat signs and symptoms of active rheumatoid arthritis. It may also be used for other conditions as determined by your doctor.

Azathioprine is an antimetabolite. It works by decreasing the effects of certain cells in the body's immune system.

Do NOT use Azathioprine if:

  • you are allergic to any ingredient in Azathioprine
  • you have a tumor or an unusual growth
  • you have rheumatoid arthritis and are pregnant
  • you are taking mercaptopurine
  • you have rheumatoid arthritis and have used alkylating agents (eg, cyclophosphamide, chlorambucil, melphalan) in the past

Contact your doctor or health care provider right away if any of these apply to you.

Before using Azathioprine :

Some medical conditions may interact with Azathioprine. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have kidney or liver problems, or gout
  • if you have an infection, a history of frequent or prolonged infections, or you have recently had a vaccination
  • if you have a history of bone marrow problems, anemia, low white blood cell or platelet levels, or unusual bruising or bleeding
  • if you have certain enzyme deficiencies (thiopurine methyltransferase [TPMT] or xanthine oxidase) or you have recently had a blood transfusion
  • if you are taking a disease-modifying antirheumatic drug (DMARD) (eg, methotrexate, adalimumab)

Some MEDICINES MAY INTERACT with Azathioprine. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Alkylating agents (eg, cyclophosphamide, chlorambucil, melphalan) because the risk of developing a tumor may be increased
  • Mercaptopurine because severe toxic effects, including severe bone marrow suppression or death, may occur
  • Allopurinol, aminosalicylates (eg, mesalazine, olsalazine, sulfasalazine), angiotensin-converting enzyme (ACE) inhibitors (eg, enalapril), doxorubicin, or trimethoprim/sulfamethoxazole because they may increase the risk of Azathioprine 's side effects
  • Anticoagulants (eg, warfarin) or hydantoins (eg, phenytoin) because their effectiveness may be decreased by Azathioprine

This may not be a complete list of all interactions that may occur. Ask your health care provider if Azathioprine may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Azathioprine :

Use Azathioprine as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Take Azathioprine by mouth with or without food. If stomach upset occurs, take with food to reduce stomach irritation.
  • Ask your doctor if you should follow any special guidelines for handling Azathioprine.
  • If you miss a dose of Azathioprine , take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Azathioprine.

Important safety information:

  • Azathioprine may lower the ability of your body to fight infection. Avoid contact with people who have colds or infections. Tell your doctor if you notice signs of infection like fever, sore throat, rash, or chills.
  • Azathioprine may reduce the number of clot-forming cells (platelets) in your blood. Avoid activities that may cause bruising or injury. Tell your doctor if you have unusual bruising or bleeding. Tell your doctor if you have dark, tarry, or bloody stools.
  • Tell your doctor or dentist that you take Azathioprine before you receive any medical or dental care, emergency care, or surgery.
  • Talk with your doctor before you receive any vaccine while you are taking Azathioprine.
  • Contact your doctor at once if you develop severe nausea and vomiting. This may occur with or without diarrhea, rash, fever, muscle pain, or dizziness. If this reaction occurs, it usually happens within the first several weeks of therapy.
  • Azathioprine may increase your risk of developing a tumor or other cancer. Contact your doctor at once if you notice any unusual growths or lumps. Discuss any questions or concerns with your doctor.
  • An enzyme called TPMT helps to break Azathioprine down in the body. Infrequently, some patients may have decreased TPMT enzyme activity. This may increase the risk of developing serious side effects (eg, severe bone marrow problems). Patients with decreased TPMT enzyme activity may need a lower dose of Azathioprine. Discuss any questions or concerns with your doctor.
  • Lab tests, including complete blood counts, liver function, and TPMT enzyme activity, may be performed while you use Azathioprine. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
  • Azathioprine should be used with extreme caution in CHILDREN; safety and efficacy in children have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: Azathioprine has been shown to cause harm to the fetus. Do not become pregnant while you are using it. If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using Azathioprine while you are pregnant. Azathioprine is found in breast milk. Do not breast-feed while taking Azathioprine.

Possible side effects of Azathioprine :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Mild nausea or vomiting.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; itching; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain or tightness; dark urine; dizziness; fever, chills, or sore throat; increased or painful urination; muscle pain or aches; pale or fatty stools; severe or persistent nausea, vomiting, or diarrhea; shortness of breath; stomach pain; unusual bleeding or bruising; unusual growths or lumps; unusual weakness or fatigue; yellowing of the eyes or skin.

What is the shelf life of the pills?

  • The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.

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Erectile dysfunction

Erectile dysfunction (ED) affects the lives of many middle-aged men and their partners. The term erectile dysfunction covers a range of disorders, but usually refers to the inability to obtain an adequate erection for satisfactory sexual activity. Although erectile dysfunction, formerly called impotence, is more common in men older than 65, it can occur at any age. An occasional episode of erectile dysfunction happens to most men and is normal. As men age, it's also normal to experience changes in erectile function. Erections may take longer to develop, may not be as rigid or may require more direct stimulation to be achieved. Men may also notice that orgasms are less intense, the volume of ejaculate is reduced and recovery time increases between erections. Erectile dysfunction may also be a sign of a physical or emotional problem that requires treatment.

Erectile dysfunction was once a taboo subject, but more men are seeking help. Doctors are gaining a better understanding of what causes erectile dysfunction and are finding new and better treatments.

This Website discusses all about erectile dysfunction, physiology of the normal erection and the pathophysiology, and treatment of ED.

What is Erectile Dysfunction?

Erectile dysfunction or impotence is a sexual dysfunction characterized by the inability to develop or maintain an erection of the penis for satisfactory sexual intercourse regardless of the capability of ejaculation. There are various underlying causes, such as diabetes, many of which are medically reversible.

The causes may be physiological or psychological. Psychological impotence can often be helped by almost anything that the patient believes in; there is a very strong placebo effect.

Due to its embarrassing nature and the shame felt by sufferers, the subject was taboo for a long time, and is the subject of many urban legends. Folk remedies have long been advocated, with some being advertised widely since the 1930s. The introduction of perhaps the first pharmacologically effective remedy for impotence, sildenafil (trade name Viagra), in the 1990s caused a wave of public attention, propelled in part by the news-worthiness of stories about it and heavy advertising.

The Latin term impotentia coeundi describes simple inability to insert the penis into the vagina. It is now mostly replaced by more precise terms.

Signs and symptoms:

Erectile dysfunction is characterized by the inability to maintain erection. Normal erections during sleep and in the early morning suggest a psychogenic cause, while loss of these erections may signify underlying disease, often cardiovascular in origin. Other things leading to erectile dysfunction are diabetes mellitus (causing neuropathy) or hypogonadism (decreased testosterone levels due to disease affecting the testicles or the pituitary gland).

Here are some causes of Erectile Dysfunction:

* Arousal: The first step is sexual arousal, which men obtain from the senses of sight, touch, hearing and smell, and from thoughts.

* Nervous system response: The brain communicates the sexual excitation to the body's nervous system, which activates increased blood flow to the penis.

* Blood vessel response:. A relaxing action occurs in the blood vessels that supply the penis, allowing more blood to flow into the shafts that produce the erection.

Physiology of normal erections:

Penile erections involve an integration of complex physiologic processes involving the CNS, peripheral nervous system, and hormonal and vascular systems. Any abnormality involving these systems, whether from medication or disease, has a significant impact on the ability to develop and sustain an erection, ejaculate, and experience orgasm. Tumescence, the vascular filling of the cavernous bodies, relies on neural and hormonal mechanisms operating at various levels of the neural axis. This is unique among visceral functions because it requires central neurological input.

Andersson et al summarized some of the information related to the pathways involved in erectile function. The degree of contraction of corpus cavernosal smooth muscle determines the functional state of the penis. The balance between contraction and relaxation is controlled by central and peripheral factors that involve many transmitters and transmitter systems. At the cellular level, smooth muscle relaxation occurs following the release of acetylcholine from the parasympathetic nerves.

Pathophysiology of erectile dysfunction:

Erectile Dysfunction is essentially a vascular disease. It is often associated with other vascular diseases and conditions such as diabetes, hypertension, and coronary artery disease. Other conditions associated with Erectile Dysfunction include neurologic disorders, endocrinopathies, benign prostatic hyperplasia, and depression. Conditions associated with reduced nerve and endothelium function, such as aging, hypertension, smoking, hypercholesterolemia, and diabetes, alter the balance between contraction and relaxation factors. These conditions cause circulatory and structural changes in penile tissues, resulting in arterial insufficiency and defective smooth muscle relaxation. In some patients, sexual dysfunction may be the presenting symptom of these disorders.

Treatment:

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