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Azatioprina

Fonte atualizada
31 de março de 2023
Versão coletada
25 de agosto de 2026

Compatibilidade

Compatível

Seguro, melhor opção

Resumo do nível

Produto seguro e/ou a amamentação é a melhor opção.

Leia o comentário completo: o nível resume o risco, mas não substitui contexto clínico, dose, idade do bebê ou orientação profissional.

Outros nomes
Αζαθειοπρίνη, أزاثيوبرين, Азатиоприн, 硫唑嘌呤, アザチオプリン, L04AX01
Marcas comerciais
Azafalk, Azahexal, Azaimun, Azamun, Azasan, Azatrilem, Azopine, Immunoprin… Ver todas as 13
Procedência
Dados editoriais
Tradução
Pendente de revisão
Grupo ATC
L04
Fonte
Abrir original

Leitura clínica

Comentário

Tiopurina. Derivado imidazólico e pró-fármaco da 6-mercaptopurina (6-MP), que é metabolizado rapidamente in vivo em 6-MP e nucleosídeos de 6-tioguanina (6-TGNs). Tem propriedades imunossupressoras e é utilizado em transplante de órgãos, doenças autoimunes como artrite reumatoide, doença inflamatória intestinal, lúpus eritematoso sistêmico, dermatomiosite, polimiosite, hepatite crônica ativa autoimune, pênfigo vulgar, poliarterite nodosa, anemia hemolítica autoimune, púrpura trombocitopênica idiopática e pioderma gangrenoso, entre outras (AEMPS 2016, Sanis HI 2015) . Administração oral ou intravenosa em uma, duas ou três doses diárias durante meses a anos ou de modo indefinido. Nem a azatioprina nem seus metabólitos 6-MP e 6-TGN são excretados no leite materno ou, em alguns casos, em quantidade clinicamente não significativa. (Christensen 2008, Sau 2007, Moretti 2006, Kane 2004, Coulam 1982) Não foram observados problemas infecciosos nem outros em lactentes cujas mães a tomavam, nem a curto nem a longo prazo. (Ikram 2021, Boyle 2021, Klintmalm 2020, de Meij 2013, Bernard 2013, Mahadevan 2012, Angelberger 2011, Christensen 2009, Zelinkova 2009, Sau 2007, Werner 2007, Gardiner 2007 y 2006, Moretti 2006, Muñoz 2001, Nyberg 1998, Grekas 1984, Coulam 1982) Os níveis de 6-MP no plasma desses lactentes foram indetectáveis ou muito baixos (Zelinkova 2009, Sau 2007, Bernard 2007, Gardiner 2007 y 2006) . Os níveis de IgA no leite materno foram normais. (Coulam 1982) Foram registrados poucos casos de neutropenia leve assintomática em lactentes (Sau 2007, Bernard 2013) , motivo pelo qual alguns autores consideram conveniente fazer controles laboratoriais (Almas 2016) . A exposição é minimizada ainda mais se for possível esperar 4 horas para amamentar após a última dose (McConnell 2016, Bar-Gil 2016, Mahadevan 2015, Butler 2014) , já que o pico de 6-MP no leite ocorre nas primeiras 4 horas, baixando para 10% na 6ª hora. (Christensen 2008) Foram descritos casos de hiperprolactinemia e/ou galactorreia. (Chaudhary 2021, Uygur 2003) A maioria das sociedades médicas, especialistas e consensos de especialistas considera seguro o uso desta medicação durante a amamentação. (Russell 2022, Sammaritano 2020 y 2014, Mahadevan 2019 y 2015, Vestergaard 2019, Bermejo 2018, Bitencourt 2018, Gilhus 2018, Anderson 2016, Noviani 2016, Nguyen 2016, McConnell 2016, Bar-Gil 2016, Almas 2016, Huang 2016, Mottet 2016, Flint 2016, Gotestam 2016, van der Woude 2015, Briggs 2015, Schaefer 2015, Durst 2015, Nielsen 2014, Constantinescu 2014, Schulze 2014, Butler 2014, Huang 2014, Yarur 2013, Habal 2012, Selinger 2012, Makol 2011, Gisbert 2010, Raj 2010, Van Aseche 2010, van der Woude 2010, Zelinkova 2009, Christensen 2009 y 2008, Mottet 2007, Gardiner 2007 y 2006, Moretti 2000) Pode consultar abaixo a informação destes produtos relacionados: Mercaptopurina (Produto seguro e/ou a amamentação é a melhor opção.) Tioguanina (Produto seguro e/ou a amamentação é a melhor opção.)

Encontrabilidade

Outros nomes e marcas

Sinônimos e grafias 6
  • Αζαθειοπρίνη
  • أزاثيوبرين
  • Азатиоприн
  • 硫唑嘌呤
  • アザチオプリン
  • L04AX01
Marcas comerciais na fonte 13
  • Azafalk
  • Azahexal
  • Azaimun
  • Azamun
  • Azasan
  • Azatrilem
  • Azopine
  • Immunoprin
  • Imuran
  • Imuran (依木兰)
  • Imurek
  • Imurel
  • Thioprine

Dados da fonte

Farmacocinética

VariávelValorUnidade
Biodisp. oral47 (27 - 85)%
Peso Molecular277daltons
Unión proteínas30%
Vd0,9l/Kg
pKa8,65-
Tmax1 - 2horas
T½0,6 - 5horas
Dosis Teórica< 0.008mg/Kg/d
Dosis Relativa0,05 - 0,6%
Dosis Rel. Ped.0,07 - 0,3%

Rastreabilidade

Bibliografia

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  69. Coulam CB, Moyer TP, Jiang NS, Zincke H. Breast-feeding after renal transplantation. Transplant Proc. 1982 Resumen

Escala de compatibilidade

Como ler os níveis

  1. CompatívelSeguro, melhor opção
  2. Compatibilidade provávelBastante seguro
  3. Compatibilidade limitadaPouco seguro
  4. IncompatívelMuito inseguro

A cor ajuda a localizar o nível; o símbolo, o rótulo e o texto trazem a mesma informação.