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Overview
Azathioprine is approved by the U.S. Food and Drug Administration (FDA) for the prevention of organ transplant rejection and for treating rheumatoid arthritis. However, it is sometimes prescribed off-label for severe cases of atopic eczema that are resistant to conventional topical treatments​​. 

Azathioprine is classified as an immunosuppressant drug, which means it works by reducing the activity of the immune system. It achieves this by interfering with the growth of certain lymphocytes (white blood cells) involved in inflammation associated with eczema.

How do I take it?
Prescribing information states that azathioprine is taken orally, typically once or twice daily, with food to reduce stomach upset​​​​. The dosage is usually calculated based on a person’s weight. The medication should be taken exactly as prescribed by a health care provider.

Side effects
Common side effects of azathioprine include nausea, vomiting, diarrhea, and loss of appetite. 

Rare but serious side effects may include bone marrow suppression, which can lead to severe anemia (low red blood cell count) and increased risk of infection​​. Liver problems may also occur, so regular liver function tests are recommended​​. Long-term use may increase the risk of skin cancer and lymphoma (a type of blood cancer). It’s important to protect your skin from the sun while taking this medication. Other rare side effects include skin rashes, alopecia (hair loss), fever, joint pain, fat malabsorption, negative nitrogen balance, reversible interstitial pneumonitis (lung inflammation), and Sweet’s syndrome (a rare skin condition)​​.

For more information about this treatment, visit:

Azathioprine — MedlinePlus

Label: Azathioprine Tablet — DailyMed

Azathioprine — National Eczema Society
 

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