Patients tend to respond relatively quickly, with improvement within several weeks. It can be a steroid-sparing drug. The possible mode of action is stabilization of lysosomal membranes and inhibition of PMN toxicity. Hemolytic jaundice may result in G6PD deficient people. Other side effects include agranulocytosis leading to death, headache, malaise, hepatitis, hypersensitivity reactions, and neuropathy.
Caution is required.
Azathioprine is a potent immunosuppressive agent that has been used as a steroid sparing agent. After initial control of the disease is obtained, tapering to maintenance doses of azathioprine is recommended. A dermatologist with expertise in the use and monitoring of these agents is recommended. Patients on long-term glucocorticoids should receive increased calcium and vitamin D as well as bisphosphates in an effort to prevent osteoporosis. Patients should utilize appropriate behaviors and protective clothing to minimize sun-exposure that may exacerbate disease activity.