{"id":55737,"date":"2024-02-07T05:38:29","date_gmt":"2024-02-07T05:38:29","guid":{"rendered":"https:\/\/medsname.com\/azoran\/"},"modified":"2026-04-30T10:24:45","modified_gmt":"2026-04-30T10:24:45","slug":"azoran","status":"publish","type":"product","link":"https:\/\/medsbase.com\/ro\/product\/azoran\/","title":{"rendered":"Azoran"},"content":{"rendered":"<p><!-- medsbase-tldr-answer --><\/p>\n<div style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:18px 22px;margin:0 0 24px 0;border-radius:4px;\">\n<h3 class=\"wp-block-heading\" style=\"margin:0 0 8px 0;font-size:16px;font-weight:700;\">\u26a1 R\u0103spuns rapid \u2014 Ce este Azoran?<\/h3>\n<p style=\"margin:0;\"><strong>Azoran<\/strong> este un comprimat oral de la RPG Life Sciences care con\u021bine <strong>azatioprin\u0103 50 mg<\/strong> \u2014 un clasic <strong>imunosupresor antagonist al purinelor<\/strong> metabolizat in vivo la <strong>6-mercaptopurin\u0103<\/strong>. Utilizat pentru a preveni respingerea transplantului de organe \u0219i pentru a controla o gam\u0103 larg\u0103 de afec\u021biuni autoimune \u0219i inflamatorii (artrit\u0103 reumatoid\u0103, lupus, boal\u0103 inflamatorie intestinal\u0103, hepatit\u0103 autoimun\u0103, miastenie gravis, vasculit\u0103, pemfigus). Doza standard pentru adul\u021bi: <strong>1\u20133 mg\/kg o dat\u0103 pe zi<\/strong>, ajustat\u0103 \u00eencet. <strong>Testarea genotipului TPMT (\u0219i ideal a NUDT15) sau a activit\u0103\u021bii enzimatice este obligatorie \u00eenainte de prima doz\u0103<\/strong> \u2014 pacien\u021bii cu activitate TPMT sc\u0103zut\u0103 sau absent\u0103 dezvolt\u0103 mielosupresie catastrofal\u0103, care pune via\u021ba \u00een pericol la doze standard. Apari\u021bia este lent\u0103 \u2014 <strong>8\u201316 s\u0103pt\u0103m\u00e2ni<\/strong> pentru efectul de economisire a steroidelor. Riscurile pe termen lung includ infec\u021bii, suprimarea m\u0103duvei osoase, hepatotoxicitate \u0219i un risc moderat crescut de limfom \u0219i cancer de piele non-melanom.<\/p>\n<\/div>\n<p><!-- medsbase-specialist-strip --><\/p>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:16px 20px;margin:0 0 24px 0;border-radius:4px;font-size:14px;\"><strong>\u2695 Medicament sub supraveghere specializat\u0103 \u2014 necesit\u0103 monitorizare clinic\u0103.<\/strong> Acesta este un medicament imunomodulator serios cu cerin\u021be specifice de screening pre-tratament, avertismente black-box \u0219i monitorizare obligatorie \u00een laborator. Ar trebui s\u0103 fie prescris \u0219i supravegheat de un reumatolog, gastroenterolog, dermatolog sau alt specialist cu experien\u021b\u0103 \u00een utilizarea sa. Nu <strong>prime\u0219te,<\/strong> autoprescrie\u021bi, nu ajusta\u021bi singur doza \u0219i nu \u00eencepe\u021bi\/opri\u021bi tratamentul f\u0103r\u0103 indica\u021biile medicului prescriptor. Furniza\u021bi \u00eentotdeauna medicului tratant re\u021beta actual\u0103 \u00eenainte de a comanda de la MedsBase.<\/div>\n<div class=\"medsbase-trust-strip\" style=\"background:#f4f6f8;border:1px solid #e1e4e8;border-radius:4px;padding:14px 18px;margin:18px 0;display:flex;flex-wrap:wrap;gap:14px;font-size:0.95em;\"><span>\u2705 <strong>Certificat WHO-GMP<\/strong> produc\u0103tor<\/span><span>\ud83d\udce6 <strong>Ambalaj discret<\/strong><\/span><span>\ud83c\udf0d <strong>Livrare \u00een toat\u0103 lumea<\/strong><\/span><span>\ud83d\udcac <a href=\"\/ro\/reviews\/\">Peste 1.400 de recenzii ale clien\u021bilor<\/a><\/span><\/div>\n<p class=\"medsbase-reship-line\" style=\"font-size:14px;color:#444;margin:8px 0 18px;\">\ud83d\udce6 Fiecare comand\u0103 este acoperit\u0103 de politica noastr\u0103 de <a href=\"https:\/\/medsbase.com\/ro\/medsbase-re-shipment-assurance-policy\/\"><strong>Politica noastr\u0103 de Reexpediere Garantat\u0103<\/strong><\/a> \u2014 dac\u0103 coletul dumneavoastr\u0103 nu sose\u0219te \u00een 20 de zile lucr\u0103toare, \u00eel relivr\u0103m.<\/p>\n<h3>De ce s\u0103 comanzi de la MedsBase<\/h3>\n<p>Medicamentele noastre generice sunt procurate de la produc\u0103tori certifica\u021bi WHO-GMP \u0219i expediate la nivel mondial \u00een ambalaje discrete \u0219i simple \u2014 f\u0103r\u0103 denumirea medicamentului pe exteriorul coletului. Pl\u0103\u021bile cu cardul sunt procesate printr-un procesor reglementat (descrierile de pe extrasul de cont includ un procesor de pl\u0103\u021bi cu card reglementat \u2014 niciodat\u0103 \u201cMedsBase\u201d sau numele vreunui medicament). Accept\u0103m \u0219i criptomonede \u0219i transferuri bancare SEPA. Fiecare comand\u0103 este sus\u021binut\u0103 de Politica noastr\u0103 de Asigurare pentru Relivrare.<\/p>\n<h2 class=\"wp-block-heading\">Ce este Azoran?<\/h2>\n<p>Azoran este un comprimat oral fabricat de RPG Life Sciences care con\u021bine <strong>azatioprin\u0103 50 mg<\/strong>. Azatioprina este un pro-medicament \u2014 odat\u0103 absorbit\u0103, este convertit\u0103 (neenzimatic \u0219i prin glutati\u00f3n-S-transferaz\u0103) \u00een <strong>6-mercaptopurin\u0103 (6-MP)<\/strong>, care este ulterior metabolizat\u0103 \u00een nucleotide de tioguanin\u0103 active care se \u00eencorporeaz\u0103 \u00een ADN \u0219i blocheaz\u0103 sinteza purinelor \u00een celulele care se divid rapid, \u00een special limfocite.<\/p>\n<p>Azoran este azatioprina generic\u0103 de marc\u0103 a RPG Life Sciences \u2014 unul dintre cele mai vechi medicamente imunosupresoare \u00eenc\u0103 \u00een uz clinic de rutin\u0103 \u0219i agentul clasic de economisire a steroidelor \u00een BCI, LES, hepatita autoimun\u0103, miastenia gravis \u0219i men\u021binerea transplantului de organe solide. Azatioprina este utilizat\u0103 clinic din anii 1960 \u0219i r\u0103m\u00e2ne unul dintre principalele imunosupresoare care economisesc steroizi \u2014 pentru men\u021binerea transplantului de organe \u0219i o gam\u0103 larg\u0103 de afec\u021biuni autoimune. Principalele sale roluri sunt fie ca imunosupresor primar (\u00een afec\u021biuni u\u0219oare p\u00e2n\u0103 la moderate), fie ca <strong>agent de economisire a steroizilor<\/strong> (ad\u0103ugat la terapia cu corticosterioide pentru a permite reducerea treptat\u0103 a steroizilor men\u021bin\u00e2nd controlul bolii).<\/p>\n<h2 class=\"wp-block-heading\">Cum func\u021bioneaz\u0103 Azoran?<\/h2>\n<p>Azatioprina ac\u021bioneaz\u0103 la nivelul ADN-ului celulelor imunitare \u00een diviziune:<\/p>\n<ul>\n<li><strong>Conversia pro-medicament<\/strong> \u2014 azatioprina este transformat\u0103 \u00een 6-MP \u00een c\u00e2teva ore de la administrare.<\/li>\n<li><strong>Metabolismul triplu al 6-MP<\/strong>:<\/li>\n<ul>\n<li><em>Calea HGPRT<\/em> \u2192 nucleotide de 6-tioguanin\u0103 (6-TGN), principalul metabolit activ. 6-TGN este \u00eencorporat \u00een ADN \u0219i perturb\u0103 sinteza purinelor \u00een limfocite.<\/li>\n<li><em>Calea TPMT<\/em> \u2192 6-metil-mercaptopurin\u0103, \u00een mare parte inactiv\u0103. Pacien\u021bii cu activitate sc\u0103zut\u0103 a TPMT direc\u021bioneaz\u0103 mai mult 6-MP c\u0103tre calea activ\u0103 6-TGN \u2014 produc\u00e2nd mielosupresie profund\u0103 la doze normale.<\/li>\n<li><em>Calea xantin-oxidaz\u0103<\/em> \u2192 acid tiuric inactiv. Aceasta este calea blocat\u0103 de <strong>allopurinol<\/strong> \u2014 explic\u00e2nd de ce allopurinol + azatioprin\u0103 \u00een doze standard este o combina\u021bie poten\u021bial letal\u0103.<\/li>\n<\/ul>\n<li><strong>Selectiv pentru limfocite<\/strong> \u2014 celulele T \u0219i B sunt deosebit de sensibile deoarece depind de <em>de novo<\/em> calea de sintez\u0103 a purinelor \u0219i nu de salvarea acestora.<\/li>\n<\/ul>\n<p>\u00cenceputul efectului clinic: <strong>8\u201316 s\u0103pt\u0103m\u00e2ni<\/strong> pentru majoritatea afec\u021biunilor autoimune. Azatioprina nu este un medicament cu ac\u021biune rapid\u0103 \u2014 corticosteroizii sunt de obicei necesari \u00een primele 2\u20133 luni p\u00e2n\u0103 c\u00e2nd azatioprina \u00ee\u0219i manifest\u0103 efectul.<\/p>\n<h2 class=\"wp-block-heading\">Utiliz\u0103ri \u0219i indica\u021bii<\/h2>\n<ul>\n<li><strong>Transplant de organe solide<\/strong> \u2014 imunosupresie de \u00eentre\u021binere pentru transplantul de rinichi, ficat, inim\u0103 (folosit mai rar \u00een prezent \u2014 micofenolatul l-a \u00eenlocuit \u00een mare m\u0103sur\u0103 \u00een protocoalele moderne)<\/li>\n<li><strong>Boal\u0103 inflamatorie intestinal\u0103<\/strong> \u2014 men\u021binere cu reducere a corticosteroizilor \u00een boala Crohn \u0219i colita ulceroas\u0103<\/li>\n<li><strong>Poliartrit\u0103 reumatoid\u0103<\/strong> \u2014 pentru pacien\u021bii care nu tolereaz\u0103 metotrexatul sau terapia biologic\u0103<\/li>\n<li><strong>Lupus eritematos sistemic (LES)<\/strong> \u2014 inclusiv men\u021binerea dup\u0103 induc\u021bia nefritei lupice<\/li>\n<li><strong>Hepatit\u0103 autoimun\u0103<\/strong> \u2014 men\u021binere standard \u00een combina\u021bie cu (sau \u00eenlocuirea) prednisolonului la doze mici<\/li>\n<li><strong>Miastenie gravis<\/strong> \u2014 terapie pe termen lung cu reducere a corticosteroizilor<\/li>\n<li><strong>Vasculit\u0103 asociat\u0103 ANCA<\/strong> \u2014 men\u021binerea remisiei dup\u0103 induc\u021bie<\/li>\n<li><strong>Pemfigus vulgar \u0219i pemfigoid bulos<\/strong> \u2014 reducerea corticosteroizilor \u00een boala cronic\u0103<\/li>\n<li><strong>Dermita atopic\u0103<\/strong> \u2014 cazuri refractare severe<\/li>\n<li><strong>Scleroz\u0103 multipl\u0103 (forma recidivant-remitent\u0103)<\/strong> \u2014 utilizare ocazional\u0103 acolo unde terapiile modificatoare de boal\u0103 nu sunt disponibile<\/li>\n<\/ul>\n<p>Azoran este <strong>prime\u0219te,<\/strong> pentru: durere articular\u0103 nediagnosticat\u0103, managementul de prim\u0103 linie al majorit\u0103\u021bii afec\u021biunilor autoimune atunci c\u00e2nd exist\u0103 alternative cu ac\u021biune mai rapid\u0103 sau mai eficient\u0103, sau pentru orice pacient care nu a efectuat testarea TPMT \u0219i analizele de baz\u0103.<\/p>\n<h2 class=\"wp-block-heading\">\u00cenainte de a \u00eencepe Azoran \u2014 Screening obligatoriu<\/h2>\n<p>Azatioprina este unul dintre pu\u021binele medicamente frecvent utilizate pentru care testarea farmacogenetic\u0103 \u00eenainte de prima doz\u0103 este standard de \u00eengrijire. Omiterea acesteia poate duce la insuficien\u021b\u0103 fatal\u0103 a m\u0103duvei osoase.<\/p>\n<ul>\n<li><strong>Test de genotip TPMT sau activitate enzimatic\u0103<\/strong> \u2014 identific\u0103 aproximativ 1 din 300 de pacien\u021bi de origine european\u0103 cu activitate TPMT absent\u0103 (variant\u0103 homozigot\u0103) \u0219i aproximativ 10% cu activitate redus\u0103 (heterozigot\u0103). Absen\u021ba activit\u0103\u021bii TPMT \u00eenseamn\u0103 c\u0103 doza standard va provoca mielosupresie catastrofal\u0103 \u00een c\u00e2teva s\u0103pt\u0103m\u00e2ni.<\/li>\n<li><strong>Genotip NUDT15 (acolo unde este disponibil)<\/strong> \u2014 deosebit de important pentru pacien\u021bii de origine asiatic\u0103, hispanic\u0103 \u0219i african\u0103, unde variantele NUDT15 cauzeaz\u0103 un risc similar de mielosupresie independent de starea TPMT.<\/li>\n<li><strong>Hemogram\u0103 complet\u0103<\/strong> \u2014 valoare de baz\u0103; nu \u00eencepe\u021bi dac\u0103 ANC &lt; 1,5 sau trombocite &lt; 100.<\/li>\n<li><strong>Teste de func\u021bie hepatic\u0103<\/strong> \u2014 valorile de baz\u0103 ALT, AST, ALP, bilirubin. Am\u00e2na\u021bi dac\u0103 sunt semnificativ anormale.<\/li>\n<li><strong>Func\u021bia renal\u0103<\/strong> \u2014 azatioprina este par\u021bial eliminat\u0103 prin metabolite inactivi \u00een urin\u0103; poate fi necesar\u0103 ajustarea dozei \u00een cazul insuficien\u021bei renale severe.<\/li>\n<li><strong>Testare hepatit\u0103 B \/ C \u0219i HIV<\/strong> \u2014 previne reactivarea hepatitei virale cronice \u0219i identific\u0103 coinfec\u021bia care necesit\u0103 \u00eengrijire specializat\u0103.<\/li>\n<li><strong>Testare tuberculoz\u0103 latent\u0103<\/strong> \u2014 Test QuantiFERON sau TST; trata\u021bi tuberculoza latent\u0103 \u00eenainte de a \u00eencepe imunosupresia prelungit\u0103.<\/li>\n<li><strong>Stare Varicella-zoster<\/strong> \u2014 pacien\u021bii seronegativi ar trebui s\u0103 primeasc\u0103 vaccinul contra varicelei (vivos) \u00ceNAINTE de a \u00eencepe azatioprina \u2014 vaccinurile vii sunt contraindicate odat\u0103 ce tratamentul a \u00eenceput.<\/li>\n<li><strong>Test de sarcin\u0103<\/strong> la femeile \u00een v\u00e2rst\u0103 reproductiv\u0103; este necesar\u0103 discu\u021bia despre contracep\u021bie.<\/li>\n<li><strong>Evaluare vaccinare<\/strong> \u2014 actualiza\u021bi vaccinurile inactivate (grip\u0103, pneumococ, COVID-19, Shingrix, HPV). Vaccinurile vii sunt contraindicate \u00een timpul tratamentului.<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Doza Azoran \u0219i mod de administrare<\/h2>\n<p>Azoran este furnizat \u00een <strong>50 mg<\/strong>. Doza se stabile\u0219te \u00een func\u021bie de greutate \u0219i se titreaz\u0103 cu aten\u021bie.<\/p>\n<ul>\n<li><strong>Gam\u0103 standard pentru adul\u021bi:<\/strong> 1\u20133 mg\/kg greutate corporal\u0103 o dat\u0103 pe zi.<\/li>\n<li><strong>\u00cencepe\u021bi cu doze mici:<\/strong> de obicei 50 mg o dat\u0103 pe zi timp de 1\u20132 s\u0103pt\u0103m\u00e2ni, cu num\u0103r\u0103toare globulare la s\u0103pt\u0103m\u00e2na 1 \u0219i s\u0103pt\u0103m\u00e2na 2; apoi cre\u0219te\u021bi la doza \u021bint\u0103 dac\u0103 analizele sunt stabile.<\/li>\n<li><strong>Men\u021binere \u00een boli autoimune:<\/strong> 1\u20132,5 mg\/kg\/zi este tipic.<\/li>\n<li><strong>Men\u021binere dup\u0103 transplant:<\/strong> 1\u20133 mg\/kg\/zi \u00een func\u021bie de regim.<\/li>\n<li><strong>Activitate TPMT heterozigot\u0103 sau intermediar\u0103:<\/strong> reduce\u021bi doza ini\u021bial\u0103 la 50% (0,5\u20131,5 mg\/kg\/zi).<\/li>\n<li><strong>Deficit homozigot TPMT sau deficit NUDT15:<\/strong> azatioprina este contraindicat\u0103 (sau utiliza\u021bi &lt; 10% din doza standard sub supraveghere specializat\u0103 cu monitorizare intensiv\u0103).<\/li>\n<li><strong>Afectare renal\u0103:<\/strong> reduce\u021bi doza \u00een cazul insuficien\u021bei severe; evita\u021bi \u00een ESRD f\u0103r\u0103 \u00eendrumare specializat\u0103.<\/li>\n<li><strong>Cu m\u00e2ncare:<\/strong> lua\u021bi \u00een timpul sau dup\u0103 mas\u0103 pentru a reduce grea\u021ba.<\/li>\n<\/ul>\n<h3 class=\"wp-block-heading\">Cum s\u0103 lua\u021bi corect Azoran<\/h3>\n<ol>\n<li><strong>Nu \u00eencepe\u021bi niciodat\u0103 f\u0103r\u0103 testare TPMT<\/strong> (\u0219i NUDT15 unde este disponibil). Acesta este cel mai important pas de siguran\u021b\u0103.<\/li>\n<li><strong>\u00cenghi\u021bi\u021bi comprimatele \u00eentregi cu ap\u0103, \u00een timpul mesei.<\/strong> Nu zdrobi\u021bi sau mesteca\u021bi \u2014 azatioprina este un medicament citotoxic \u0219i praful poate fi d\u0103un\u0103tor pentru cei care \u00eengrijesc. Sp\u0103la\u021bi-v\u0103 m\u00e2inile dup\u0103 manipulare.<\/li>\n<li><strong>O dat\u0103 pe zi, la acela\u0219i or.<\/strong> \u2014 de obicei cu masa de sear\u0103 pentru a reduce orice senza\u021bie de grea\u021b\u0103 pe parcursul zilei.<\/li>\n<li><strong>Analize CBC \u0219i LFT \u00een s\u0103pt\u0103m\u00e2nile 1, 2, 4, 8, 12, apoi la fiecare 3 luni<\/strong> pe termen nedefinit. Orice sc\u0103dere a leucocitelor sub 3,0 sau a neutrofilelor sub 1,5 necesit\u0103 evaluare specializat\u0103 \u0219i de obicei reducerea sau \u00eentreruperea dozei.<\/li>\n<li><strong>Nu neglija analizele de monitorizare<\/strong> \u2014 mielosupresia cu debut \u00eent\u00e2rziat poate ap\u0103rea la luni sau ani dup\u0103 \u00eenceperea tratamentului, \u00een special la introducerea de noi medicamente concomitente (alopurinolul este declan\u0219atorul clasic).<\/li>\n<li><strong>Produs de protec\u021bie solar\u0103 cu spectru larg SPF 50 zilnic<\/strong>. Azatioprina cre\u0219te semnificativ riscul de cancer cutanat non-melanocitar \u2014 evaluare dermatologic\u0103 anual\u0103 pentru pacien\u021bii cu piele deschis\u0103 la culoare sau pentru cei \u00een tratament pe termen lung.<\/li>\n<li><strong>Raporta\u021bi imediat orice durere \u00een g\u00e2t, febr\u0103 neexplicat\u0103, v\u00e2n\u0103t\u0103i, s\u00e2nger\u0103ri, ulcera\u021bii bucale sau oboseal\u0103 sever\u0103<\/strong> \u2014 pot fi primele semne de suprimare a m\u0103duvei osoase.<\/li>\n<li><strong>Informa\u021bi fiecare medic prescriptor<\/strong> c\u0103 lua\u021bi azatioprin\u0103 \u2014 mai ales \u00eenainte de a \u00eencepe orice medicament nou care con\u021bine \u201calopurinol\u201d sau orice terapie de reducere a uratului.<\/li>\n<li><strong>Evita\u021bi vaccinurile cu virus vii<\/strong> pe durata tratamentului \u0219i pentru cel pu\u021bin 3 luni dup\u0103 \u00eentrerupere.<\/li>\n<li><strong>Planifica\u021bi sarcina \u00een avans cu medicul prescriptor<\/strong> \u2014 azatioprina este \u00een general considerat\u0103 compatibil\u0103 cu sarcina pentru indica\u021bii materne (spre deosebire de micofenolat), dar decizia este individualizat\u0103.<\/li>\n<\/ol>\n<h2 class=\"wp-block-heading\">Efecte Secundare ale Azoran<\/h2>\n<p><strong>Frecvente (primele 4\u20138 s\u0103pt\u0103m\u00e2ni):<\/strong><\/p>\n<ul>\n<li>Grea\u021b\u0103, v\u0103rs\u0103turi, dureri abdominale (de obicei se amelioriaz\u0103; cele mai intense \u00een prima lun\u0103)<\/li>\n<li>Diaree<\/li>\n<li>Oboseal\u0103<\/li>\n<li>Dureri de cap<\/li>\n<li>Sub\u021biere u\u0219oar\u0103 a p\u0103rului<\/li>\n<li>Cre\u0219tere u\u0219oar\u0103 a enzimelor hepatice (ALT, AST)<\/li>\n<\/ul>\n<p><strong>Mai pu\u021bin frecvente, dar importante:<\/strong><\/p>\n<ul>\n<li><strong>Mielosupresie<\/strong> \u2014 leucopenie, neutropenie, trombocitopenie, anemie. De obicei dependente de doz\u0103 \u0219i reversibile.<\/li>\n<li><strong>Reac\u021bie de hipersensibilitate<\/strong> \u2014 febr\u0103, erup\u021bie cutanat\u0103, dureri articulare, uneori hipotensiune, de obicei \u00een primele 4 s\u0103pt\u0103m\u00e2ni. Se rezolv\u0103 la \u00eentrerupere \u0219i de obicei recidiveaz\u0103 la reexpunere.<\/li>\n<li><strong>Hepatotoxicitate<\/strong> \u2014 cre\u0219terea u\u0219oar\u0103 a ALT este frecvent\u0103; hepatita colestatic\u0103 \u0219i boala veno-ocluziv\u0103 sunt rare dar grave.<\/li>\n<li><strong>Pancreatit\u0103<\/strong> \u2014 idiosincratic\u0103, mai frecvent\u0103 la pacien\u021bii cu BCI. \u00centrerupe\u021bi permanent dac\u0103 apare.<\/li>\n<li>Ulcer\u0103ri bucale<\/li>\n<li>Risc crescut de infec\u021bii \u2014 bacteriene, virale (\u00een special herpes zoster), fungice, parazitare<\/li>\n<\/ul>\n<p><strong>Rar dar grav \u2014 cere consult urgent:<\/strong><\/p>\n<ul>\n<li><strong>Mielosupresie sever\u0103, poten\u021bial letal\u0103<\/strong> \u2014 pacien\u021bi cu deficit de TPMT, coprescrip\u021bie de alopurinol sau expunere la doze mari. G\u00e2tul inflamat brusc, febr\u0103, v\u00e2n\u0103t\u0103i, s\u00e2nger\u0103ri sau oboseal\u0103 sever\u0103 sunt semnale de avertizare.<\/li>\n<li><strong>Limon<\/strong> \u2014 boal\u0103 limfoproliferativ\u0103 post-transplant (PTLD); limfom hepatosplenic cu celule T (rar dar adesea fatal; risc mai mare la tinerii de sex masculin cu IBD sub terapie combinat\u0103 azatioprin\u0103 + inhibitor TNF)<\/li>\n<li><strong>Cancer cutanat non-melanocitar<\/strong> \u2014 semnificativ crescut la utilizarea pe termen lung, \u00een special la pacien\u021bii cu piele deschis\u0103 la culoare \u0219i expunere cumulativ\u0103 la soare<\/li>\n<li><strong>Leucoencefalopatie multifocal\u0103 progresiv\u0103 (PML)<\/strong> \u2014 rar dar raportat, de obicei la pacien\u021bi cu imunosupresie sever\u0103<\/li>\n<li><strong>Reactivarea hepatitei B sau a herpes zoster<\/strong>, herpes diseminat, infec\u021bie oportunist\u0103<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Avertismente \u0219i precau\u021bii<\/h2>\n<ul>\n<li><strong>Infec\u021bie activ\u0103 grav\u0103<\/strong> \u2014 nu \u00eencepe tratamentul; suspend\u0103 \u00een timpul afec\u021biunilor febrile.<\/li>\n<li><strong>Istoric de malignitate sau malignitate activ\u0103 (altele dec\u00e2t cancerul de piele non-melanom tratat)<\/strong> \u2014 contraindica\u021bie relativ\u0103; decizie specializat\u0103.<\/li>\n<li><strong>Tineri de sex masculin cu IBD<\/strong> \u2014 risc specific (rar) de limfom hepatosplenic cu celule T, \u00een special atunci c\u00e2nd azatioprina este combinat\u0103 cu un inhibitor TNF. Discuta\u021bi alternativele de monoterapie.<\/li>\n<li><strong>Hepatit\u0103 cronic\u0103 B sau C<\/strong> \u2014 risc de reactivare viral\u0103; administra\u021bi terapie antiviral\u0103 (entecavir sau tenofovir pentru HBV) acolo unde este cazul.<\/li>\n<li><strong>Tuberculoz\u0103 latent\u0103<\/strong> \u2014 trata\u021bi \u00eenainte de a \u00eencepe imunosupresia prelungit\u0103.<\/li>\n<li><strong>Sarcin\u0103<\/strong> \u2014 azatioprina este \u00een general considerat\u0103 compatibil\u0103 cu sarcina pentru afec\u021biuni autoimune materne (spre deosebire de micofenolat, care este absolut contraindiat). Continuarea \u00een timpul sarcinii ar trebui s\u0103 fie o decizie luat\u0103 \u00een comun cu aportul unui specialist; afec\u021biunile autoimune active netratate prezint\u0103 adesea un risc fetal mai mare dec\u00e2t medicamentul. B\u0103rba\u021bii care iau azatioprin\u0103 \u00een momentul concep\u021biei: nu exist\u0103 dovezi puternice de teratogenitate.<\/li>\n<li><strong>Al\u0103ptare<\/strong> \u2014 cantit\u0103\u021bi mici de metaboli\u021bi trec \u00een laptele matern, dar utilizarea clinic\u0103 sugereaz\u0103 un risc sc\u0103zut pentru sugari; \u00een general considerat\u0103 acceptabil\u0103 cu monitorizarea sugarului.<\/li>\n<li><strong>Copii<\/strong> \u2014 utilizat\u0103 \u00een BCI pediatric, transplant \u0219i hepatit\u0103 autoimun\u0103. Este necesar acela\u0219i test farmacogenetic.<\/li>\n<li><strong>Vaccinurile vii sunt contraindicate \u00een timpul tratamentului<\/strong>. Vaccinurile inactivate sunt permise. Planifica\u021bi vaccinurile Shingrix \u0219i cele de c\u0103l\u0103torie \u00eenainte de a \u00eencepe tratamentul.<\/li>\n<li><strong>Expunere la soare<\/strong> \u2014 protec\u021bie solar\u0103 zilnic\u0103 cu spectru larg SPF 50; consult dermatologic anual pentru pacien\u021bii cu piele deschis\u0103 la culoare \u0219i cei afla\u021bi \u00een tratament pe termen lung.<\/li>\n<li><strong>Manipulare de c\u0103tre \u00eengrijitori gravide sau care al\u0103pteaz\u0103<\/strong> \u2014 azatioprina este clasificat\u0103 ca medicament citotoxic. Folosi\u021bi m\u0103nu\u0219i la dispensarea tabletelor sparte sau zdrobite; sp\u0103la\u021bi-v\u0103 m\u00e2inile dup\u0103 manipulare.<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Contraindica\u021bii \u2014 Cine NU ar trebui s\u0103 ia Azoran<\/h2>\n<ul>\n<li>Hipersensibilitate cunoscut\u0103 la azatioprin\u0103, 6-mercaptopurin\u0103 sau orice excipient din tablet\u0103<\/li>\n<li>Deficien\u021b\u0103 complet\u0103 de TPMT sau NUDT15 (variant\u0103 homozigot\u0103) \u2014 utiliza\u021bi o alt\u0103 clas\u0103 de medicamente<\/li>\n<li>Infec\u021bie activ\u0103 sever\u0103 (bacterian\u0103, viral\u0103, fungic\u0103, micobacterian\u0103)<\/li>\n<li>Hepatit\u0103 B sau C activ\u0103 netratat\u0103 f\u0103r\u0103 acoperire antiviral\u0103<\/li>\n<li>Boal\u0103 hepatic\u0103 sever\u0103 (ciroz\u0103 decompensat\u0103)<\/li>\n<li>Pancreatit\u0103 indus\u0103 anterior de azatioprin\u0103 (contraindica\u021bie absolut\u0103 pentru readministrare)<\/li>\n<li>Mielosupresie sever\u0103 de baz\u0103 (ANC &lt; 1,0, trombocite &lt; 75, Hb &lt; 8 g\/dL)<\/li>\n<li>Planificare sarcin\u0103 \u00een cazurile \u00een care nu s-au luat \u00een considerare micofenolat sau metotrexat ca alternative (decizie specialist)<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Interac\u021biuni medicamentoase<\/h2>\n<table style=\"border-collapse:collapse;width:100%;margin:12px 0;\">\n<thead>\n<tr style=\"background:#2c7cb0;color:#fff;\">\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Combina\u021bi cu<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Efect<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Ce s\u0103 face\u021bi<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\"><strong>Alopurinol, febuxostat<\/strong> (sc\u0103dere a nivelului de acid uric)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\"><strong>Mielosupresie care pune via\u021ba \u00een pericol<\/strong> \u2014 xanthine oxidase este blocat\u0103, 6-MP se acumuleaz\u0103 \u00een c\u0103ile citotoxice active. Decese raportate.<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\"><strong>Reduce\u021bi azatioprina la 25\u201333% din doza standard \u0218I monitoriza\u021bi hemoleucograma s\u0103pt\u0103m\u00e2nal timp de 4 s\u0103pt\u0103m\u00e2ni.<\/strong> Alternativ\u0103: trece\u021bi la un tratament pentru gut\u0103 cu un agent non-XO (lesinurad, uricosurice).<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Aminosalicila\u021bi (mesalamin\u0103, sulfasalazin\u0103, olsalazin\u0103)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Inhib\u0103 TPMT \u2014 risc moderat suplimentar de mielosupresie<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Combina\u021bie frecvent\u0103 \u00een IBD. Monitoriza\u021bi hemoleucograma mai frecvent.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Warfarin<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Azatioprina poate reduce efectul warfarinei (mecanism necunoscut)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Monitoriza\u021bi \u00eendeaproape INR-ul la iniciarea sau \u00eentreruperea azatioprinei.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Inhibitori ACE, BRA<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Risc adi\u021bional de anemie<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Monitorare Hb.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Co-trimoxazol (trimetoprim-sulfametoxazol)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Mielosupresie aditiv\u0103<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Folosit frecvent pentru profilaxia Pneumocystis la pacien\u021bii cu imunosupresie sever\u0103 \u2014 monitoriza\u021bi hemograma.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Ribavirin\u0103 (tratament hepatit\u0103 C)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Mielosupresie sever\u0103 prin inhibarea dehidrogenazei inozin monofosfat<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\"><strong>Evita\u021bi combina\u021bia.<\/strong> Finaliza\u021bi tratamentul pentru HCV \u00eenainte de a \u00eencepe azatioprina, acolo unde este posibil.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Inhibitori TNF (infliximab, adalimumab, certolizumab)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Combina\u021bie standard \u00een BCI; risc mic adi\u021bional de limfom, \u00een special la b\u0103rba\u021bii tineri (limfom T celular hepatosplenic)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Evalua\u021bi beneficiul (controlul BCI) versus riscul rar de limfom. Lua\u021bi \u00een considerare monoterapia odat\u0103 stabilizat.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Vaccinuri cu virus viu (MMR, varicel\u0103, febra galben\u0103, BCG, Zostavax, grip\u0103 nazal\u0103 cu virus viu)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Risc de infec\u021bie diseminat\u0103 cu tulpina vaccinal\u0103<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\"><strong>Contraindicate \u00een timpul tratamentului<\/strong> \u0219i pentru 3 luni dup\u0103 \u00eentrerupere.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Corticoesteroizi<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Imunosupresie aditiv\u0103 (combina\u021bie inten\u021bionat\u0103)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Standard \u2014 azatioprina este utilizat\u0103 \u00een mod obi\u0219nuit ca agent de economisire a steroizilor.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Alte imunosupresoare (MMF, ciclosporin\u0103, tacrolimus, inhibitori JAK, biologice)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Risc adi\u021bional de infec\u021bii \u0219i malignit\u0103\u021bi<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Doar \u00een contexte de transplant sau specializate, monitorizate atent.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2 class=\"wp-block-heading\">Instruc\u021biuni de Depozitare<\/h2>\n<ul>\n<li>Se p\u0103streaz\u0103 la temperatura camerei, <strong>sub 25\u00b0C<\/strong>, \u00een ambalajul original blister, protejat de lumin\u0103 \u0219i umiditate.<\/li>\n<li>P\u0103stra\u021bi \u00een afara reachii copiilor \u2014 azatioprina este citotoxic\u0103 \u0219i periculoas\u0103 dac\u0103 este \u00eenghi\u021bit\u0103 de un copil sau animal de companie.<\/li>\n<li>Nu utiliza\u021bi dup\u0103 data de expirare indicat\u0103 pe ambalaj.<\/li>\n<li>Returna\u021bi comprimatele nefolosite la o farmacie ca de\u0219eu citotoxic \u2014 nu le arunca\u021bi la gunoiul menajer \u0219i nu le arunca\u021bi \u00een toalet\u0103.<\/li>\n<li>Sp\u0103la\u021bi-v\u0103 m\u00e2inile dup\u0103 manipulare. \u00cengrijitorii ar trebui s\u0103 utilizeze m\u0103nu\u0219i dac\u0103 manipuleaz\u0103 comprimate sparte, \u00een special dac\u0103 sunt gravide sau al\u0103pteaz\u0103.<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Alternative conexe pe MedsBase<\/h2>\n<p>Alte medicamente utilizate \u00een tratamentul antiinflamator \u0219i autoimun disponibile al\u0103turi de acest produs:<\/p>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/ro\/barinat\/\"><strong>Barinat (baricitinib 2 \/ 4 mg) \u2014 inhibitor JAK1\/2 pentru AR<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/tofe\/\"><strong>Tofe (tofacitinib 5 mg) \u2014 inhibitor JAK1\/3 pentru AR, UC, PsA<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/lefuheal\/\"><strong>Lefuheal (leflunomid\u0103) \u2014 DMARD oral pentru artrita reumatoid\u0103<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/conimune-me\/\"><strong>Conimune ME (ciclosporin\u0103) \u2014 inhibitor al calcineurinei<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/wysolone\/\"><strong>Wysolone (prednisolon 5 \/ 10 \/ 20 mg) \u2014 corticosteroid oral<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/medrol\/\"><strong>Medrol (metilprednisolon 4 \/ 8 \/ 16 mg) \u2014 corticosteroid oral<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/predniheal\/\"><strong>Predniheal (prednisolon) \u2014 corticosteroid oral<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/hisone\/\"><strong>Hisone (hidrocortizon) \u2014 steroid fiziologic de \u00eenlocuire<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/budez-cr\/\"><strong>Budez CR (budesonid\u0103) \u2014 corticosteroid cu ac\u021biune intestinal\u0103 pentru boala Crohn<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/kenacort\/\"><strong>Kenacort (triamcinolon) \u2014 corticosteroid sistemic<\/strong><\/a><\/li>\n<\/ul>\n<p>Explora\u021bi \u00eentreaga <a href=\"https:\/\/medsbase.com\/ro\/anti-inflammatory-autoimmune-care\/\">\u00cengrijire antiinflamatoare \u0219i autoimun\u0103<\/a> categorie.<\/p>\n<h2 id=\"faqs\">\u00centreb\u0103ri frecvente<\/h2>\n<h3 class=\"wp-block-heading\">De ce am nevoie de testarea TPMT \u00eenainte de a \u00eencepe Azoran?<\/h3>\n<p>Tiopurin\u0103 metiltransferaza (TPMT) este enzima care detoxific\u0103 metabolitul activ al azatioprinei. Aproximativ 1 din 300 de persoane de origine european\u0103 nu au deloc TPMT func\u021bional\u0103 (deficien\u021b\u0103 homozigot\u0103), iar aproximativ 10% au activitate redus\u0103 (heterozigot\u0103). La doza standard, un pacient cu deficien\u021b\u0103 de TPMT va dezvolta o suprresie catastrofal\u0103, care pune via\u021ba \u00een pericol, a m\u0103duvei osoase \u00een c\u00e2teva s\u0103pt\u0103m\u00e2ni. Testarea TPMT \u2014 fie genotip, fie test de activitate enzimatic\u0103 \u2014 identific\u0103 ace\u0219ti pacien\u021bi \u00eenainte de a lua primul comprimat. Testarea NUDT15 este \u00een plus important\u0103 pentru pacien\u021bii de origine asiatic\u0103, hispanic\u0103 \u0219i african\u0103, care au o alt\u0103 variant\u0103 de risc ridicat.<\/p>\n<h3 class=\"wp-block-heading\">C\u00e2nd va \u00eencepe Azoran s\u0103 fac\u0103 efect?<\/h3>\n<p>Azatioprina ac\u021bioneaz\u0103 lent. Efectul clinic devine evident <strong>8\u201316 s\u0103pt\u0103m\u00e2ni<\/strong> \u00cen aceast\u0103 perioad\u0103 de induc\u021bie ve\u021bi r\u0103m\u00e2ne de obicei sub corticosteroizi sau un alt medicament cu ac\u021biune rapid\u0103 pentru controlul bolii. Nu v\u0103 a\u0219tepta\u021bi s\u0103 sim\u021bi\u021bi o diferen\u021b\u0103 \u00een primele 4 s\u0103pt\u0103m\u00e2ni \u2014 \u0219i nu opri\u021bi azatioprina pentru c\u0103 \u201cnu pare s\u0103 func\u021bioneze\u201d \u00een prima lun\u0103.<\/p>\n<h3 class=\"wp-block-heading\">De ce este alopurinolul at\u00e2t de periculos cu Azoran?<\/h3>\n<p>Allopurinolul blocheaz\u0103 xantin oxidaza, una dintre cele trei enzime care metabolizeaz\u0103 6-MP (forma activ\u0103 a azatioprinei). Cu xantin oxidaza blocat\u0103, mai mult 6-MP este direc\u021bionat c\u0103tre calea citotoxic\u0103 activ\u0103 \u2014 nivelurile cresc brusc \u0219i poate urma o insuficien\u021b\u0103 sever\u0103 a m\u0103duvei osoare \u00een c\u00e2teva s\u0103pt\u0103m\u00e2ni. Dac\u0103 lua\u021bi azatioprin\u0103 \u0219i ave\u021bi nevoie de terapie pentru reducerea acidului uric, fie (a) reduce\u021bi doza de azatioprin\u0103 la 25\u201333% din cea normal\u0103 \u0218I monitoriza\u021bi hemograma s\u0103pt\u0103m\u00e2nal, (b) trece\u021bi la un medicament care nu ac\u021bioneaz\u0103 pe xantin oxidaz\u0103 (lesinurad, probenecid), sau (c) \u00eentrerupe\u021bi temporar azatioprina. Aceasta este cea mai periculoas\u0103 interac\u021biune medicamentoas\u0103 pentru azatioprin\u0103.<\/p>\n<h3 class=\"wp-block-heading\">Ce analize de s\u00e2nge am nevoie pentru Azoran?<\/h3>\n<p>Hemogram\u0103 complet\u0103 \u0219i teste de func\u021bie hepatic\u0103 la s\u0103pt\u0103m\u00e2nile 1, 2, 4, 8, 12, apoi la fiecare 3 luni pe termen nelimitat. Mai frecvente (s\u0103pt\u0103m\u00e2nal timp de 4 s\u0103pt\u0103m\u00e2ni) la \u00eenceperea oric\u0103rui medicament nou, \u00een special allopurinol sau co-trimoxazol. Orice sc\u0103dere a leucocitelor sub 3,0 \u00d7 10&amp;sup9;\/L sau a ANC sub 1,5, sau orice cre\u0219tere a ALT peste de 3 ori limita superioar\u0103 normal\u0103, necesit\u0103 evaluare de c\u0103tre medic \u0219i de obicei reducerea sau \u00eentreruperea dozei.<\/p>\n<h3 class=\"wp-block-heading\">Pot r\u0103m\u00e2ne \u00eens\u0103rcinat\u0103 \u00een timp ce iau Azoran?<\/h3>\n<p>Azatioprina este considerat\u0103 \u00een general compatibil\u0103 cu sarcina \u00een cazul bolilor autoimune materne \u2014 medicamentul trece \u00een f\u0103t, dar ficatul f\u0103tului \u00een stadiu timpuriu nu are enzimele necesare pentru a-l activa \u00een 6-TGN, astfel expunerea f\u0103tului la forma activ\u0103 este limitat\u0103. Aceasta este foarte diferit de micofenolat, care este puternic teratogen \u0219i absolut contraindiat \u00een sarcin\u0103. Mul\u021bi reumatologi, speciali\u0219ti \u00een BCI \u0219i medici transplanta\u021bi continu\u0103 azatioprina \u00een timpul sarcinii deoarece riscurile bolii materne necontrolate dep\u0103\u0219esc riscul medicamentului. Discuta\u021bi cu specialistul dumneavoastr\u0103 cu cel pu\u021bin 3 luni \u00eenainte de concepere planificat\u0103. Contraceptia eficient\u0103 nu este obligatorie, dar luarea deciziilor \u00eemp\u0103rt\u0103\u0219ite este.<\/p>\n<h3 class=\"wp-block-heading\">De ce sunt mai predispus la infec\u021bii \u0219i cancer de piele \u00een timp ce iau Azoran?<\/h3>\n<p>Azatioprina suprinde \u00een general limfocitele, astfel capacitatea dumneavoastr\u0103 de a r\u0103spunde la infec\u021bii bacteriene, virale \u0219i fungice este redus\u0103 \u2014 \u00een special reactivarea herpes zoster. De asemenea, afecteaz\u0103 specific repararea ADN-ului \u00een celulele pielii deteriorate de UV, cresc\u00e2nd substan\u021bial riscul de cancer de piele scuamos \u0219i bazocelular (observat de obicei dup\u0103 5+ ani de tratament). Protec\u021bia zilnic\u0103 cu SPF 50, \u00eembr\u0103c\u0103minte protectoare, evitarea paturilor solare \u0219i evaluarea dermatologic\u0103 anual\u0103 reduc semnificativ acest risc.<\/p>\n<h3 class=\"wp-block-heading\">Ce trebuie s\u0103 fac dac\u0103 am o durere sever\u0103 de g\u00e2t sau febr\u0103 \u00een timp ce iau Azoran?<\/h3>\n<p>\u00centrerupe\u021bi Azoran imediat \u0219i face\u021bi urgent o hemogram\u0103 complet\u0103. Febr\u0103 neexplicat\u0103, durere sever\u0103 de g\u00e2t, ulcera\u021bii bucale, v\u00e2n\u0103t\u0103i neobi\u0219nuite, gingii care s\u00e2ngereaz\u0103 sau oboseal\u0103 extrem\u0103 sunt semnale de avertizare ale suprimerii m\u0103duvei osoare sau ale unei infec\u021bii severe. Orice dintre acestea la un pacient care ia azatioprin\u0103 este tratat ca o urgen\u021b\u0103 p\u00e2n\u0103 c\u00e2nd o hemogram\u0103 normal\u0103 o exclude. Relua\u021bi azatioprina numai dup\u0103 evaluarea medicului prescriptor.<\/p>\n<h3 class=\"wp-block-heading\">Pot primi vaccinuri cu virus vii \u00een timp ce iau Azoran?<\/h3>\n<p>Nu. Vaccinurile cu virus viu \u2014 MMR, varicel\u0103, febra galben\u0103, BCG, vaccinul Zostavax viu contra herpes zoster, vaccinul nazal viu contra gripei \u2014 sunt contraindicate \u00een timpul tratamentului cu azatioprin\u0103 \u0219i pentru 3 luni dup\u0103 \u00eentrerupere. Planifica\u021bi toate acestea \u00eenainte de a \u00eencepe tratamentul. <strong>Vaccinurile inactivate sunt acceptabile \u0219i recomandate<\/strong>: vaccinul anual contra gripei, pneumococic, COVID-19, Shingrix recombinant, HPV. Vaccinul Shingrix recombinant (nu cel vechi Zostavax viu) este vaccinul corect contra herpes zoster pentru pacien\u021bii imunosuprima\u021bi.<\/p>\n<h3 class=\"wp-block-heading\">C\u00e2t timp voi lua Azoran?<\/h3>\n<p>Pentru majoritatea afec\u021biunilor autoimune \u0219i inflamatorii, azatioprina este un tratament de \u00eentre\u021binere pe termen lung \u2014 adesea 2\u201310 ani, uneori pe nedeterminat\u0103, \u00een func\u021bie de controlul bolii \u0219i de alternativele disponibile. Pentru indica\u021biile post-transplant, este necesar\u0103 pe via\u021b\u0103. Specialistul dumneavoastr\u0103 va evalua periodic dac\u0103 continuarea tratamentului este \u00eenc\u0103 necesar\u0103. Nu \u00eentrerupe\u021bi azatioprina brusc f\u0103r\u0103 consultarea specialistului \u2014 recidiva bolii este frecvent\u0103 \u0219i poate fi sever\u0103.<\/p>\n<h3 class=\"wp-block-heading\">De ce s\u0103 comanzi de la MedsBase<\/h3>\n<p>Azoran este furnizat de un produc\u0103tor certificat WHO-GMP cu documenta\u021bie COA complet\u0103. Livr\u0103m \u00een toat\u0103 lumea \u00een ambalaje discrete \u0219i simple, iar fiecare comand\u0103 este acoperit\u0103 de <a href=\"\/ro\/medsbase-re-shipment-assurance-policy\/\">Politica noastr\u0103 de Reexpediere Garantat\u0103<\/a>. Descrierea tranzac\u021biei la plata cu cardul afi\u0219eaz\u0103 procesatorul de pl\u0103\u021bi reglementat (un procesator de pl\u0103\u021bi cu card reglementat), niciodat\u0103 \u201cMedsBase\u201d sau nume de medicamente.<\/p>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h3 class=\"wp-block-heading\">Alte Medicamente Antiinflamatoare \u0219i Autoimune<\/h3>\n<p>Dac\u0103 Azoran nu se potrive\u0219te situa\u021biei dumneavoastr\u0103, urm\u0103toarele op\u021biuni sunt disponibile \u00een aceast\u0103 categorie:<\/p>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/ro\/lefuheal\/\">Lefuheal (Leflunomid\u0103 10\/20 mg) \u2014 inhibitor al sintezei pirimidinice<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/conimune-me\/\">Conimune ME (Ciclosporin\u0103 25\/50\/100 mg) \u2014 inhibitor al calcineurinei<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/barinat\/\">Barinat (Baricitinib 2\/4 mg) \u2014 inhibitor selectiv JAK1\/JAK2<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/tofe\/\">Tofe (Tofacitinib 5 mg) \u2014 inhibitor pan-JAK<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/wysolone\/\">Wysolone (Prednisolon 5\/10\/20 mg) \u2014 corticosteroid de punte<\/a><\/li>\n<\/ul>","protected":false},"excerpt":{"rendered":"<p>\u2705 Modulare a sistemului imunitar<br \/>\n\u2705 Reduce inflama\u021bia<br \/>\n\u2705 Previne respingerea organelor<br \/>\n\u2705 Trateaz\u0103 boli autoimune<br \/>\n\u2705 Management pe termen lung<\/p>\n<p>Azoran con\u021bine Azatioprin\u0103.<\/p>","protected":false},"featured_media":55738,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3897,3141,3223],"product_tag":[3973,3974],"class_list":{"0":"post-55737","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-anti-inflammatory-autoimmune-care","7":"product_cat-category-overview","8":"product_cat-chronic-conditions","9":"product_tag-azathioprine","10":"product_tag-azoran","12":"first","13":"instock","14":"shipping-taxable","15":"purchasable","16":"product-type-variable","17":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product\/55737","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/comments?post=55737"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/media\/55738"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/media?parent=55737"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product_brand?post=55737"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product_cat?post=55737"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product_tag?post=55737"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}