The Pemphigus & Pemphigoid Society

Azathioprine (Imuran)
Azathioprine is an immunosupressive agent. Certain blood problems may result from therapy. This can increase the risk of infection and slow healing times. It is best to avoid individuals with a cold and not have vaccinations while taking azathiorprine therapy. Dental problems may occur, so be cautious with day to day care of your teeth and gums. Side effects to report to your health care provider as soon as possible include: dark yellow or brown urine, black-tarry stools, diarrhea, fever;chills;sore throat, lower back pain, joint pain, mouth sores, muscle pain, pain or difficulty passing urine, stomach pain, swelling of the feet or legs, unusual bleeding or bruising, red spots on the skin, unusual or sudden weight gain, unusual tiredness or weakness, yellowing of skin or eyes. Other side effects that do not require medical attention unless bothersome include: hair loss, loss of appetite, nausea/vomiting, skin rash/itching.

Methotrexate (MTX, Rheumatrex)
Methotrexate is a type of chemotherapeutic agent used to treat a variety of inflammatory diseases and cancers. Methotrexate affects rapidly growing cells (cancer, stomach, and mouth cells). Blood tests are necessary during methotrexate treatment. Methotrexate may cause damage to the liver, decrease the body's ability to fight infections, and cause sun sensitivity. Water should be consumed throughout the day to avoid kidney problems. Proper dental care is also needed due to increased risk of infection.

Side effects to report to your health care provider as soon as possible include: changes in vision, confusion, diarrhea, difficulty breathing (a non productive cough), difficulty walking, headache, mouth or throat sores/ulcers, redness;blistering;peeling;or loosening of the skin (including inside the mouth), seizure, skin rash (hives or itching), symptoms of infection (fever, chills, cough, sore throat, pain or difficulty passing urine), symptoms of decreased platelets or bleeding (bruising, pinpoint red spots on the skin, black-tarry stools, bloody urine), symptoms of decreased red blood cells (unusual weakness or tiredness, fainting, lightheadedness), vomiting, and yellowing of the skin or eyes.

Side effects that do not require medical attention unless bothersome include: eye irritation, hair loss, increased sensitivity to sun or UV light, loss of appetite, and nausea.

Cyclophosphamide (Cytoxan, Neosar)
Cyclophosphamide is used to treat a number of immune-related conditions and various types of cancer. It interferes with rapidly growing cells and inhibits the immune system.

Side effects to report to your health care provider as soon as possible include:blood in the urine, low blood counts, signs of infection, signs of decreased platelets or bleeding, signs of decreased red blood cells, confusion or agitation, difficulty breathing/wheezing, joint or muscle pain, mouth or throat sores, pain or difficulty passing urine, swollen feet or legs, weight gain.

Other side effects include: decreased appetite, hair loss, missed menstrual periods, muscle pains, nausea/vomiting, skin rash, stomach pain.

Cyclosporine (Sandimmune, Neoral)
Cyclosporine decreases the immune response. It used primarily to prevent rejection for organ or bone marrow transplants. Cyclosporine can increase your risk of infections and certain type of skin cancer.

Side effects to report to your health care provider as soon as possible include: confusion, depression, high blood pressure, irregular heartbeat, increased urge to urinate or frequent urination, numbness or tingling in the hands and feet, seizures, signs and symptoms of infection, stomach pain, wheezing or shortness of breath, yellow colored skin or eyes.

Other side effects include: acne, bleeding or tender gums, overgrowth of gum tissue, diarrhea, excessive hair growth, headache, leg cramps, loss of appetite, nausea/vomiting, and tremors.

Immunosuppressants Azathioprine (Imuran) Mycophenolate mofetil (CellCept) Methotrexate (MTX, Rheumatrex) Cyclophosphamide (Cytoxan, Neosar) Cyclosporine (Sandimmune, Neoral) Dapsone (DDS) Minocycline (Minocin) Nicotinamide Gold Salts (Aurothioglucose, auranofin) See also: Common pharmacy abbreviations
	\| HOME \| MEMBERS \| GLOSSARY \| CONTACT
	> Immunosuppressants These drugs are commonly used in conjunction with prednisone
	Azathioprine (Imuran) Azathioprine is an immunosupressive agent. Certain blood problems may result from therapy. This can increase the risk of infection and slow healing times. It is best to avoid individuals with a cold and not have vaccinations while taking azathiorprine therapy. Dental problems may occur, so be cautious with day to day care of your teeth and gums. Side effects to report to your health care provider as soon as possible include: dark yellow or brown urine, black-tarry stools, diarrhea, fever;chills;sore throat, lower back pain, joint pain, mouth sores, muscle pain, pain or difficulty passing urine, stomach pain, swelling of the feet or legs, unusual bleeding or bruising, red spots on the skin, unusual or sudden weight gain, unusual tiredness or weakness, yellowing of skin or eyes. Other side effects that do not require medical attention unless bothersome include: hair loss, loss of appetite, nausea/vomiting, skin rash/itching. Methotrexate (MTX, Rheumatrex) Methotrexate is a type of chemotherapeutic agent used to treat a variety of inflammatory diseases and cancers. Methotrexate affects rapidly growing cells (cancer, stomach, and mouth cells). Blood tests are necessary during methotrexate treatment. Methotrexate may cause damage to the liver, decrease the body's ability to fight infections, and cause sun sensitivity. Water should be consumed throughout the day to avoid kidney problems. Proper dental care is also needed due to increased risk of infection. Side effects to report to your health care provider as soon as possible include: changes in vision, confusion, diarrhea, difficulty breathing (a non productive cough), difficulty walking, headache, mouth or throat sores/ulcers, redness;blistering;peeling;or loosening of the skin (including inside the mouth), seizure, skin rash (hives or itching), symptoms of infection (fever, chills, cough, sore throat, pain or difficulty passing urine), symptoms of decreased platelets or bleeding (bruising, pinpoint red spots on the skin, black-tarry stools, bloody urine), symptoms of decreased red blood cells (unusual weakness or tiredness, fainting, lightheadedness), vomiting, and yellowing of the skin or eyes. Side effects that do not require medical attention unless bothersome include: eye irritation, hair loss, increased sensitivity to sun or UV light, loss of appetite, and nausea. Cyclophosphamide (Cytoxan, Neosar) Cyclophosphamide is used to treat a number of immune-related conditions and various types of cancer. It interferes with rapidly growing cells and inhibits the immune system. Side effects to report to your health care provider as soon as possible include:blood in the urine, low blood counts, signs of infection, signs of decreased platelets or bleeding, signs of decreased red blood cells, confusion or agitation, difficulty breathing/wheezing, joint or muscle pain, mouth or throat sores, pain or difficulty passing urine, swollen feet or legs, weight gain. Other side effects include: decreased appetite, hair loss, missed menstrual periods, muscle pains, nausea/vomiting, skin rash, stomach pain. Cyclosporine (Sandimmune, Neoral) Cyclosporine decreases the immune response. It used primarily to prevent rejection for organ or bone marrow transplants. Cyclosporine can increase your risk of infections and certain type of skin cancer. Side effects to report to your health care provider as soon as possible include: confusion, depression, high blood pressure, irregular heartbeat, increased urge to urinate or frequent urination, numbness or tingling in the hands and feet, seizures, signs and symptoms of infection, stomach pain, wheezing or shortness of breath, yellow colored skin or eyes. Other side effects include: acne, bleeding or tender gums, overgrowth of gum tissue, diarrhea, excessive hair growth, headache, leg cramps, loss of appetite, nausea/vomiting, and tremors.	Dapsone (DDS) Dapsone is an antiinfective medication. It is used to control certain skin conditions and leprosy. Side effects to report to your health care provider as soon as possible include: blood in urine, bluish fingernails or lips, dark yellow or brown urine, decrease or increase in amount of urine passed, difficulty breathing, fever, chills or sore throat, lower back pain, pale skin, skin rash (redness, blistering, peeling or loosening of skin), stomach pain, tingling or numbness of hands or feet, unusual bleeding or bruising, unusual weakness or tiredness, yellowing of skin or eyes. Other side effects include: nausea/vomiting, loss of appetite, and increased sensitivity to sun or UV light. Chlorambucil (Leukeran) Chlorambucil is a chemotherapeutic agent used to treat certain cancers. Side effects to report to your health care provider as soon as possible include: blood in urine, black-tarry stools, chest pain, dark yellow or brown urine, difficulty breathing or wheezing, confusion, clumsiness, fever or chills, sore throat or cough, joint or muscle pain, lower back pain, mouth or throat sores, pain or difficulty passing urine, seizures, skin rash (itching), swollen feet or legs, tingling or pain in hands or feet, tremors, unusual bleeding or bruising, unusual tiredness or weakness, vomiting, yellowing of eyes or skin. Other side effects include: diarrhea, missed menstrual periods, nausea, and weight loss. Minocycline (Minocin) Minocycline is a tetracycline type antibiotic. It is used to treat certain infections of the skin and other areas. Side effects to report to your health care provider as soon as possible include: dark yellow or brown urine, difficulty breathing, fever, headache, increased sensitivity to sun or UV light, itching in the rectal or genital areas, pain or swelling at injection sites, redness or blistering of the skin (even inside the mouth), stomach pain or cramps, skin rash or itching, unusual bleeding or bruising, unusual tiredness or weakness, yellowing of skin or eyes. Other side effects include: diarrhea, discolored tongue or teeth, drowsiness/dizziness, loss of appetite, nausea/vomiting, and sore mouth. Mycophenolate mofetil (CellCept) - Take mycophenolate mofetil on an empty stomach. Laboratory tests should be taken regularly. Infections and colds are more likely so try to avoid crowds or people who are ill. Complications can rise from poor oral hygiene. Common side effects to report to your doctor include blood in the urine, chest pain, shortness of breath, swelling of feet or lower legs, cough, fever or chills, muscle or joint pain, tremors or unusual bleeding. Common side effects to report if bothersome include headache, stomach pain, heartburn, diarrhea and weakness. Nicotinamide Nicotinamide is a form of Vitamin B3 that may preserve or improve beta cell function Side effects to report to your health care provider as soon as possible include: dark yellow or brown urine, fainting, grayish stool color, nausea/vomiting, palpitations, severe stomach pain and loss of appetite, shortness of breath, skins rash/itching, weakness or tiredness, yellowing of skin or eyes Other side effects include: diarrhea, dizziness, dry skin, flushing or warmth of the skin, headache, and stomach discomfort or bleeding. Gold Salts (Aurothioglucose,auranofin) Gold salts are used to decrease the immune response. They have fallen out of use and may be reserved for last line treatment. The side effect profile is very similar to the other immunosupressants listed above.
	TOP\| HOME \| MEMBERS \| GLOSSARY \| CONTACT

Immunosuppressants

These drugs are commonly used in conjunction with prednisone