Using Methotrexate and Azathioprine to Treat Wegener's

Methotrexate as a Wegener's Medication

In people with active but not immediately threatening Wegener's granulomatosis, methotrexate has been used in combination with prednisone as Wegener's medication. It also is used to maintain remission after a person has initially received cyclophosphamide. People with Wegener's granulomatosis usually take methotrexate for one to two years, after which time, if the disease stays in remission, it is decreased and then stopped.
Methotrexate is given once a week, usually by mouth, but occasionally as an injection under the skin or in the muscle. People taking methotrexate need to have regular blood work to monitor their response and to watch for side effects.
Possible side effects of methotrexate include:
  • Infection
  • Lowering of the blood counts
  • Nausea
  • Soreness and ulceration of the inside of the mouth
  • Irritation of the lungs (pneumonitis)
  • Inflammation and scarring of the liver.
People taking methotrexate cannot drink alcoholic beverages. Methotrexate cannot be given to people who have poor kidney function or who have underlying liver disease, such as hepatitis.

Azathioprine as a Wegener's Medication

In cases of Wegener's granulomatosis, azathioprine (also called Imuran®) is used primarily to maintain remission in people who have initially been treated and gone into remission with cyclophosphamide.
It is taken once a day by mouth. Similar to methotrexate, people with the disease take this Wegener's medication for one to two years, after which time the dosage is lowered until it is stopped.
  • Infection
  • lowering of the blood counts
  • An allergic-type reaction (this is rare).
In people who receive azathioprine to prevent rejection of a transplanted organ, there has been a suggestion of an increased risk of blood cancers (leukemia and lymphoma), but it is not clear whether this risk exists in other situations, for example, in people with Wegener's. People with poor kidney function or liver disease can take azathioprine.
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