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Also indexed as: Imuran


Azathioprine is used to prevent organ rejection following kidney transplant and to treat severe cases of rheumatoid arthritis.

Summary of Interactions with Vitamins, Herbs, and Foods
In some cases, an herb or supplement may appear in more than one category, which may seem contradictory. For clarification, read the full article for details about the summarized interactions.

Beneficial May Be Beneficial: Depletion or interference—The medication may deplete or interfere with the absorption or function of the nutrient. Taking these nutrients may help replenish them.

Folic acid

Side effect reduction/prevention

None known

Supportive interaction

None known

Reduced drug absorption/bioavailability

None known

Adverse interaction

None known

An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.

Interaction with Herbs

Folic acid
People receiving dialysis for kidney failure often have low blood levels of folic acid. However, folic acid blood levels should return to normal following kidney transplant. A preliminary study of people taking azathioprine to prevent organ rejection revealed that blood levels of folic acid remained well below those of individuals not taking the drug. The highest blood folic acid level was observed in an individual who had not taken azathioprine for two years.1 Controlled studies are needed to determine whether people taking azathioprine should supplement with folic acid.


1. Zazgornik J, Druml W, Balcke P, et al. Diminished serum folic acid levels in renal transplant recipients. Clin Nephrol 1982;18:306–10.

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