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Azathioprine neutropenia — GPhC CRA MCQ

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HardAdverse Drug Reactions and SafetyAzathioprine neutropeniaGPhC CRA

A 39-year-old woman taking azathioprine 150mg daily for ulcerative colitis asks about new bruising and fever. Her FBC from yesterday shows WBC 2.1 x10^9/L and neutrophils 0.7 x10^9/L. What monitoring is required?

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Correct answer: BUrgent prescriber contact and withholding azathioprine pending clinical review

Azathioprine can cause bone marrow suppression, and neutropenia with fever is a serious safety concern. The prescriber or specialist team should be contacted urgently and the medicine withheld pending review according to local shared-care guidance. Routine monitoring in several months would be unsafe. Amylase may be relevant for pancreatitis symptoms but does not address the current neutropenic sepsis risk.

Reference: BNF; Specialist Pharmacy Service monitoring guidance