Why Is Azasan So Hard to Find? [Explained for 2026]

If You Can't Find Azasan, You're Not Alone

You've been taking Azasan (Azathioprine) for months — maybe even years — to manage your transplant, rheumatoid arthritis, or autoimmune condition. Then one day, your pharmacy tells you they can't fill your prescription. No explanation. No timeline. Just "we don't have it right now."

If this sounds familiar, you're not alone. Thousands of patients across the country have struggled to find Azasan in stock at their local pharmacies. In this article, we'll explain exactly why Azasan has been hard to find and what you can do about it.

What Is Azasan?

Azasan is a brand-name prescription medication containing Azathioprine, an immunosuppressant drug. It belongs to a class of medications called purine analogs and works by suppressing the immune system to prevent it from attacking transplanted organs or healthy tissue.

Azasan is FDA-approved for two primary uses:

• Preventing kidney transplant rejection — used alongside other immunosuppressants after a kidney transplant
• Treating rheumatoid arthritis — for patients who haven't responded to conventional treatments

Doctors also prescribe Azathioprine off-label for conditions like Crohn's disease, ulcerative colitis, lupus, myasthenia gravis, and autoimmune hepatitis. It's manufactured by Salix Pharmaceuticals, a subsidiary of Bausch Health Companies.

Azasan comes in 75 mg and 100 mg scored tablets. The generic version, Azathioprine, is also available in 25 mg and 50 mg tablets from several manufacturers. To learn more about how this drug works in your body, check out our guide on how Azasan works.

Why Is Azasan So Hard to Find?

There's no single reason Azasan has been difficult to locate. Instead, it's a combination of factors that have created a perfect storm for patients:

1. Limited Brand-Name Manufacturing

Azasan is manufactured by only one company — Salix Pharmaceuticals. Unlike generic Azathioprine, which is produced by multiple manufacturers, the brand-name Azasan has a single source of supply. If Salix experiences any production delays, quality issues, or raw material shortages, the entire supply chain is affected.

2. Increased Demand for Immunosuppressants

The number of organ transplants performed in the United States has been growing steadily. Combined with the expanding off-label use of Azathioprine for autoimmune conditions like Crohn's disease and lupus, demand for the drug has outpaced supply at times. The ASHP (American Society of Health-System Pharmacists) has previously listed Azathioprine tablets on its shortage list due to increased demand.

3. Injectable Form Shortage Creates Spillover

The injectable form of Azathioprine sodium has been on the ASHP drug shortage list since September 2024. When hospitals can't get the IV form, some switch patients to oral Azathioprine sooner, increasing demand for tablets and making them harder to find at retail pharmacies.

4. Pharmacy Stocking and Distribution Issues

Many large chain pharmacies use automated ordering systems that don't always keep specialty medications like Azasan in stock. If your pharmacy doesn't regularly fill Azasan prescriptions, they may not carry it at all. Smaller pharmacies and independent pharmacies sometimes have better luck sourcing medications through different wholesale distributors.

What You Can Do If You Can't Find Azasan

The good news is that there are several practical steps you can take to find your medication:

Use Medfinder to Check Pharmacy Availability

Medfinder lets you search for pharmacies near you that currently have Azasan or generic Azathioprine in stock. Instead of calling pharmacy after pharmacy, you can check availability in seconds.

Ask About Generic Azathioprine

If your doctor prescribed brand-name Azasan but you can't find it, ask whether generic Azathioprine would work for you. The generic version is produced by multiple manufacturers and is typically much easier to find. It's also significantly cheaper — as low as $6 to $15 for a 30-day supply with a discount coupon, compared to $340 or more for brand-name Azasan. Learn more about saving money on Azasan.

Try Independent and Specialty Pharmacies

Independent pharmacies often have more flexibility in sourcing medications from different wholesalers. Specialty pharmacies that focus on transplant or autoimmune medications may also be more likely to keep Azasan in stock.

Call Ahead and Plan Ahead

Don't wait until you're out of medication to refill. Call your pharmacy 7 to 10 days before you run out and ask them to order it if they don't have it on the shelf. This gives them time to get it from their distributor.

Talk to Your Doctor About Alternatives

If Azasan and generic Azathioprine are both unavailable, your doctor may be able to switch you to an alternative medication like Mycophenolate (CellCept), Tacrolimus (Prograf), or Methotrexate, depending on your condition.

Final Thoughts

Finding Azasan shouldn't feel like a treasure hunt, but for many patients, that's exactly what it's become. Supply issues, limited manufacturing, and growing demand have all contributed to the problem.

The most important thing is to never stop taking your immunosuppressant without talking to your doctor first. Missing doses can lead to transplant rejection or disease flares. If you can't find Azasan, use Medfinder to check local pharmacy stock, ask about the generic version, and work with your healthcare team to find a solution.

For more information, read our complete guide on what Azasan is and how it's used, or learn how to find Azasan in stock near you.