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Drug interactions

Anakinra + Azathioprine

Severity: Major

Anakinra and Azathioprine: major interaction.

Last updated Sources: Health Canada product monograph

For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.

Summary

Both drugs suppress immune function, and combining them raises the risk of infection and neutropenia. Anakinra labeling advises caution when used with other immunosuppressants.

What this interaction means in plain words

Anakinra and Azathioprine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.

Anakinra belongs to Musculoskeletal; Azathioprine belongs to Gastrointestinal Tract.

Evidence level: Low

Why it happens

Additive immunosuppression from IL-1 receptor blockade and thiopurine activity.

What to do

Avoid if alternatives exist; otherwise monitor neutrophil counts and signs of infection.

What to ask your pharmacist

  • Does the benefit of taking both outweigh the risk in my case?
  • Do I need any blood test, ECG or other check while on both?
  • What early warning signs should I watch for, and what should I do if they appear?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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References

Frequently asked questions

Can I take Anakinra with Azathioprine?

MediHelp rates the interaction as major. Anakinra and Azathioprine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Both drugs suppress immune function, and combining them raises the risk of infection and neutropenia. Anakinra labeling advises caution when used with other immunosuppressants.

How serious is the interaction between Anakinra and Azathioprine?

MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid if alternatives exist; otherwise monitor neutrophil counts and signs of infection.

What other medicines interact with Azathioprine?

MediHelp also lists interactions of Azathioprine with, for example, Adenovirus types 4 and 7 live, Bcg vaccine live, Febuxostat. The full list is on the Azathioprine page.

Full monographs, dosing and an interaction checker in the MediHelp app

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