Drug interactions
Axicabtagene ciloleucel + Azathioprine
Severity: Major
Axicabtagene ciloleucel and Azathioprine: major interaction.
Last updated
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
Azathioprine may impair T-cell function and reduce CAR-T cell expansion and efficacy. Concurrent immunosuppression also adds to infection risk after lymphodepletion.
What this interaction means in plain words
Axicabtagene ciloleucel 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.
Axicabtagene ciloleucel belongs to Oncology; Azathioprine belongs to Gastrointestinal Tract.
Why it happens
Immunosuppressive antimetabolite activity against lymphocytes may reduce CAR-T cell expansion and persistence.
What to do
Discontinue azathioprine before leukapheresis and infusion as advised by the treating CAR-T center. Monitor for infections if immunosuppression cannot be stopped.
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?
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Other interactions of Azathioprine
- Adenovirus types 4 and 7 live + Azathioprine Contraindicated
- Azathioprine + Bcg vaccine live Contraindicated
- Azathioprine + Febuxostat Contraindicated
- Azathioprine + Influenza virus vaccine quadrivalent intranasal Contraindicated
- Azathioprine + Measles mumps and rubella vaccine Contraindicated
- Azathioprine + Measles mumps and rubella vaccine live Contraindicated
Other interactions of Axicabtagene ciloleucel
Frequently asked questions
Can I take Axicabtagene ciloleucel with Azathioprine?
MediHelp rates the interaction as major. Axicabtagene ciloleucel 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. Azathioprine may impair T-cell function and reduce CAR-T cell expansion and efficacy. Concurrent immunosuppression also adds to infection risk after lymphodepletion.
How serious is the interaction between Axicabtagene ciloleucel 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: Discontinue azathioprine before leukapheresis and infusion as advised by the treating CAR-T center. Monitor for infections if immunosuppression cannot be stopped.
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.
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