Drug interactions
Azathioprine + Baricitinib
Severity: Major
Azathioprine and Baricitinib: major interaction.
Last updated Sources: UK SmPC
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
Baricitinib is not recommended with potent immunosuppressants such as azathioprine because of the greater risk of serious infection. Cytopenias may also be additive.
What this interaction means in plain words
Azathioprine and Baricitinib 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 belongs to Gastrointestinal Tract; Baricitinib belongs to Musculoskeletal.
Why it happens
Additive immunosuppression from JAK inhibition and thiopurine antimetabolite effects.
What to do
Avoid the combination and choose an alternative regimen where possible. If used, monitor closely for infection and blood count changes.
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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References
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 Baricitinib
- Adenovirus types 4 and 7 live + Baricitinib Contraindicated
- Baricitinib + Bcg vaccine live Contraindicated
- Baricitinib + Tofacitinib Contraindicated
- Baricitinib + Upadacitinib Contraindicated
- Abatacept + Baricitinib Major
- Adalimumab + Baricitinib Major
Frequently asked questions
Can I take Azathioprine with Baricitinib?
MediHelp rates the interaction as major. Azathioprine and Baricitinib 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. Baricitinib is not recommended with potent immunosuppressants such as azathioprine because of the greater risk of serious infection. Cytopenias may also be additive.
How serious is the interaction between Azathioprine and Baricitinib?
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 the combination and choose an alternative regimen where possible. If used, monitor closely for infection and blood count changes.
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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