Drug interactions
Azathioprine + Captopril-hydrochlorothiazide
Severity: Major
Azathioprine and Captopril-hydrochlorothiazide: major interaction.
Last updated Sources: US FDA label
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
ACE inhibitors given with azathioprine have been associated with anemia and leukopenia or other bone marrow suppression, particularly in patients with renal impairment. Cytopenias may be serious and delayed.
What this interaction means in plain words
Azathioprine and Captopril-hydrochlorothiazide 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; Captopril-hydrochlorothiazide belongs to Cardiovascular.
Why it happens
ACE inhibition may reduce erythropoietin and bone marrow responsiveness, adding to azathioprine myelosuppression.
What to do
Monitor complete blood counts regularly, particularly early in combined therapy and in renal impairment. Reduce or stop azathioprine or switch the antihypertensive if cytopenias develop.
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 Captopril-hydrochlorothiazide
- Aliskiren + Captopril-hydrochlorothiazide Contraindicated
- Captopril-hydrochlorothiazide + Dofetilide Contraindicated
- Captopril-hydrochlorothiazide + Sacubitril / valsartan Contraindicated
- Aceclofenac + Captopril-hydrochlorothiazide Major
- Aldesleukin + Captopril-hydrochlorothiazide Major
- Amifostine + Captopril-hydrochlorothiazide Major
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
Frequently asked questions
Can I take Azathioprine with Captopril-hydrochlorothiazide?
MediHelp rates the interaction as major. Azathioprine and Captopril-hydrochlorothiazide 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. ACE inhibitors given with azathioprine have been associated with anemia and leukopenia or other bone marrow suppression, particularly in patients with renal impairment. Cytopenias may be serious and delayed.
How serious is the interaction between Azathioprine and Captopril-hydrochlorothiazide?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor complete blood counts regularly, particularly early in combined therapy and in renal impairment. Reduce or stop azathioprine or switch the antihypertensive if cytopenias develop.
What other medicines interact with Captopril-hydrochlorothiazide?
MediHelp also lists interactions of Captopril-hydrochlorothiazide with, for example, Aliskiren, Dofetilide, Sacubitril / valsartan. The full list is on the Captopril-hydrochlorothiazide page.
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