Drug interactions
Azathioprine + Denosumab
Severity: Moderate
Azathioprine and Denosumab: moderate 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
Denosumab has been associated with serious infections, including skin and urinary tract infections, and the risk may be higher in patients on immunosuppressants. Azathioprine adds to this by suppressing lymphocyte proliferation, so the combination can increase infection susceptibility.
What this interaction means in plain words
Azathioprine and Denosumab can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Azathioprine belongs to Gastrointestinal Tract; Denosumab belongs to Oncology.
Why it happens
Additive pharmacodynamic effects on immune function; denosumab inhibits RANKL signalling while azathioprine impairs purine synthesis in lymphocytes.
What to do
Counsel the patient to report fever or signs of infection promptly and treat infections early. Monitor for infection and review the need for continued immunosuppression if serious infections occur.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Denosumab
- Abatacept + Denosumab Moderate
- Adalimumab + Denosumab Moderate
- Alefacept + Denosumab Moderate
- Alemtuzumab + Denosumab Moderate
- Anakinra + Denosumab Moderate
- Azacitidine + Denosumab Moderate
Frequently asked questions
Can I take Azathioprine with Denosumab?
MediHelp rates the interaction as moderate. Azathioprine and Denosumab can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Denosumab has been associated with serious infections, including skin and urinary tract infections, and the risk may be higher in patients on immunosuppressants. Azathioprine adds to this by suppressing lymphocyte proliferation, so the combination can increase infection susceptibility.
How serious is the interaction between Azathioprine and Denosumab?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Counsel the patient to report fever or signs of infection promptly and treat infections early. Monitor for infection and review the need for continued immunosuppression if serious infections occur.
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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