Drug interactions
Azathioprine + Ifosfamide
Severity: Major
Azathioprine and Ifosfamide: 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
Ifosfamide is a myelosuppressive alkylating agent, and combining it with azathioprine increases the likelihood and depth of leukopenia and immunosuppression. This raises the risk of serious infection.
What this interaction means in plain words
Azathioprine and Ifosfamide 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; Ifosfamide belongs to Oncology.
Why it happens
Additive myelosuppressive and immunosuppressive effects.
What to do
Monitor blood counts closely and consider reducing or withholding azathioprine during chemotherapy cycles. Watch for early 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?
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References
- Azathioprine 25mg Film-Coated Tablets - SmPC sections 4.3/4.5 (class statement: cytostatic agents; "Where possible, concomitant administration of cytostatic agents, or medicinal products which may have a myelosuppressive effect, such as penicillamine, should b") — electronic medicines compendium (UK SmPC)
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 Ifosfamide
- Adenovirus types 4 and 7 live + Ifosfamide Contraindicated
- Ifosfamide + Measles mumps and rubella vaccine Contraindicated
- Ifosfamide + Measles mumps and rubella vaccine live Contraindicated
- Ifosfamide + Measles mumps rubella and varicella vaccine live Contraindicated
- Ifosfamide + Measles vaccine Contraindicated
- Ifosfamide + Rotavirus oral vaccine live Contraindicated
Frequently asked questions
Can I take Azathioprine with Ifosfamide?
MediHelp rates the interaction as major. Azathioprine and Ifosfamide 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. Ifosfamide is a myelosuppressive alkylating agent, and combining it with azathioprine increases the likelihood and depth of leukopenia and immunosuppression. This raises the risk of serious infection.
How serious is the interaction between Azathioprine and Ifosfamide?
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 blood counts closely and consider reducing or withholding azathioprine during chemotherapy cycles. Watch for early 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.
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