Drug interactions
Azathioprine + Imidapril
Severity: Moderate
Azathioprine and Imidapril: 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
ACE inhibitors given with azathioprine have been associated with anemia and leukopenia or neutropenia, particularly in patients with renal impairment. The effect may be severe and appears to be related to suppression of bone marrow.
What this interaction means in plain words
Azathioprine and Imidapril 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; Imidapril belongs to Cardiovascular.
Why it happens
Additive bone marrow suppression; ACE inhibitors may reduce erythropoietin effect and hematopoiesis while azathioprine is myelosuppressive.
What to do
Monitor complete blood counts regularly, especially at initiation and in renal impairment. Reduce or stop azathioprine if leukopenia or anemia develops.
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 Imidapril
- Amiloride + Imidapril Major
- Eplerenone + Imidapril Major
- Imidapril + Lithium Major
- Imidapril + Pregabalin Major
- Imidapril + Spironolactone Major
- Imidapril + Triamterene Major
Frequently asked questions
Can I take Azathioprine with Imidapril?
MediHelp rates the interaction as moderate. Azathioprine and Imidapril 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. ACE inhibitors given with azathioprine have been associated with anemia and leukopenia or neutropenia, particularly in patients with renal impairment. The effect may be severe and appears to be related to suppression of bone marrow.
How serious is the interaction between Azathioprine and Imidapril?
MediHelp rates it moderate, 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, especially at initiation and in renal impairment. Reduce or stop azathioprine if leukopenia or anemia develops.
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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