Drug interactions
Azathioprine + Mesalamine
Severity: Moderate
Azathioprine and Mesalamine: 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
Mesalamine may inhibit thiopurine methyltransferase, raising active thioguanine nucleotide levels. This can increase the risk of leukopenia and other myelosuppression.
What this interaction means in plain words
Azathioprine and Mesalamine 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; Mesalamine belongs to Gastrointestinal Tract.
Why it happens
Inhibition of TPMT by mesalamine increases thiopurine metabolite exposure.
What to do
Monitor complete blood counts regularly and reduce azathioprine dose if leukopenia 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 Mesalamine
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 Mesalamine?
MediHelp rates the interaction as moderate. Azathioprine and Mesalamine 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. Mesalamine may inhibit thiopurine methyltransferase, raising active thioguanine nucleotide levels. This can increase the risk of leukopenia and other myelosuppression.
How serious is the interaction between Azathioprine and Mesalamine?
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 and reduce azathioprine dose if leukopenia develops.
What other medicines interact with Mesalamine?
MediHelp also lists interactions of Mesalamine with, for example, Measles mumps rubella and varicella vaccine live, Varicella virus vaccine live, Aceclofenac. The full list is on the Mesalamine page.
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