Drug interactions
Azathioprine + Mycophenolate mofetil
Severity: Major
Azathioprine and Mycophenolate mofetil: major interaction.
Last updated Sources: Health Canada product monograph
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
Both drugs inhibit purine synthesis and lymphocyte proliferation, and together they increase the risk of bone marrow suppression and infection. The combination is generally not recommended.
What this interaction means in plain words
Azathioprine and Mycophenolate mofetil 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; Mycophenolate mofetil belongs to Miscellaneous.
Why it happens
Additive antimetabolite effects on purine synthesis causing myelosuppression and immunosuppression.
What to do
Avoid using both together and choose one agent. If overlap is unavoidable, monitor blood counts and infection closely.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Azathioprine and Mycophenolate mofetil, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
References
Other interactions of Mycophenolate mofetil
- Adenovirus types 4 and 7 live + Mycophenolate mofetil Contraindicated
- Bcg vaccine live + Mycophenolate mofetil Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Mycophenolate mofetil Contraindicated
- Measles mumps and rubella vaccine live + Mycophenolate mofetil Contraindicated
- Measles mumps rubella and varicella vaccine live + Mycophenolate mofetil Contraindicated
- Measles vaccine + Mycophenolate mofetil Contraindicated
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 Mycophenolate mofetil?
MediHelp rates the interaction as major. Azathioprine and Mycophenolate mofetil 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. Both drugs inhibit purine synthesis and lymphocyte proliferation, and together they increase the risk of bone marrow suppression and infection. The combination is generally not recommended.
How serious is the interaction between Azathioprine and Mycophenolate mofetil?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid using both together and choose one agent. If overlap is unavoidable, monitor blood counts and infection closely.
What other medicines interact with Mycophenolate mofetil?
MediHelp also lists interactions of Mycophenolate mofetil with, for example, Adenovirus types 4 and 7 live, Bcg vaccine live, Influenza virus vaccine quadrivalent intranasal. The full list is on the Mycophenolate mofetil page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
