Drug interactions
Azathioprine + Mycophenolic acid
Severity: Major
Azathioprine and Mycophenolic acid: major 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
Both inhibit purine synthesis pathways and together can cause additive bone marrow suppression, with leukopenia and increased infection risk. Combination offers no established benefit.
What this interaction means in plain words
Azathioprine and Mycophenolic acid 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; Mycophenolic acid belongs to Miscellaneous.
Why it happens
Additive inhibition of purine metabolism in lymphocytes and marrow cells.
What to do
Avoid the combination; use one agent only. If a switch is made, monitor complete blood counts.
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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Other interactions of Mycophenolic acid
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 Mycophenolic acid?
MediHelp rates the interaction as major. Azathioprine and Mycophenolic acid 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 inhibit purine synthesis pathways and together can cause additive bone marrow suppression, with leukopenia and increased infection risk. Combination offers no established benefit.
How serious is the interaction between Azathioprine and Mycophenolic acid?
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 the combination; use one agent only. If a switch is made, monitor complete blood counts.
What other medicines interact with Mycophenolic acid?
MediHelp also lists interactions of Mycophenolic acid with, for example, Activated charcoal, Cholestyramine, Ganciclovir. The full list is on the Mycophenolic acid page.
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