Drug interactions
Azathioprine + Ponesimod
Severity: Moderate
Azathioprine and Ponesimod: 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
Ponesimod reduces circulating lymphocytes, and azathioprine independently suppresses lymphocyte function. Together they may cause excessive immunosuppression and increase infection risk, which can persist after stopping either drug.
What this interaction means in plain words
Azathioprine and Ponesimod 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; Ponesimod belongs to Central Nervous System.
Why it happens
Additive immunosuppression: S1P receptor modulation sequesters lymphocytes while azathioprine inhibits lymphocyte proliferation.
What to do
Monitor lymphocyte and complete blood counts and watch for infection. Consider the prolonged effect of azathioprine when switching therapies.
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 Ponesimod
- Fingolimod + Ponesimod Contraindicated
- Ponesimod + Siponimod Contraindicated
- Amiodarone + Ponesimod Major
- Amisulpride + Ponesimod Major
- Anagrelide + Ponesimod Major
- Anti-thymocyte + Ponesimod Major
Frequently asked questions
Can I take Azathioprine with Ponesimod?
MediHelp rates the interaction as moderate. Azathioprine and Ponesimod 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. Ponesimod reduces circulating lymphocytes, and azathioprine independently suppresses lymphocyte function. Together they may cause excessive immunosuppression and increase infection risk, which can persist after stopping either drug.
How serious is the interaction between Azathioprine and Ponesimod?
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 lymphocyte and complete blood counts and watch for infection. Consider the prolonged effect of azathioprine when switching therapies.
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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