Drug interactions
Azathioprine + Siponimod
Severity: Moderate
Azathioprine and Siponimod: 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
Siponimod 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 Siponimod 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; Siponimod 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 Siponimod
- Cladribine + Siponimod Contraindicated
- Fingolimod + Siponimod Contraindicated
- Fluconazole + Siponimod Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Siponimod Contraindicated
- Ponesimod + Siponimod Contraindicated
- Siponimod + Thioridazine Contraindicated
Frequently asked questions
Can I take Azathioprine with Siponimod?
MediHelp rates the interaction as moderate. Azathioprine and Siponimod 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. Siponimod 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 Siponimod?
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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