Drug interactions
Azathioprine + Sirolimus
Severity: Major
Azathioprine and Sirolimus: 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
Concurrent use intensifies immunosuppression, increasing the risk of bacterial, viral and fungal infections and of malignancy. Myelosuppression such as leukopenia and thrombocytopenia may also be more pronounced.
What this interaction means in plain words
Azathioprine and Sirolimus 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; Sirolimus belongs to Miscellaneous.
Why it happens
Additive pharmacodynamic immunosuppression via purine antimetabolite activity and mTOR inhibition.
What to do
Use only under transplant specialist supervision with the lowest effective doses. Monitor complete blood count, sirolimus trough levels and signs of infection.
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 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 Sirolimus
- Adenovirus types 4 and 7 live + Sirolimus Contraindicated
- Bcg vaccine live + Sirolimus Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Sirolimus Contraindicated
- Ketoconazole + Sirolimus Contraindicated
- Levoketoconazole + Sirolimus Contraindicated
- Measles mumps and rubella vaccine live + Sirolimus Contraindicated
Frequently asked questions
Can I take Azathioprine with Sirolimus?
MediHelp rates the interaction as major. Azathioprine and Sirolimus 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. Concurrent use intensifies immunosuppression, increasing the risk of bacterial, viral and fungal infections and of malignancy. Myelosuppression such as leukopenia and thrombocytopenia may also be more pronounced.
How serious is the interaction between Azathioprine and Sirolimus?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use only under transplant specialist supervision with the lowest effective doses. Monitor complete blood count, sirolimus trough levels and signs of infection.
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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