Drug interactions
Azathioprine + Tacrolimus
Severity: Major
Azathioprine and Tacrolimus: 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 agents suppress T-cell immunity, and combined use raises the risk of infections and lymphoproliferative or skin malignancies. This pairing is used deliberately in some transplant regimens, but overall immunosuppression must be carefully balanced.
What this interaction means in plain words
Azathioprine and Tacrolimus 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; Tacrolimus belongs to Miscellaneous.
Why it happens
Additive immunosuppression from purine synthesis inhibition and calcineurin inhibition.
What to do
If the combination is intended, keep doses as low as effective and monitor tacrolimus trough levels and blood counts. Educate the patient about infection symptoms and skin protection.
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 Tacrolimus
- Adenovirus types 4 and 7 live + Tacrolimus Contraindicated
- Bcg vaccine live + Tacrolimus Contraindicated
- Cidofovir + Tacrolimus Contraindicated
- Cyclosporin + Tacrolimus Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Tacrolimus Contraindicated
- Measles mumps and rubella vaccine live + Tacrolimus Contraindicated
Frequently asked questions
Can I take Azathioprine with Tacrolimus?
MediHelp rates the interaction as major. Azathioprine and Tacrolimus 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 agents suppress T-cell immunity, and combined use raises the risk of infections and lymphoproliferative or skin malignancies. This pairing is used deliberately in some transplant regimens, but overall immunosuppression must be carefully balanced.
How serious is the interaction between Azathioprine and Tacrolimus?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: If the combination is intended, keep doses as low as effective and monitor tacrolimus trough levels and blood counts. Educate the patient about infection symptoms and skin protection.
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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